Lymphscintigraphy predicts response to complex physical therapy in patients with early stage extremity lymphedema.
We investigated whether baseline lymphscintigraphic findings can predict long-term response to complex physical therapy (CPT) in patients with early stage extremity lymphedema. Twenty patients with unilateral extremity lymphedema of clinical stage I or II underwent CPT after baseline lymphscintigraphy. Therapeutic responses (good vs. poor) were evaluated at 1 year post-CPT based on changes in skin status and subjective symptoms, and percent volume reductions and compared with clinical factors and lymphscintigraphic findings. Eleven patients showed good response to CPT with significant volume reduction of edematous extremities, and no significant volume reduction was observed in the remaining 9. Patients with good or poor responses to CPT showed no significant differences in terms of clinical variables. However, significant differences were observed between the lymphscintigraphic findings of these patients. More specifically, a lymphscintigraphic finding of main lymphatic vessels without collateral lymphatic vessels was the best predictor for a good response to CPT; the sensitivity, specificity and accuracy of this lymphscintigraphic finding is 91% (10/11), 100% (9/9) and 95% (19/20), respectively. In patients with unilateral extremity lymphedema of early stage, baseline lymphscintigraphy may usefully predict long-term response to CPT.
Hwang
J H
JH
Department of Physical Medicine and Rehabilitation, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Choi
J Y
JY
Lee
J Y
JY
Hyun
S H
SH
Choi
Y
Y
Choe
Y S
YS
Lee
K H
KH
Kim
B T
BT
D000328:Adult; D000965:Antimony; D005121:Extremities; D005260:Female; D006801:Humans; D008209:Lymphedema / Q000000981:diagnostic imaging / Q000628:therapy*; D061305:Lymphoscintigraphy; D008297:Male; D008875:Middle Aged; D026741:Physical Therapy Modalities; D012680:Sensitivity and Specificity; D017556:Technetium Compounds
D017556:Technetium Compounds; C019096:technetium Tc 99m antimony sulfide; D000965:Antimony