Estimating Lymphodynamic Conditions and Lymphovenous Anastomosis Efficacy Using 99mTc-phytate Lymphoscintigraphy with SPECT-CT in Patients with Lower-limb Lymphedema
Identifieur interne : 001E24 ( Main/Merge ); précédent : 001E23; suivant : 001E25Estimating Lymphodynamic Conditions and Lymphovenous Anastomosis Efficacy Using 99mTc-phytate Lymphoscintigraphy with SPECT-CT in Patients with Lower-limb Lymphedema
Auteurs : Takeshi Iimura ; Yoshimitsu Fukushima ; Shinichiro Kumita ; Rei Ogawa ; Hiko HyakusokuSource :
- Plastic and Reconstructive Surgery Global Open [ 2169-7574 ] ; 2015.
Abstract
Diagnostic and therapeutic strategies for lower-limb lymphedema have not yet been established. The purpose of this study was to estimate the lymphodynamic condition and therapeutic efficacy of lymphovenous anastomosis (LVA) in lower-limb lymphedema patients using 2-phase 99mTc-phytate lymphoscintigraphy with single-photon emission computed tomography-computed tomography (SPECT-CT).
In this study, consecutive patients with lower-limb lymphedema who underwent 2-phase lymphoscintigraphy using 99mTc-phytate were enrolled between June 2013 and June 2014. SPECT-CT was also performed to clarify the relationships between functional and morphological information. In both the early and delayed images, inguinal lymph node accumulation, dermal backflow, and their sequential alternations were evaluated, and liver-to-blood ratio and inguinal lymph node-to-blood ratio were calculated. All participants were classified into 6 types of lymphodynamic conditions based on the image findings. Patients with both dermal backflow and associated normal lymphatic vessel accumulation proceeded to LVA and underwent a second lymphoscintigraphy after the operation.
Of all 30 participants, the largest population was categorized as type 4, which had consistent inguinal lymph node accumulation defect with dermal backflow. In 12 operated cases, dermal backflow was degraded in 10 cases by LVA. Liver-to-blood ratio in both early and delayed images and inguinal lymph node-to-blood ratio in delayed image significantly increased after LVA.
Lymphoscintigraphy with SPECT-CT can provide both functional and morphological information simultaneously in patients with lower-limb lymphedema. Using these procedures, a type categorization for the patients was devised, which reflects their lymphodynamic conditions. The therapeutic efficacy of LVA could also be estimated quantitatively by the derived findings.
Url:
DOI: 10.1097/GOX.0000000000000375
PubMed: 26090294
PubMed Central: 4457267
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Estimating Lymphodynamic Conditions and Lymphovenous Anastomosis Efficacy Using <sup>99m</sup>Tc-phytate Lymphoscintigraphy with SPECT-CT in Patients with Lower-limb Lymphedema</title><author><name sortKey="Iimura, Takeshi" sort="Iimura, Takeshi" uniqKey="Iimura T" first="Takeshi" last="Iimura">Takeshi Iimura</name><affiliation><nlm:aff id="aff1"></nlm:aff></affiliation></author><author><name sortKey="Fukushima, Yoshimitsu" sort="Fukushima, Yoshimitsu" uniqKey="Fukushima Y" first="Yoshimitsu" last="Fukushima">Yoshimitsu Fukushima</name><affiliation><nlm:aff id="aff1"></nlm:aff></affiliation></author><author><name sortKey="Kumita, Shinichiro" sort="Kumita, Shinichiro" uniqKey="Kumita S" first="Shinichiro" last="Kumita">Shinichiro Kumita</name><affiliation><nlm:aff id="aff1"></nlm:aff></affiliation></author><author><name sortKey="Ogawa, Rei" sort="Ogawa, Rei" uniqKey="Ogawa R" first="Rei" last="Ogawa">Rei Ogawa</name><affiliation><nlm:aff id="aff1"></nlm:aff></affiliation></author><author><name sortKey="Hyakusoku, Hiko" sort="Hyakusoku, Hiko" uniqKey="Hyakusoku H" first="Hiko" last="Hyakusoku">Hiko Hyakusoku</name><affiliation><nlm:aff id="aff1"></nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">26090294</idno><idno type="pmc">4457267</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4457267</idno><idno type="RBID">PMC:4457267</idno><idno type="doi">10.1097/GOX.0000000000000375</idno><date when="2015">2015</date><idno type="wicri:Area/Pmc/Corpus">000465</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000465</idno><idno type="wicri:Area/Pmc/Curation">000465</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000465</idno><idno type="wicri:Area/Pmc/Checkpoint">001280</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">001280</idno><idno