The washout rate of a subcutaneous 99mTc-HSA depot in lower extremity lymphoedema
Identifieur interne : 000073 ( PascalFrancis/Checkpoint ); précédent : 000072; suivant : 000074The washout rate of a subcutaneous 99mTc-HSA depot in lower extremity lymphoedema
Auteurs : Mads R. Jensen [Danemark] ; Lene Simonsen [Danemark] ; Tonny Karlsmark [Danemark] ; Jens Bülow [Danemark]Source :
- Clinical physiology and functional imaging : (Print) [ 1475-0961 ] ; 2012.
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Abstract
Purpose: Lymphoscintigraphy is currently the leading diagnostic modality of lower extremity lymphoedema but has been criticized for being unreliable. Washout rate constants have been investigated and proven to be of diagnostic value in several studies of breast-cancer-related lymphoedema; however, the applicability in lower extremity lymphoedema needs further evaluation. The aim of the study was to verify if washout of 99mTc-Human Serum Albumin (99mTc-HSA) is a reliable diagnostic tool in lower extremity lymphoedema. Methods: Twenty healthy volunteers and eight patients (11 legs) with lymphoscintigraphy verified lower extremity lymphoedema participated in the study. A depot consisting of 0.1 ml 10 MBq/ml 99mTc-HSA was injected subcutaneously into the dorsum of each foot. The depot washout rate was measured using a portable scintillation detector system and time-activity curves were generated. After 30 min of supine rest and 10 min of standardized ergometric exercise, measurements were recorded for 20 min. Following correction for physical decay of 99mTc, the depot washout rate constant was calculated using linear regression analysis. Finally depot half-life was calculated from the washout rate constant. Results: Median half-life for healthy volunteers was 9.4 h (range 2.5-28.3 h). Median half-life for lymphoedema patients was 10-7 h (range 1.5-35.1 h). No statistical significant difference could be detected between healthy volunteers and lymphoedema patients (P = 0-78). Conclusions: The washout rate of a subcutaneous 99mTc-HSA depot is not a reliable diagnostic tool in examination of lower extremity lymphoedema. Additional examinations revealed in vivo instability of the utilized 99mTc-HSA as the likely reason.
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Jensen</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Department of Clinical Physiology and Nuclear and Medicine and</s1><s3>DNK</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>4 aut.</sZ></inist:fA14><country>Danemark</country><wicri:noRegion>Department of Clinical Physiology and Nuclear and Medicine and</wicri:noRegion></affiliation></author><author><name sortKey="Simonsen, Lene" sort="Simonsen, Lene" uniqKey="Simonsen L" first="Lene" last="Simonsen">Lene Simonsen</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Department of Clinical Physiology and Nuclear and Medicine and</s1><s3>DNK</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>4 aut.</sZ></inist:fA14><country>Danemark</country><wicri:noRegion>Department of Clinical Physiology and Nuclear and Medicine and</wicri:noRegion></affiliation></author><author><name sortKey="Karlsmark, Tonny" sort="Karlsmark, Tonny" uniqKey="Karlsmark T" first="Tonny" last="Karlsmark">Tonny Karlsmark</name><affiliation wicri:level="3"><inist:fA14 i1="02"><s1>Department of Dermatology and Venereology, Bispebjerg Hospital, University Hospital of Copenhagen</s1><s2>Copenhagen</s2><s3>DNK</s3><sZ>3 aut.</sZ></inist:fA14><country>Danemark</country><placeName><settlement type="city">Copenhague</settlement><region type="région" nuts="2">Hovedstaden</region></placeName></affiliation></author><author><name sortKey="Bulow, Jens" sort="Bulow, Jens" uniqKey="Bulow J" first="Jens" last="Bülow">Jens Bülow</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Department of Clinical Physiology and Nuclear and Medicine and</s1><s3>DNK</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>4 aut.