title: Primary lymphedema of the lower limb: the clinical utility of single photon emission computed tomography/CT.
abstract: OBJECTIVE
  The aim of this prospective study was to determine whether the additional use of the single photon emission computed tomography/CT (SPECT/CT) technique improves the diagnostic value of planar lymphoscintigraphy in patients presenting with primary lymph edema of the lower limb.
  
  
  METHODS
  For a defined period of three years (April 2011-April 2014) a total of 34 consecutive patients (28 females; age range, 27-83 years) presenting with swelling of the leg(s) suspicious of (uni- or bilateral, proximal or distal) primary lymphedema were prospectively examined by planar lymphoscintigraphy (lower limbs, n = 67) and the tomographic SPECT/CT technique (anatomical sides, n = 65).
  
  
  RESULTS
  In comparison to pathological planar scintigraphic findings, the addition of SPECT/CT provided relevant additional information regarding the presence of dermal backflow (86%), the anatomical extent of lymphatic disorders (64%), the presence or absence of lymph nodes (46%), and the visualization of lymph vessels (4%).
  
  
  CONCLUSIONS
  As an adjunct to planar lymphoscintigraphy, SPECT/CT specifies the anatomical correlation of lymphatic disorders and thus improves assessment of the extent of pathology due to the particular advantages of tomographic separation of overlapping sources. The interpretation of scintigraphic data benefits not only in baseline diagnosis, but also in physiotherapeutical and microsurgical treatments of primary lymphedema.
authors.affiliation: Department of Nuclear Medicine, Ludwig-Maximilians-University of Munich, Muenchen D-81377, Germany.
authors.forename: Mayo
authors.initials: M
authors.lastname: Weiss
authors.affiliation: Department of Micro-, Hand-, and Reconstructive Surgery, Ludwig-Maximilians-University of Munich, Muenchen D-81377, Germany.
authors.forename: Ruediger G H
authors.initials: RG
authors.lastname: Baumeister
authors.affiliation: Department of Micro-, Hand-, and Reconstructive Surgery, Ludwig-Maximilians-University of Munich, Muenchen D-81377, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Frick
authors.affiliation: Department of Micro-, Hand-, and Reconstructive Surgery, Ludwig-Maximilians-University of Munich, Muenchen D-81377, Germany.
authors.forename: Jens
authors.initials: J
authors.lastname: Wallmichrath
authors.affiliation: Department of Nuclear Medicine, Ludwig-Maximilians-University of Munich, Muenchen D-81377, Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Bartenstein
authors.affiliation: Department of Nuclear Medicine, Ludwig-Maximilians-University of Munich, Muenchen D-81377, Germany.
authors.forename: Axel
authors.initials: A
authors.lastname: Rominger
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D035002:Lower Extremity / Q000033:anatomy & histology / Q000000981:diagnostic imaging*; D042601:Lymphatic Vessels / Q000000981:diagnostic imaging; D008209:Lymphedema / Q000175:diagnosis* / Q000000981:diagnostic imaging; D061305:Lymphoscintigraphy; D008875:Middle Aged; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D015899:Tomography, Emission-Computed, Single-Photon; D014057:Tomography, X-Ray Computed
chemical_list: D019275:Radiopharmaceuticals
keywords: Dermal backflow; Hybrid imaging; Lymphedema; Lymphoscintigraphy; SPECT/CT