type="wicri:source">PubMed</idno><idno type="wicri:Area/PubMed/Corpus">000E24</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">000E24</idno><idno type="wicri:Area/PubMed/Curation">000E24</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Curation">000E24</idno><idno type="wicri:Area/PubMed/Checkpoint">000E24</idno><idno type="wicri:explorRef" wicri:stream="Checkpoint" wicri:step="PubMed">000E24</idno><idno type="wicri:Area/Ncbi/Merge">007511</idno><idno type="wicri:Area/Ncbi/Curation">007511</idno><idno type="wicri:Area/Ncbi/Checkpoint">007511</idno><idno type="wicri:Area/Main/Merge">001E24</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Estimating Lymphodynamic Conditions and Lymphovenous Anastomosis Efficacy Using <sup>99m</sup>Tc-phytate Lymphoscintigraphy with SPECT-CT in Patients with Lower-limb Lymphedema</title><author><name sortKey="Iimura, Takeshi" sort="Iimura, Takeshi" uniqKey="Iimura T" first="Takeshi" last="Iimura">Takeshi Iimura</name><affiliation><nlm:aff id="aff1"></nlm:aff></affiliation></author><author><name sortKey="Fukushima, Yoshimitsu" sort="Fukushima, Yoshimitsu" uniqKey="Fukushima Y" first="Yoshimitsu" last="Fukushima">Yoshimitsu Fukushima</name><affiliation><nlm:aff id="aff1"></nlm:aff></affiliation></author><author><name sortKey="Kumita, Shinichiro" sort="Kumita, Shinichiro" uniqKey="Kumita S" first="Shinichiro" last="Kumita">Shinichiro Kumita</name><affiliation><nlm:aff id="aff1"></nlm:aff></affiliation></author><author><name sortKey="Ogawa, Rei" sort="Ogawa, Rei" uniqKey="Ogawa R" first="Rei" last="Ogawa">Rei Ogawa</name><affiliation><nlm:aff id="aff1"></nlm:aff></affiliation></author><author><name sortKey="Hyakusoku, Hiko" sort="Hyakusoku, Hiko" uniqKey="Hyakusoku H" first="Hiko" last="Hyakusoku">Hiko Hyakusoku</name><affiliation><nlm:aff id="aff1"></nlm:aff></affiliation></author></analytic><series><title level="j">Plastic and Reconstructive Surgery Global Open</title><idno type="eISSN">2169-7574</idno><imprint><date when="2015">2015</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background:</title><p>Diagnostic and therapeutic strategies for lower-limb lymphedema have not yet been established. The purpose of this study was to estimate the lymphodynamic condition and therapeutic efficacy of lymphovenous anastomosis (LVA) in lower-limb lymphedema patients using 2-phase <sup>99m</sup>Tc-phytate lymphoscintigraphy with single-photon emission computed tomography-computed tomography (SPECT-CT).</p></sec><sec><title>Methods:</title><p>In this study, consecutive patients with lower-limb lymphedema who underwent 2-phase lymphoscintigraphy using <sup>99m</sup>Tc-phytate were enrolled between June 2013 and June 2014. SPECT-CT was also performed to clarify the relationships between functional and morphological information. In both the early and delayed images, inguinal lymph node accumulation, dermal backflow, and their sequential alternations were evaluated, and liver-to-blood ratio and inguinal lymph node-to-blood ratio were calculated. All participants were classified into 6 types of lymphodynamic conditions based on the image findings. Patients with both dermal backflow and associated normal lymphatic vessel accumulation proceeded to LVA and underwent a second lymphoscintigraphy after the operation.</p></sec><sec><title>Results:</title><p>Of all 30 participants, the largest population was categorized as type 4, which had consistent inguinal lymph node accumulation defect with dermal backflow. In 12 operated cases, dermal backflow was degraded in 10 cases by LVA. Liver-to-blood ratio in both early and delayed images and inguinal lymph node-to-blood ratio in delayed image significantly increased after LVA.</p></sec><sec><title>Conclusions:</title><p>Lymphoscintigraphy with SPECT-CT can provide both functional and morphological information simultaneously in patients with lower-limb lymphedema. Using these procedures, a type categorization for the patients was devised, which reflects their lymphodynamic conditions. The therapeutic efficacy of LVA could also be estimated quantitatively by the derived findings.