</sZ></inist:fA14><country>Danemark</country><wicri:noRegion>Department of Clinical Physiology and Nuclear and Medicine and</wicri:noRegion></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">INIST</idno><idno type="inist">12-0107035</idno><date when="2012">2012</date><idno type="stanalyst">PASCAL 12-0107035 INIST</idno><idno type="RBID">Pascal:12-0107035</idno><idno type="wicri:Area/PascalFrancis/Corpus">000113</idno><idno type="wicri:Area/PascalFrancis/Curation">000844</idno><idno type="wicri:Area/PascalFrancis/Checkpoint">000073</idno><idno type="wicri:explorRef" wicri:stream="PascalFrancis" wicri:step="Checkpoint">000073</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">The washout rate of a subcutaneous <sup>99m</sup>Tc-HSA depot in lower extremity lymphoedema</title><author><name sortKey="Jensen, Mads R" sort="Jensen, Mads R" uniqKey="Jensen M" first="Mads R." last="Jensen">Mads R. Jensen</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Department of Clinical Physiology and Nuclear and Medicine and</s1><s3>DNK</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>4 aut.</sZ></inist:fA14><country>Danemark</country><wicri:noRegion>Department of Clinical Physiology and Nuclear and Medicine and</wicri:noRegion></affiliation></author><author><name sortKey="Simonsen, Lene" sort="Simonsen, Lene" uniqKey="Simonsen L" first="Lene" last="Simonsen">Lene Simonsen</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Department of Clinical Physiology and Nuclear and Medicine and</s1><s3>DNK</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>4 aut.</sZ></inist:fA14><country>Danemark</country><wicri:noRegion>Department of Clinical Physiology and Nuclear and Medicine and</wicri:noRegion></affiliation></author><author><name sortKey="Karlsmark, Tonny" sort="Karlsmark, Tonny" uniqKey="Karlsmark T" first="Tonny" last="Karlsmark">Tonny Karlsmark</name><affiliation wicri:level="3"><inist:fA14 i1="02"><s1>Department of Dermatology and Venereology, Bispebjerg Hospital, University Hospital of Copenhagen</s1><s2>Copenhagen</s2><s3>DNK</s3><sZ>3 aut.</sZ></inist:fA14><country>Danemark</country><placeName><settlement type="city">Copenhague</settlement><region type="région" nuts="2">Hovedstaden</region></placeName></affiliation></author><author><name sortKey="Bulow, Jens" sort="Bulow, Jens" uniqKey="Bulow J" first="Jens" last="Bülow">Jens Bülow</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Department of Clinical Physiology and Nuclear and Medicine and</s1><s3>DNK</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>4 aut.</sZ></inist:fA14><country>Danemark</country><wicri:noRegion>Department of Clinical Physiology and Nuclear and Medicine and</wicri:noRegion></affiliation></author></analytic><series><title level="j" type="main">Clinical physiology and functional imaging : (Print)</title><title level="j" type="abbreviated">Clin. physiol. funct. imaging : (Print)</title><idno type="ISSN">1475-0961</idno><imprint><date when="2012">2012</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Clinical physiology and functional imaging : (Print)</title><title level="j" type="abbreviated">Clin. physiol. funct. imaging : (Print)</title><idno type="ISSN">1475-0961</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Biological transport</term><term>Human</term><term>Lower extremity</term><term>Lymphedema</term><term>Mammalia</term><term>Pathophysiology</term><term>Rhythm</term><term>Serum albumin</term><term>Subcutaneous</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Rythme</term><term>Souscutané</term><term>Extrémité inférieure</term><term>Homme</term><term>Sérumalbumine</term><term>Transport biologique</term><term>Physiopathologie</term><term>Mammalia</term><term>Lymphoedème</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Homme</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Purpose: Lymphoscintigraphy is currently the leading diagnostic modality of lower extremity lymphoedema but has been criticized for being unreliable. Washout rate constants have been investigated and proven to be of diagnostic value in several studies of breast-cancer-related lymphoedema; however, the applicability in lower extremity lymphoedema needs further evaluation. The aim of the study was to verify if washout of <sup>99m</sup>Tc-Human Serum Albumin (<sup>99m</sup>Tc-HSA) is a reliable diagnostic tool in lower extremity lymphoedema. Methods: Twenty healthy volunteers and eight patients (11 legs) with lymphoscintigraphy verified lower extremity lymphoedema participated in the study. A depot consisting of 0.1 ml 10 MBq/ml <sup>99m</sup>Tc-HSA was injected subcutaneously into the dorsum of each foot. The depot washout rate was measured using a portable scintillation detector system and time-activity curves were generated. After 30 min of supine rest and 10 min of standardized ergometric exercise, measurements