OJMI  Vol.3 No.3 , September 2013
Lymphoscintigraphy Using Dynamic Imaging and SPECT/CT in Chylothorax
Abstract: Lymphoscintigraphy readily provides confirmation of chylothorax but not detailed localization of the leakage site. A 77-year-old woman developed traumatic chylothorax and underwent lymphoscintigraphy with radiolabeled albumin to identify the site of lymph leakage. Dynamic imaging demonstrated appearance of focal activity presumably in the upper mediastinum, followed by spread to the left hemithorax. Subsequently, SPECT/CT showed that the leakage site was located in the left side of the upper mediastinum, and this location was confirmed during video-assisted thoracoscopic surgery. Dynamic imaging demonstrated the site of first appearance of abnormal activity, and SPECT/CT enabled detailed localization of the abnormal activity with anatomic correlation. The combination of dynamic imaging with SPECT/CT appears to be recommendable for lymphoscintigraphic assessment of chylothorax.
Cite this paper: A. Ohtsuka, Y. Inoue, Y. Asano, R. Woodhams and K. Shiomi, "Lymphoscintigraphy Using Dynamic Imaging and SPECT/CT in Chylothorax," Open Journal of Medical Imaging, Vol. 3 No. 3, 2013, pp. 86-89. doi: 10.4236/ojmi.2013.33013.

[1]   I. E. Platis and C. E. Nwogu, “Chylothorax,” Thoracic Surgery Clinics, Vol. 16, No. 3, 2006, pp. 209-214. doi:10.1016/j.thorsurg.2006.05.011

[2]   V. G. Valentine and T. A. Raffin, “The Management of Chylothorax,” Chest, Vol. 102, No. 2, 1992, pp. 586-591. doi:10.1378/chest.102.2.586

[3]   S. Heyman and R. Wilmott, “Chylothorax on Technetium-99m Antimony Sulfide Colloid Scan,” Journal of Nuclear Medicine, Vol. 27, No. 11, 1986, pp. 1783-1784.

[4]   Y. Inoue, T. Otake, J. Nishikawa and Y. Sasaki, “Lymphoscintigraphy Using Tc-99m Human Serum Albumin in Chylothorax,” Clinical Nuclear Medicine, Vol. 22, No. 1, 1997, p. 60. doi:10.1097/00003072-199701000-00018

[5]   K. Suga, N. Kume, A. Hara, G. Miura, N. Matsunaga, K. Sugi, et al., “Abnormal Lymphatic Flow Demonstrated by Lymphoscintigraphy in Chylothorax Correlation with Lymphography,” Clinical Nuclear Medicine, Vol. 24, No. 9, 1999, pp. 716-717. doi:10.1097/00003072-199909000-00026

[6]   T. Stavngaard, J. Mortensen, J. Brenoe and L. B. Svendsen, “Lymphoscintigraphy Using Technetium-99m Human Serum Albumin in Chylothorax,” The Thoracic and Cardiovascular Surgeon, Vol. 50, No. 4, 2002, pp. 250-252. doi:10.1055/s-2002-33099

[7]   M. Momose, S. Kawakami, T. Koizumi, K. Yoshida, S. Kanda and R. Kondo, et al., “Lymphoscintigraphy Using Technetium-99m HSA-DTPA with SPECT/CT in Chylothorax after Childbirth,” Radiation Medicine, Vol. 26, No. 8, 2008, pp. 508-511. doi:10.1007/s11604-008-0265-4

[8]   D. Kayano, J. Taki, H. Wakabayashi and S. Kinuya, “Tc-99m Human Serum Albumin Lymphoscintigraphy with SPECT/CT in Chylothorax,” Clinical Nuclear Medicine, Vol. 36, No. 11, 2011, pp. 1056-1057. doi:10.1097/RLU.0b013e31821a2ba3

[9]   N. Prevot, O. Tiffet, J. Avet Jr., E. Quak, M. Decousus and F. Dubois, “Lymphoscintigraphy and SPECT/CT Using 99mTc Filtered Sulphur Colloid in Chylothorax,” European Journal of Nuclear Medicine and Molecular Imaging, Vol. 38, No. 9, 2011, p. 1746. doi:10.1007/s00259-011-1793-1

[10]   D. J. Boffa, M. J. Sands, T. W. Rice, S. C. Murthy, D. P. Mason, M. A. Geisinger, et al., “A Critical Evaluation of a Percutaneous Diagnostic and Treatment Strategy for Chylothorax after Thoracic Surgery,” European Journal of Cardio-Thoracic Surgery, Vol. 33, No. 3, 2008, pp. 435-439. doi:10.1016/j.ejcts.2007.11.028

[11]   E. Ohtake, K. Matsui, Y. Kobayashi and Y. Ono, “Dynamic Lymphoscintigraphy with Tc-99m Human Serum Albumin,” Radiation Medicine, Vol. 1, No. 2, 1983, pp. 132-136.