RELATIONSHIP BETWEEN LYMPHOSCINTIGRAPHY AND CLINICAL FINDINGS IN LOWER LIMB LYMPHEDEMA (LO): TOWARD A COMPREHENSIVE STAGING

Abstract

Although radionuclide lymphoscintigraphy(RNL) is widely used diagnosticallyfor patients with lymphedema (LE), it has notbeen utilized for LE staging, which is stillbased upon clinical findings. The aim of thiswork is to establish whether the results ofboth conventional RNL and fusion imagingobtained from hybrid detectors may be usedfor a comprehensive clinicoimaging staging inLE. Radiolabeled nanocolloids (0.2 ml) weresubcutaneously injected in 4,328 patients(23-78 years) with clinical lower limb LE andwithout venous disease. Patients wereclassified according to the ISL classificationand had a minimal follow-up of 2 years.Images were taken 60 minutes after theinjection as a whole body scanning and fusionimages of functional SPET and anatomicalCT. Clinical and RNL results were not inaccordance, and a specific RNL staging wasestablished. The association of clinical andfunctional staging yields a new method tograde LE patients, and this staging correlatedwith treatment efficacy. RNL is an importanttool in lymphology, and its association withthe clinical evaluation offers a new gradingsystem which may be able to delineate patientswith good prognosis, patients at risk for acomplex decongestive physiotherapy (CDP)failure, and patients who may benefit fromother therapeutic protocols.