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Nawaz, K" uniqKey="Nawaz K">K Nawaz</name></author><author><name sortKey="Hamad, M" uniqKey="Hamad M">M Hamad</name></author><author><name sortKey="Sadek, S" uniqKey="Sadek S">S Sadek</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Suehiro, K" uniqKey="Suehiro K">K Suehiro</name></author><author><name sortKey="Morikage, N" uniqKey="Morikage N">N Morikage</name></author><author><name sortKey="Murakami, M" uniqKey="Murakami M">M Murakami</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Szuba, A" uniqKey="Szuba A">A Szuba</name></author><author><name sortKey="Shin, Ws" uniqKey="Shin W">WS Shin</name></author><author><name sortKey="Strauss, Hw" uniqKey="Strauss H">HW Strauss</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Maegawa, J" uniqKey="Maegawa J">J Maegawa</name></author><author><name sortKey="Mikami, T" uniqKey="Mikami T">T Mikami</name></author><author><name sortKey="Yamamoto, Y" uniqKey="Yamamoto Y">Y Yamamoto</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Seok, Jw" uniqKey="Seok J">JW Seok</name></author><author><name sortKey="Choi, Ys" uniqKey="Choi Y">YS Choi</name></author><author><name sortKey="Chong, S" uniqKey="Chong S">S Chong</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Blum, Ks" uniqKey="Blum K">KS Blum</name></author><author><name sortKey="Radtke, C" uniqKey="Radtke C">C Radtke</name></author><author><name sortKey="Knapp, Wh" uniqKey="Knapp W">WH Knapp</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Pecking, Ap" uniqKey="Pecking A">AP Pecking</name></author><author><name sortKey="Wartski, M" uniqKey="Wartski M">M Wartski</name></author><author><name sortKey="Cluzan, Rv" uniqKey="Cluzan R">RV Cluzan</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="O Rien, Bm" uniqKey="O Rien B">BM O’Brien</name></author><author><name sortKey="Sykes, P" uniqKey="Sykes P">P Sykes</name></author><author><name sortKey="Threlfall, Gn" uniqKey="Threlfall G">GN Threlfall</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Campisi, C" uniqKey="Campisi C">C Campisi</name></author><author><name sortKey="Davini, D" uniqKey="Davini D">D Davini</name></author><author><name sortKey="Bellini, C" uniqKey="Bellini C">C Bellini</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Campisi, C" uniqKey="Campisi C">C Campisi</name></author><author><name sortKey="Eretta, C" uniqKey="Eretta C">C Eretta</name></author><author><name sortKey="Pertile, D" uniqKey="Pertile D">D Pertile</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Yamamoto, T" uniqKey="Yamamoto T">T Yamamoto</name></author><author><name sortKey="Matsuda, N" uniqKey="Matsuda N">N Matsuda</name></author><author><name sortKey="Todokoro, T" uniqKey="Todokoro T">T Todokoro</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Unno, N" uniqKey="Unno N">N Unno</name></author><author><name sortKey="Inuzuka, K" uniqKey="Inuzuka K">K Inuzuka</name></author><author><name sortKey="Suzuki, M" uniqKey="Suzuki M">M Suzuki</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Yamamoto, T" uniqKey="Yamamoto T">T Yamamoto</name></author><author><name sortKey="Narushima, M" uniqKey="Narushima M">M Narushima</name></author><author><name sortKey="Doi, K" uniqKey="Doi K">K Doi</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Yamamoto, T" uniqKey="Yamamoto T">T Yamamoto</name></author><author><name sortKey="Matsuda, N" uniqKey="Matsuda N">N Matsuda</name></author><author><name sortKey="Doi, K" uniqKey="Doi K">K Doi</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="O Ahony, S" uniqKey="O Ahony S">S O’Mahony</name></author><author><name sortKey="Britton, Tb" uniqKey="Britton T">TB Britton</name></author><author><name sortKey="Ballinger, Jr" uniqKey="Ballinger J">JR Ballinger</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Edwards, Jm" uniqKey="Edwards J">JM Edwards</name></author><author><name sortKey="Kinmonth, Jb" uniqKey="Kinmonth J">JB. 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Greene</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Martel, C" uniqKey="Martel C">C Martel</name></author><author><name sortKey="Li, W" uniqKey="Li W">W Li</name></author><author><name sortKey="Fulp, B" uniqKey="Fulp B">B Fulp</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Lim, Hy" uniqKey="Lim H">HY Lim</name></author><author><name sortKey="Rutkowski, Jm" uniqKey="Rutkowski J">JM Rutkowski</name></author><author><name sortKey="Helft, J" uniqKey="Helft J">J Helft</name></author></analytic></biblStruct></listBibl></div1></back></TEI></record>Pour manipuler ce document sous Unix (Dilib)
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