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핵의학
- 2024년 01월호
[Sci Rep .] The added value of SPECT/CT lymphoscintigraphy in the initial assessment of secondary extremity lymphedema patients이화의대 / 윤해전*, 우경제*
- 출처
- Sci Rep .
- 등재일
- 2023 Nov 9
- 저널이슈번호
- 13(1):19494. doi: 10.1038/s41598-023-44471-2.
- 내용
Abstract
An added value of SPECT/CT over planar lymphoscintigraphy for initial staging in patients with secondary extremity lymphedema was investigated. Furthermore, we developed a hybrid SPECT/CT classification combining dermal backflow (DBF) of SPECT and honeycomb pattern (HP) of CT, correlated it with lymphoscintigraphic staging and clinical severity. Forty-one patients with secondary extremity lymphedema who underwent lymphoscintigraphy with SPECT/CT were included retrospectively. The severity of extremity lymphedema was assessed using CT volumetry. Lymphoscintigraphic findings were evaluated using the Taiwan Lymphoscintigraphy Staging (TLS), and CT-based and SPECT-based quantitative analysis were performed. TLS was performed by planar scintigraphy only and with SPECT/CT, respectively. The SPECT/CT findings were classified into DBF-/HP-, DBF+/HP-, DBF+/HP+, and DBF-/HP+. Based on these findings, patients were categorized into five classes: Class 1 = DBF-HP- entire limb, Class 2 = DBF+/HP- proximal/distal limb without DBF+/HP+ or DBF-/HP+, Class 3 = DBF+/HP+ proximal/distal limb without DBF-/HP+, Class 4 = Mixed DBF+/HP+ and DBF-/HP+ in proximal/distal limb, Class 5 = DBF-/HP+ entire limb. Adding SPECT/CT to planar scintigraphy showed a 15.4% modification rate in lymphoscintigraphic staging. HP volume ratio significantly increased as clinical severity and lymphoscintigraphic staging increased, while DBF volume ratio increased with severity and followed expected patterns according to lymphoscintigraphic staging. Hybrid SPECT/CT lymphoscintigraphic classification showed strong positive correlation with clinical severity and TLS. Our results demonstrated substantial modification of lymphoscintigraphic staging by adding SPECT/CT to a conventional planar scintigraphy. In addition, a hybrid SPECT/CT is expected to provide new indicators reflecting lymphoscintigraphic staging and clinical severity by providing both of functional DBF and anatomical HP information.Affiliations
Hai-Jeon Yoon # 1, Kyong-Je Woo # 2, Ji-Young Kim 3, Seo Young Kang 3, Byung Seok Moon 3, Bom Sahn Kim 3
1Department of Nuclear Medicine, Ewha Womans University College of Medicine, Seoul, Korea. haijeon.yoon@ewha.ac.kr.
2Department of Plastic Surgery, Ewha Womans University College of Medicine, Seoul, Korea. economywoo@ewha.ac.kr.
3Department of Nuclear Medicine, Ewha Womans University College of Medicine, Seoul, Korea.
#Contributed equally.
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편집위원
SPECT/CT의 임상적 유용성은 다양한 질환의 진단에서 평면 감마카메라 영상 보다 유용한 점이 밝혀져 있으며, 적응증이 지속적으로 확장되고 있음. 해당 임상연구는 lymphoscintigraphy에서 SPECT/CT 추가적 적용의 가치를 보여준 연구임. 이 연구에서는 SPECT/CT 추가가 림프부종의 임상적 심각도을 더 잘 반영해 줄수 있은 것으로 나타남. 이러한 결과는 lymphoscintigraphy에서 SPECT/CT 적용가능성을 높이는 역할을 할 수 있을 것으로 생각됨.
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