Imaging of lymphatic vessels in breast cancer-related lymphedema: intradermal versus subcutaneous injection of 99mTc-immunoglobulin

AJR. American Journal of Roentgenology
Susan O'MahonyA Michael Peters

Abstract

The disordered physiology that results from axillary lymph node clearance surgery for breast cancer and that leads to breast cancer-related lymphedema is poorly understood. Rerouting of lymph around the axilla or through new pathways in the axilla may protect women from breast cancer-related lymphedema. The aim of the study was to compare intradermal with subcutaneous injection of technetium-99m ((99m)Tc)-labeled human polyclonal IgG (HIG) with respect to lymphatic vessel imaging. Six women with breast cancer-related lymphedema underwent unilateral upper limb lymphoscintigraphy, using a web space injection of (99m)Tc-labeled HIG, after intradermal and subcutaneous injections on separate occasions. Multiple sequential images were obtained of the affected upper limb and torso over 3 hr on each occasion. Accumulation of activity in blood was quantified from venous blood samples taken from the opposite arm. Imaging after intradermal injection clearly showed discrete lymphatic vessels in five of six patients, in contrast to imaging after subcutaneous injection, which did not show any discrete vessels in any patient. Intradermal injection resulted in more rapid visualization of cutaneous lymph rerouting than subcutaneous injection in...Continue Reading

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Citations

Feb 11, 2010·Lymphatic Research and Biology·Richard T LucarelliPeter L Choyke
Sep 18, 2014·Lymphatic Research and Biology·Georgia KeramidaA Michael Peters
Jun 24, 2014·Microvascular Research·Lance L Munn, Timothy P Padera
Jun 4, 2008·Annals of the New York Academy of Sciences·Ruchi SharmaEva M Sevick-Muraca
Oct 27, 2010·Annals of the New York Academy of Sciences·J Brandon Dixon
Dec 25, 2019·Nature Biomedical Engineering·Tyler S NelsonJ Brandon Dixon
Jul 26, 2017·Plastic and Reconstructive Surgery. Global Open·Navid M ToyserkaniJens A Sørensen
Sep 7, 2020·Advanced Drug Delivery Reviews·Anna K Polomska, Steven T Proulx
Aug 18, 2021·Journal of Vascular Surgery. Venous and Lymphatic Disorders·A Michael Peters, Peter S Mortimer

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