Lymphoscintigraphy

What is lymphoscintigraphy?

A lymphoscintigraphy is a type of nuclear medicine imaging test. It uses safe radioactive dyes to see how well your lymphatic system works. A special camera takes pictures of the dye as it travels through your lymph nodes. These pictures show how fluid moves and drains. They help find any areas that aren’t working correctly.

Healthcare providers use lymphoscintigraphy to:

• Diagnose and stage certain types of cancer: Providers most commonly use it to diagnose breast cancer and melanoma. It can also help providers plan for a biopsy.
• Locate sentinel nodes for surgical removal: A sentinel node is the first lymph node that cancer cells spread to from a primary tumor.
• Diagnose lymph system diseases: This includes conditions like lymphedema or blockages in lymph vessels.
• Monitor the progress of treatment: It can help providers see whether cancer treatment is working.

Another name for lymphoscintigraphy is lymph node mapping.

What happens during lymphoscintigraphy?

Lymphoscintigraphy involves your provider using a radioactive substance called radiotracers. When your provider injects the material under your skin, radiotracers “gather” in tumors or other areas of concern. Radiotracers show up on the special gamma camera the test uses. The camera sends this information to a computer that creates pictures. Finally, a radiologist examines the pictures for abnormalities in your lymphatic system.

The general steps of the test are:

1. A healthcare provider will ask you to lie down on a table. (You might be able to wear your own clothing during the procedure. But your provider may ask you to change into a gown before they begin.)
2. Your provider will inject radiotracer near your lymph nodes or in the area they’re interested in taking a closer look at. They’ll place a small needle just beneath your skin.
3. The radiotracer flows through your lymphatic system.
4. The camera detects the movement of the radiotracer. It takes a series of pictures of how the tracer moves.
5. The camera might stay still or rotate around you.
6. The technologist may ask you to change positions between images.

You’ll need to remain very still for short periods while the gamma camera takes pictures.

You can go home right after and go about your normal activities.

The test itself shouldn’t hurt. You might feel a slight sting when your provider injects the radiotracer.

How do I prepare for this procedure?

You won’t need to stay in the hospital. But you might if your surgeon is using it to locate sentinel lymph nodes for cancer surgery. In those cases, you’ll usually have the test the same day as your surgery.

Your healthcare provider will tell you how to prepare for your lymphoscintigraphy. But in general, you should:

• Leave jewelry at home, as metal may interfere with the imaging test.
• Tell your provider if you’re pregnant or breastfeeding.
• Bring an updated list of any medications, vitamins or supplements you’re taking.

How long does a lymphoscintigraphy take?

It depends on why you need the test. It could last 30 minutes, or it could take a few hours. Your provider can let you know what to expect on the day of your appointment.

What are the risks and side effects of lymphoscintigraphy?

Lymphoscintigraphy might not be right for you if you’re pregnant or breastfeeding, or if you have:

• Inflammatory breast cancer
• Multiple breast tumors or a breast tumor larger than 5 centimeters
• Ductal carcinoma in situ (DCIS)

Side effects are rare, but some people develop an allergic reaction to the radiotracer.

What to expect after lymph node mapping

Unless your healthcare provider tells you otherwise, you’ll be able to resume normal activities immediately. The radiotracer will leave your body when you pee and poop over the next couple of days. Drink plenty of water to help this process along.

When should I know the results of my lymphoscintigraphy procedure?

You should know the results within one week. A radiologist will contact your provider. This process can take a few days, but your provider will call you as soon as they receive your results.

If my results are abnormal, what are the next steps?

It depends on which condition you have. But if your provider is looking for cancer, they’ll do a sentinel node biopsy. They’ll talk with you about what your results mean and discuss next steps.

When should I call my healthcare provider?

Contact your healthcare provider if you have any questions before the test or about your results. They’re the best person to discuss your concerns with.