**Northern Lincolnshire and Goole NHS Foundation Trust - Nuclear Medicine** 

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^  Authorised By  ^  Authorising Role  ^  Authorisation Signature \\  (only on master paper copy)  ^  Date Authorised  |
|  Prof G Avery  |  ARSAC Licence Holder  |    |  2025-01-16  |

====== REF019 - Lymphoscintigraphy ======
See [[referral_criteria:ref000-how_to_refer_to_nlagnm|REF000 - Referring to Nuclear Medicine (NLAG)]] for details on how to refer.

===== Description =====
Lymphatic and lymph node imaging of the lower limbs is useful in assessing the patency of lymphatic drainage following traumatic injury and in assessing suspected lymphoedema. 

Imaging is needed at various times following administration of the radiopharmaceutical to assess passage through the lymphatic system. By 4 to 6 hours, the lymphatic ducts should have been visualised. In some cases, however, lymphatic transportation is slow and it may be necessary to undertake late imaging on the day following administration.

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SELECT nuclide AS Nuclide, pharmaceutical_form AS "Pharmaceutical Form",  
local_drl AS "Local DRL (MBq)" FROM drls INNER JOIN nuclides ON drls.nuclide_id=nuclides.id 
WHERE drls.id=15|0]]

^Typical Radiation Dose (mSv)  |  0.09  | 

===== Staff Entitled to Refer =====
  * The referrer may be any clinician holding a current valid medical qualification and currently employed in Secondary Care.
  * Referrals from Primary Care will be accepted if the investigation has been suggested by a Consultant Radiologist in a report from a previous investigation or following discussion with a Consultant Radiologist or secondary care specialist. Details of such suggestions or discussions should be included on the request form.

===== Supplementary Drugs =====
  * None 

===== Patient Preparation =====
  * Remove stockings for lymphoedema at least 3-4 hours before the study. [(A MacDonald, S Burrell. Infrequently performed studies in Nuclear Medicine: Part 2. J Nucl Med Technol 2009; 37:1-13.)]

===== Contraindications =====
^ Demographics |• This study is contraindicated in paediatric patients. | 
^ Pregnancy and Breast Feeding |•  This study is contraindicated in patients who are pregnant. \\ • No interruption to breast feeding is required, however as lymphoedema is a non-life threatening condition, consideration should  be given to delaying investigation until after breast feeding has ceased. | 
^ Allergies|• The use of this radiopharmaceutical should also be avoided in patients with a history of hypersensitivity to products containing human albumin. |

===== Clinical Indications =====
|Investigation of suspected abnormal lymphatic drainage  |
|Assessment of lymphatic drainage in suspected bilateral or unilateral Lymphoedema  |
|Assessment of lymphatic drainage following traumatic injury suspected to involve the lymphatic system |
|Assessment of inflammatory hyperplastic changes in lymphatics  |