The role of lymphoscintigraphy in the diagnosis of lymphedema

Abstract

Introduction. Lymphedema is a chronic disease of the lymphatic system that often remains undiagnosed or poorly diagnosed and can lead to severe and disabling swelling of the extremities. The aim of this paper was to review the literature on lymphoscintigraphy as a nuclear medicine imaging technique in the diagnosis of lymphedema, as well as to present clinical cases where lymphoscintigraphy was performed due to edema of unknown origin. Material and Methods. A literature review was performed using PubMed and manual search. Additionally, characteristics of diagnostic radiopharmaceuticals, methodological aspects of lymphoscintigraphy and interpretation criteria used in our department were presented in two clinical cases. Results. Literature data analysis showed that in the diagnosis of lymphedema, lymphoscintigraphy is a reliable diagnostic method in evaluation of the functional capacity of the lymphatic system, with a sensitivity of up to 96% and a specificity of 100%. In the presented clinical cases, lymphoscintigraphy diagnosed functional dysfunction/ obstruction of the lymphatic pathways in the lower extremities. Conclusion. Lymphoscintigraphy is a safe and reliable method in the diagnostic algorithm of patients with lymphedema, also valuable in monitoring the condition after the applied therapeutic modalities.