Hospitals & Services

Lymphoscintigraphy & Sentinel Lymph Nodes

About Lymphoscintigraphy & Sentinel Lymph Nodes..  

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.

 

Indications:

  • Assessment of patients with suspected lymphoedema.

  • Identification of sentinel lymph node (SLN) prior to surgery.

Preparation:

  • 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.

Procedure:

Suspected lymphoedema

  • 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. 

Lymphatic Scan Breast.jpg 

 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.

Lymphatic Scan Melanoma Neck Node.jpg 

 

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Page last reviewed: 23 March 2015
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