REF019 - Lymphoscintigraphy

Northern Lincolnshire and Goole NHS Foundation Trust - Nuclear Medicine

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SOP Code	Title	Review Date
REF019	Lymphoscintigraphy	2028-01-16

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 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.

ARSAC Licence Holders
Prof Ged Avery
Dr Najeeb Ahmed

Nuclide	Pharmaceutical Form	Local DRL (MBq)
Tc99m	Nanocolloid	20 in each limb

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. ^[1]

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

^[1] A MacDonald, S Burrell. Infrequently performed studies in Nuclear Medicine: Part 2. J Nucl Med Technol 2009; 37:1-13.

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