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Procedure:

• You have been referred to us for a Lymphoscintigraphy study to map out the lymph drainage from your primary melanoma or breast lesion.

• The test usually takes 2 hours to complete but may be extended to 4 hours (if poor drainage of the lymphatics occurs).

• ​The length of the scan can never be accurately estimated until we have commenced the first set of images.

• Performing the test requires 2 - 4 injections of 99mTc-Antimony Sulphide Colloid around the primary lesion.

• There are no side effects to the injections, only that they sting (similar to local anesthetic).

• Early images are performed to visualise the drainage within the lymph channels and lymphnodes.

• Later images (20 min to 3 hours after the injections) allow us to visualise the draining node fields.

• We mark/tattoo your "Sentinel Nodes"(1) after finishing the later images using a Gamma Camera (2) and some indelible ink.

• 3D scanning (or SPECT/CT (3) as it is known) is performed after your sentinel nodes have been marked. This gives the surgeon clear visualisation of the sentinel nodes in relation to the anatomical structures around these nodes.

• Sometimes, an Ultrasound is performed of these sentinel nodes. This is usually done straight after the 3D scanning.

• The Ultrasound is to document that the sentinel nodes appear structurally normal.

• If the lymphnodes appear abnormal on Ultrasound, you may require a Fine Needle Aspiration Biopsy (FNAB). This is done under ultrasound guidance using local anesthetic and is performed by the Nuclear Physician. If histology is positive for melanoma, then the surgeon may remove more nodes than just the sentinel nodes.

• It can take approximately 15 - 45 minutes for the report and films to be ready for you to take into surgery.

• You receive a slight radiation dose by having a Lymphoscintigraphy Study ~ up to 0.9 times your yearly background radiation (4).

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Patient Preparation:

• If you are pregnant, trying to fall pregnant or breast feeding, you must inform our staff.

• If you have had prior imaging e.g. PET, Nuclear Scan, CT, MRI, X-Ray, Ultrasound, etc... please bring these with you.

• Please also bring your referral and any blood results that you may have had done.

• There is no preparation for a Lymphoscintigraphy Study i.e. you may eat and drink as normal, unless you are undergoing surgery the same day.

• If you are on any medications, please take these as normal. Again check with surgical staff for any restrictions e.g. anti-coagulants, aspirin, etc...

• If you are having surgery on the day of your scan, please consult the surgical staff for correct preparation i.e. Nil by mouth, etc...

• Wear comfortable clothing and minimise the amount of metal jewellery you have on (all metal objects will need to be removed prior to imaging).

• Important Note: You cannot have this test if you have had a PET or Nuclear Scan within 24 hours prior to this test. If you have had Iodine-131 therapy, allow 4-weeks before having this test. Please ring to discuss booking options.​

 

Breast-Feeding Mothers: Once you have been given the tracer, you need to stop breast-feeding for 8-hours. During this time, you need to express and discard your breast milk as often as required. You will need to bottle-feed your child during this period.

 

(1) Sentinel Node(s): Any lymphnode receiving direct drainage from the primary cancer site. Hence, there may be more than one Sentinel Node.

(2) A Gamma Camera is a device that detects gamma-rays (gamma-rays are very similar to x-rays) and does not emit any radiation.

(3) SPECT/CT imaging (Single Photon Emission Computer Tomography / Computer Tomography).

(4) We all receive a yearly background radiation dose ~ 2.4mSv. Lymphoscintigraphy Study with SPECT/CT ~ 2.152mSv = 0.896 times yearly background dose. Reference: http://interactive.snm.org/docs/pg_ch24_0403.pdf

 

For more details, click onto Brochure 1 and Brochure 2 ...