ThP8.8 - Role of Lymphoscintigraphy in Lymphoedema

Abstract Aim Lymphoscinigraphy (LSG) is a gold standard of investigation in patients with Lymphoedema, though not all patients with Lymphoedema are offered LSG and some who are offered decline to have the test. The aim of the present study was to do a clinico-radiological correlation of Lymphoscintigraphic findings. Methods All patients who underwent Lymphoscinti scans at a tertiary vascular centre over a 3 year period were included in the study. The technique was standardised and involved injection of a radioactive tracer in the Ist web space of both feet and uptake of the tracer at the groin at 2 hours was determined. Uptake less than 8% at 2 hours was considered abnormal. Clinical findings were compared with scan findings. Results 207 patients underwent LSG scans for suspected lower limb lymphoedema. 53 (26%) scans were normal. Of those with abnormal scans, 24 had mild lymphatic dysfunction (uptake 5-8%); 57 (28%) had moderate lymphatic dysfunction (uptake 2-5%) and 73 (35%) had severe lymphatic dysfunction with an uptake of <2%. Male to female ratio was 1:3. Median age at presentation was 60 years (range 3-89). Median BMI was 37Kg/m2 (range 17-71). Clinical profile based on the worst leg having moderate to severe Lymphatic dysfunction on LSG showed a 78-93% match between the leg affected and the LSG findings. This dropped to 29% in those with mild dysfunction. Conclusion Lymphoscintigraphy can objectively confirm and grade lymphoedema. It can be used to guide patients and their carers in following preventative measures to prevent complications.