Medicină nucleară — Limfoscintigrafie extremități (MCB)

Updated Extremity Lymphoscintigraphy 9/8/2024 ●Indications To localize axillary, pelvic and inguinal lymph nodes in the setting of lymphedema.  ●Radiopharmaceutical: 2 mCi Tc-99m sulfur colloid divided into 4 syringes (each containing 0.1 mL fluid) ●Method of Administration: If desired, administer 1 mL 1% lidocaine intradermally into the dorsal aspects of both hands and both feet. 5 mins after lidocaine administration, inject radionuclide intradermally at the same locations. ●Patient Preparation: Patients must remove any compression stockings for the duration of the exam. ●Conflicting Examinations/Medications: No Nuclear Medicine exams within the previous 24 hrs. No barium GI exams within the previous 24 hrs. ●Pregnancy/Lactation: Pregnancy status does not need to be assessed due to short t1/2, low administered activity and extremely low radiation risks. Breast feeding mothers should discard breast milk for 24 hrs following Tc-99m Lymphoseek / sulfur colloid administration. ●Imaging Technique: Collimator - LEHR or LEAP Photopeak - 140 keV 20% window for Tc-99m Image Speed - 12 cm/min Matrix Size - 256 x 1024 Zoom - none Patient Positioning - supine feet first with arms over head ●Images/Views: A Co-57 sheet flood source should be placed under the patient to outline his/her anatomy.  Obtain anterior and posterior whole body images (from the fingertips to the toes) at 20 mins and 4 hrs after radionuclide administration. Obtain anterior and posterior whole body images at 5-6 hrs if liver activity is not visualized on the 4 hrs images.