Optimized lymphoscintigraphy and diagnostics of lymphatic oedema of the lower extremities.

BACKGROUND The elementary diagnostic method for the detection of lymph circulation abnormalities in extremities is lymphoscintigraphy. This method provides information on the morphology and function of the lymphatic system. However, there are no generally acceptable standards for lymphoscintigraphy, which makes judgment of its clinical usefulness very difficult. MATERIAL AND METHODS In this work, a discussion is presented on the usefulness of static qualitative scintigraphy of the lymphatic system of lower extremities as well as of its quantitative interpretation, depending upon: (1) time measurement of radiopharmaceutical transport in the system, and (2) assessment of its regional uptake in lymph nodes. The effectiveness of visual assessment combined with each of the quantitative evaluations mentioned is also presented. RESULTS/CONCLUSIONS Combination of visual evaluation of static scintigraphy with each of the listed quantitative procedures improves the sensitivity of lymphoscintigraphy in the diagnosis of lymphatic oedema of lower extremities without affecting the specificity of visual evaluation. Both combined methods are characterized by similar indices of diagnostic efficacy. This enables limitation of the quantitative evaluation of lymphatic scintigraphy to the measurement of the final uptake of RPh in the inguinal lymphatic nodes.