Characterizing Normal Upper Extremity Lymphatic Flow with <sup>99m</sup>Tc In-House Dextran: A Retrospective Study
Issued Date
2024-09-01
Resource Type
eISSN
20754418
Scopus ID
2-s2.0-85203620340
Journal Title
Diagnostics
Volume
14
Issue
17
Rights Holder(s)
SCOPUS
Bibliographic Citation
Diagnostics Vol.14 No.17 (2024)
Suggested Citation
Katiyarangsan W., Charoenphun P., Chuamsaamarkkee K., Musikarat S., Kiranantawat K., Sakulpisuti C., Thamnirat K., Kositwattanarerk A., Sritara C., Chamroonrat W. Characterizing Normal Upper Extremity Lymphatic Flow with <sup>99m</sup>Tc In-House Dextran: A Retrospective Study. Diagnostics Vol.14 No.17 (2024). doi:10.3390/diagnostics14171960 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/101328
Title
Characterizing Normal Upper Extremity Lymphatic Flow with <sup>99m</sup>Tc In-House Dextran: A Retrospective Study
Corresponding Author(s)
Other Contributor(s)
Abstract
Lymphoscintigraphy evaluates the lymphatic system using radiocolloid compounds like 99mTc-sulfur colloid and 99mTc-nanocolloid, which vary in particle size and distribution timing. A local in-house Dextran kit (15–40 nm) was developed in 2005 and began clinical use in 2008 to localize sentinel lymph nodes; diagnose lymphedema; and detect lymphatic leakage. The normal drainage pattern remains unexplored. We retrospectively analyzed 84 upper extremity lymphoscintigraphies from 2008 to 2021. 99mTc in-house Dextran was intradermally injected into both hands, followed by whole-body imaging at specified intervals (≤15 min; 16–30 min; 31–45 min; 46–60 min), with some receiving delayed imaging. Visual and quantitative analyses recorded axillary and forearm lymph nodes and liver, kidney, and urinary bladder activity. Results showed 92% (77/84) upper extremity lymphatic tract visualization within 45 min. Axillary node detection rates increased from 46% (≤15 min) to 86% (46–60 min). Delayed imaging further revealed nodes. Epitrochlear or brachial node visualization was rare (4%, 3/84). Hepatic, renal, and urinary bladder activity was noted in 54%, 71%, and 93% at 1 h, respectively. The axillary node uptake ratio was minimal (<2.5% of injection site activity; median 0.33%). This study characterizes normal upper extremity lymphatic drainage using 99mTc in-house Dextran, offering insights into its clinical application