Purpose

We aimed to evaluate the potential role of quantitative methods associated with lymphoscintigraphy for the assessment of severity of lymphedema post-operatively in patients with breast cancer who did not show definite dermal backflow activity on the lymphoscintigraphy.

Methods

We evaluated 47 lymphoscintigraphies without dermal backflow in patients with lymphedema who received a mastectomy and axillary dissection or sentinel lymph node dissection for invasive ductal carcinoma of the breast. The quantitative asymmetry indices (QAIs) of both arms were calculated for each axilla, upper arm, forearm, and the whole arm. The QAI was defined as the radiopharmaceutical uptake ratio of the affected side to the unaffected side. Arm circumference was measured at four locations per arm to identify the maximal circumference difference (MCD) between affected and unaffected sides.

Results

The total and forearm QAIs of each side arm were significantly higher in the group with above moderate stage lymphedema compared with the mild stage group. Previous radiotherapy also had a significant effect on radiotracer retention expressed as QAI. The MCD was significantly correlated with QAI values of the forearm and the whole arm. The QAI of axillary areas was not significantly correlated with circumferential measurements of the arm.

Conclusions

The QAIs have significant value for the diagnosis and severity of lymphedema and may therefore potentially be used as an objective tool for the assessment of lymphedema.

中文翻译：

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无明显真皮回流的淋巴闪烁显像定量参数评估乳腺癌术后患者淋巴水肿的可行性

目的

我们旨在评估与淋巴闪烁显像相关的定量方法在评估在淋巴闪烁显像中未显示明确的真皮回流活动的乳腺癌患者术后淋巴水肿严重程度的潜在作用。

方法

我们评估了接受乳房切除术和腋窝清扫术或前哨淋巴结清扫术治疗乳腺浸润性导管癌的淋巴水肿患者的 47 例无真皮回流的淋巴闪烁显像。计算每个腋窝、上臂、前臂和整个手臂的双臂的定量不对称指数 (QAI)。QAI 定义为患侧与未患侧的放射性药物摄取比。在每只手臂的四个位置测量手臂周长，以确定受影响侧和未受影响侧之间的最大周长差异 (MCD)。

结果

中度以上淋巴水肿组各侧臂总QAI和前臂QAI明显高于轻度组。以前的放射治疗对以 QAI 表示的放射性示踪剂保留也有显着影响。MCD与前臂和整个手臂的QAI值显着相关。腋窝区域的 QAI 与手臂的圆周测量值没有显着相关性。

结论

QAI 对淋巴水肿的诊断和严重程度具有重要价值，因此可能被用作评估淋巴水肿的客观工具。