Scintigraphy and indirect lymphography Practical aspects

Lymphoedema is a life-long disease which may be improved but not healed by our therapy. Therefore it seems to be desirable to ascertain the clinical suspicion of lymphoedema or to rule out this diagnosis at least once in the life of a patient suffering from chronic swelling of the extremities. The most appropriate methods for that purpose are lymphoscintigraphy and indirect lymphography. Radionuclide lymphography and indirect lymphography are based on a similar principle: lymphatic drainage is assessed after „indirect“ application of a tracer into the tissue, in contrary to the „direct“ injection of contrast-material performed in conventional lymphangiography. Labelled compounds are used for scintigraphy, and newly developed, water-soluble contrast media for indirect lymphography. While radionuclide lymphography has become the most important diagnostic tool for diagnosing compromised lymph-drainage, indirect lymphography has been established only in few centres, mainly for scientific reasons.