[The clinical yield of SPECT/CT for the assessment of lymphatic transport disorders. First experiences].
The aim of this study was to determine whether the additional use of SPECT/CT-technique improves the diagnostic value of planar lymphoscintigraphy in patients presenting with lymphatic transport disorders.


METHODS
For a defined period of two years 36 consecutive patients (27 women, 9 men; age 27-87 years) were included in our study. In addition to planar scintigraphy further acquisition of the affected extremities or of the trunk was performed using SPECT/CT-technique. In total, 48 anatomic lymph drainage areas were prospectively analysed by planar scintigraphy and tomographic SPECT/CT.


RESULTS
In 28/48 cases (58%) the SPECT/CT-imaging provided relevant additional information before treatment compared to planar technique; among them 27 regarding the exact anatomic localization of lymphatic transport disorders and 8 cases in which the dimension of the lymphatic transport disorders were estimated to a greater extent than in single use of planar lymphoscintigraphy. In 3 cases SPECT/CT provides differential diagnosis of lymph nodes versus lymphoceles. In none of the cases lymph vessels or lymph vessel grafts could be demonstrated by the morphological CT-component.


CONCLUSIONS
Additionally to planar lymphoscintigraphy, SPECT/CT specifies anatomical correlation of lymphatic transport disorders and thus the assessment of the extension of the pathology. Furthermore, SPECT/CT dissipates overlapping of anatomic structures by tomographic acquisition and enables differential diagnosis of lymph nodes versus lymphoceles.
Priv.-Doz. Dr. med. Mayo Weiss, Klinik und Poliklinik für Nuklearmedizin, Ludwig-Maximilians-Universität München, Marchioninistr. 15, 81377 München , E-Mail: mayo.weiss@med.uni-muenchen.de.
M
M
Weiss
S
S
Landrock
J
J
Wallmichrath
R G H
RG
Baumeister
P
P
Bartenstein
A
A
Frick
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D042601:Lymphatic Vessels / Q000000981:diagnostic imaging*; D008209:Lymphedema / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods*; D010865:Pilot Projects; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods*
SPECT/CT; hybrid imaging; lymphatic transport disorder; oedema; planar lymphoscintigraphy