were recorded for 20 min. Following correction for physical decay of <sup>99m</sup>Tc, the depot washout rate constant was calculated using linear regression analysis. Finally depot half-life was calculated from the washout rate constant. Results: Median half-life for healthy volunteers was 9.4 h (range 2.5-28.3 h). Median half-life for lymphoedema patients was 10-7 h (range 1.5-35.1 h). No statistical significant difference could be detected between healthy volunteers and lymphoedema patients (P <sub>=</sub> 0-78). Conclusions: The washout rate of a subcutaneous <sup>99m</sup>Tc-HSA depot is not a reliable diagnostic tool in examination of lower extremity lymphoedema. Additional examinations revealed in vivo instability of the utilized <sup>99m</sup>Tc-HSA as the likely reason.</div></front></TEI><inist><standard h6="B"><pA><fA01 i1="01" i2="1"><s0>1475-0961</s0></fA01><fA03 i2="1"><s0>Clin. physiol. funct. imaging : (Print)</s0></fA03><fA05><s2>32</s2></fA05><fA06><s2>2</s2></fA06><fA08 i1="01" i2="1" l="ENG"><s1>The washout rate of a subcutaneous <sup>99m</sup>Tc-HSA depot in lower extremity lymphoedema</s1></fA08><fA11 i1="01" i2="1"><s1>JENSEN (Mads R.)</s1></fA11><fA11 i1="02" i2="1"><s1>SIMONSEN (Lene)</s1></fA11><fA11 i1="03" i2="1"><s1>KARLSMARK (Tonny)</s1></fA11><fA11 i1="04" i2="1"><s1>BÜLOW (Jens)</s1></fA11><fA14 i1="01"><s1>Department of Clinical Physiology and Nuclear and Medicine and</s1><s3>DNK</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>4 aut.</sZ></fA14><fA14 i1="02"><s1>Department of Dermatology and Venereology, Bispebjerg Hospital, University Hospital of Copenhagen</s1><s2>Copenhagen</s2><s3>DNK</s3><sZ>3 aut.</sZ></fA14><fA20><s1>126-132</s1></fA20><fA21><s1>2012</s1></fA21><fA23 i1="01"><s0>ENG</s0></fA23><fA43 i1="01"><s1>INIST</s1><s2>19275</s2><s5>354000508679860080</s5></fA43><fA44><s0>0000</s0><s1>© 2012 INIST-CNRS. All rights reserved.</s1></fA44><fA45><s0>1 p.1/4</s0></fA45><fA47 i1="01" i2="1"><s0>12-0107035</s0></fA47><fA60><s1>P</s1></fA60><fA61><s0>A</s0></fA61><fA64 i1="01" i2="1"><s0>Clinical physiology and functional imaging : (Print)</s0></fA64><fA66 i1="01"><s0>GBR</s0></fA66><fC01 i1="01" l="ENG"><s0>Purpose: Lymphoscintigraphy is currently the leading diagnostic modality of lower extremity lymphoedema but has been criticized for being unreliable. Washout rate constants have been investigated and proven to be of diagnostic value in several studies of breast-cancer-related lymphoedema; however, the applicability in lower extremity lymphoedema needs further evaluation. The aim of the study was to verify if washout of <sup>99m</sup>Tc-Human Serum Albumin (<sup>99m</sup>Tc-HSA) is a reliable diagnostic tool in lower extremity lymphoedema. Methods: Twenty healthy volunteers and eight patients (11 legs) with lymphoscintigraphy verified lower extremity lymphoedema participated in the study. A depot consisting of 0.1 ml 10 MBq/ml <sup>99m</sup>Tc-HSA was injected subcutaneously into the dorsum of each foot. The depot washout rate was measured using a portable scintillation detector system and time-activity curves were generated. After 30 min of supine rest and 10 min of standardized ergometric exercise, measurements were recorded for 20 min. Following correction for physical decay of <sup>99m</sup>Tc, the depot washout rate constant was calculated using linear regression analysis. Finally depot half-life was calculated from the washout rate constant. Results: Median half-life for healthy volunteers was 9.4 h (range 2.5-28.3 h). Median half-life for lymphoedema patients was 10-7 h (range 1.5-35.1 h). No statistical significant difference could be detected between healthy volunteers and lymphoedema patients (P <sub>=</sub> 0-78). Conclusions: The washout rate of a subcutaneous <sup>99m</sup>Tc-HSA depot is not a reliable diagnostic tool in examination of lower extremity lymphoedema. 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Jensen</name></noRegion><name sortKey="Bulow, Jens" sort="Bulow, Jens" uniqKey="Bulow J" first="Jens" last="Bülow">Jens Bülow</name><name sortKey="Karlsmark, Tonny" sort="Karlsmark, Tonny" uniqKey="Karlsmark T" first="Tonny" last="Karlsmark">Tonny Karlsmark</name><name sortKey="Simonsen, Lene" sort="Simonsen, Lene" uniqKey="Simonsen L" first="Lene" last="Simonsen">Lene Simonsen</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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