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The feasibility of quantitative parameters of lymphoscintigraphy without significant dermal backflow for the evaluation of lymphedema in post-operative patients with breast cancer

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

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.

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Funding

This study was supported by Biomedical Research Institute Grant (2017B024), Pusan National University Hospital.

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Authors and Affiliations

  1. Department of Nuclear Medicine, Pusan National University Hospital and Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea

    Keunyoung Kim, In-Joo Kim, Kyoungjune Pak & Su Jung Choi

  2. Department of Nuclear Medicine and Research Institute for Convergence of Biomedical Science and Technology, Yangsan Pusan National University Hospital, Yangsan, Republic of Korea

    Seong-Jang Kim

  3. Department of Surgery, Busan Cancer Center, Pusan National University Hospital and Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea

    Heeseung Park & Taewoo Kang

  4. Department of Rehabilitation Medicine, Pusan National University School of Medicine and Biomedical Research Institute, Pusan National University Hospital, Gudeok-Ro Seo-Gu, Busan, 602-739, South Korea

    In Joo Kong, Yong Beom Shin & Jin A Yoon

  5. Department of Hemato-oncology, Pusan National University Hospital and Pusan National University School of Medicine, Busan, Republic of Korea

    Hyojeong Kim

Authors
  1. Keunyoung Kim
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  2. In-Joo Kim
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  3. Kyoungjune Pak
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  4. Seong-Jang Kim
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  5. Su Jung Choi
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  6. Heeseung Park
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  7. Taewoo Kang
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  8. In Joo Kong
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  9. Yong Beom Shin
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  10. Hyojeong Kim
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  11. Jin A Yoon
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Contributions

Conceptualization: Shin Y, Yoon J. Data curation: Yoon J, Kim S, Kim S, Jang M, Kim H. Writing-original draft: Yoon J, Shin Y. Writing-review and editing: Kim S, Kim S, Jang M.

Corresponding author

Correspondence to Jin A Yoon.

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Conflict of interest

The authors declare that they have no conflicts of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This retrospective study was approved by our institutional review board (IRB No. D-1803-012-065).

Informed consent

Requirement for written informed consent was waived for our retrospective study.

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This article is part of the Topical Collection on Oncology – Chest

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Kim, K., Kim, IJ., Pak, K. et al. The feasibility of quantitative parameters of lymphoscintigraphy without significant dermal backflow for the evaluation of lymphedema in post-operative patients with breast cancer. Eur J Nucl Med Mol Imaging 47, 1094–1102 (2020). https://doi.org/10.1007/s00259-019-04576-1

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  • DOI: https://doi.org/10.1007/s00259-019-04576-1

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