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Small radiolabelled colloidal particles are injected into lymphatic rich epidermal areas. The particles are small enough to move freely in lymph vessels and are temporarily trapped in nodes.
Lymphoscintigraphy is a technique used to identify the Sentinel Lymph Node (SLN), this is the first node that drains from a tumour. If the node is biopsied and found to be tumour free, then the likelihood of nodal spread of tumour is very low. The SLN is identified in the operating theatre using a specially designed radiation probe and a blue dye.
Assessment of patients with suspected lymphoedema.
Identification of sentinel lymph node (SLN) prior to surgery.
The length of the procedure, (1–3 hours) should be noted when organising a patient's theatre schedule. If the patient has early morning surgery, the procedure should be arranged for the afternoon before.
4 x 0.1ml of 99mTc-nano-colloid are injected into the web spaces of the hands or feet.
Images are taken imediately and after 2 hours.
Sentinel Lymph Node - Breast Carcinoma
2x 0.1ml of 99mTc-nano-colloid are injected in the periareolar region of the affected breast.
During the waiting time, the patient is asked to massage the breast to encourage lymphatic flow.
Images are taken 1 - 2 hours later. The position of the node/s is marked on the skin.
Sentinel Lymph Node - Melanoma or Merkle cell
2x 0.1ml of 99mTc-nano-colloid are injected either side of the melanoma or merckle cell scar.
Images are usually taken immediately after injection and approx. 2 hours later. SPECT/CT may be used for anatomical localisation. The position of the sentinel node or nodes are then marked on the skin.
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