IPC12. Does Lymphoscintigraphy Correlate to Clinical Presentation in Lymphoedema?

Abstract

To compare lymphoscintigraphy scan Results, the gold standard of investigation for lymphedema, with clinical presentation. We have collected the data from electronic patient records for patients who had a Lymphoscintigraphy scan from October 1, 2016, to March 31, 2018. The examination protocol involved subcutaneous injection of nanocolloid tracer in first web space in each foot and determining its uptake at the groin at 30 minutes and 2 hours after injection. Uptake of less than 8% at 2 hours was considered abnormal, as was dermal backflow. Uptake of 9% to 14% was considered normal, while uptakes of 19% to 22% were considered accidental venous contamination. Forty-seven patients, with age ranging between 9 and 78 years, underwent a lymphoscintigraphy scan in this time period, 12 of which had uptake of less than 8% in one limb. In 58.33% (n = 7) of these, the lymphoscintigraphy scan result did not correlate with laterality of clinical presentation. Nineteen patients had an uptake of less than 8% in both limbs. Of these in 26.31% (n = 5) the lymphoscintigraphy scan Results did not correlate with laterality of clinical presentation. Sixteen patients had a normal scan. Of these 3 had evidence of venous incompetence in relevant limb(s) but 13 had a normal venous scan and 4 patients had unintentional venous puncture, 2 of which were identified as normal results in a clearly lymphedema case and 2 as greater than 20% tracer uptake. Lymphoscintigraphy does not seem to correlate with laterality of clinical picture and has limited usefulness in clinical decision making on treatment.