Advantages of the intradermal lymphoscintigraphy

Abstract

Lymphoscintigraphy is a nuclear medicine procedure that uses a small quantity of radioactive particles for visualizing the lymphatic system. Traditionally, the radiotracer was injected subcutaneously, but the quality of lymphatic path imaging was scarce due to high background. Intradermal radiotracer injection is considered the modern-day intralymphatic injection. We propose rest/stress intradermal lymphoscintigraphy for the diagnosis, staging and surgical planning of lymphedema. Major and minor findings were described in primary and secondary lymphedema. Based on the in-depth information of the lymphatic pathways, physiotherapists and microsurgeons can obtain important functional information in patients’ selection to treat with physical treatments and/or undergo microsurgery.

Keywords: Intradermal injection; Lymphoscintigraphy; Exercise; Rest; Stress; Lymphedema; Radionuclide imaging; Lymphatic system

Core Tip: Intradermal lymphoscintigraphy is a helpful functional nuclear imaging test that evaluates the lymphatic flow of the superficial and deeper lymphatic pathways at rest as well as following short and prolonged muscular activity, thus visualizing draining lymph nodes in a single 1-hour examination. This diagnostic method may help physiotherapists to evaluate the effects of muscular exercise and physical therapy on lymph drainage and surgeons to plan microsurgical treatments in advanced clinical stages of lymphedema.