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The added value of SPECT/CT lymphoscintigraphy in the initial assessment of secondary extremity lymphedema patients
- Title
- The added value of SPECT/CT lymphoscintigraphy in the initial assessment of secondary extremity lymphedema patients
- Authors
- Yoon; Hai-Jeon; Woo; Kyong-Je; Kim; Ji-Young; Kang; Seo Young; Moon; Byung Seok; Bom Sahn
- Ewha Authors
- 김범산; 윤혜전; 우경제; 문병석; 강서영; 김지영
- SCOPUS Author ID
- 김범산; 윤혜전; 우경제; 문병석; 강서영; 김지영
- Issue Date
- 2023
- Journal Title
- Scientific Reports
- ISSN
- 2045-2322
- Citation
- Scientific Reports vol. 13, no. 1
- Publisher
- Nature Research
- Indexed
- SCIE; SCOPUS
- Document Type
- Article
- Abstract
- An added value of SPECT/CT over planar lymphoscintigraphy for initial staging in patients with secondary extremity lymphedema was investigated. Furthermore, we developed a hybrid SPECT/CT classification combining dermal backflow (DBF) of SPECT and honeycomb pattern (HP) of CT, correlated it with lymphoscintigraphic staging and clinical severity. Forty-one patients with secondary extremity lymphedema who underwent lymphoscintigraphy with SPECT/CT were included retrospectively. The severity of extremity lymphedema was assessed using CT volumetry. Lymphoscintigraphic findings were evaluated using the Taiwan Lymphoscintigraphy Staging (TLS), and CT-based and SPECT-based quantitative analysis were performed. TLS was performed by planar scintigraphy only and with SPECT/CT, respectively. The SPECT/CT findings were classified into DBF−/HP−, DBF+/HP−, DBF+/HP+, and DBF−/HP+. Based on these findings, patients were categorized into five classes: Class 1 = DBF−HP− entire limb, Class 2 = DBF+/HP− proximal/distal limb without DBF+/HP+ or DBF−/HP+, Class 3 = DBF+/HP+ proximal/distal limb without DBF−/HP+, Class 4 = Mixed DBF+/HP+ and DBF−/HP+ in proximal/distal limb, Class 5 = DBF−/HP+ entire limb. Adding SPECT/CT to planar scintigraphy showed a 15.4% modification rate in lymphoscintigraphic staging. HP volume ratio significantly increased as clinical severity and lymphoscintigraphic staging increased, while DBF volume ratio increased with severity and followed expected patterns according to lymphoscintigraphic staging. Hybrid SPECT/CT lymphoscintigraphic classification showed strong positive correlation with clinical severity and TLS. Our results demonstrated substantial modification of lymphoscintigraphic staging by adding SPECT/CT to a conventional planar scintigraphy. In addition, a hybrid SPECT/CT is expected to provide new indicators reflecting lymphoscintigraphic staging and clinical severity by providing both of functional DBF and anatomical HP information. © 2023, The Author(s).
- DOI
- 10.1038/s41598-023-44471-2
- Appears in Collections:
- 의과대학 > 의학과 > Journal papers
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