Nuclear medicine techniques used in lymphatic system imaging

Lymphoscintigraphy is a non-invasive examination technigue that can very easily contribute to the diagnosis of lymphoedema in patients suffering from swelling of the lower extremities. Thanks to the low radiation burden and minimum risk of allergic reactions, this technique can be used for repeated examinations as well as for monitoring the effects of the treatment. In this thesis, I am trying to familiarize readers with the principles of lymphoscintigraphy of the lower extremities and with various options for processing the images obtained. My objective was to compare the results of the semi-quantitative evaluation of the currently used static imaging techniques with whole body scintigraphy, thus contributing to the simplification of this examination. A group of 96 patients was formed for whom I always used two methods of data acquisition (currently used static images followed by whole body recording). Given the different possibilities of semi-quantitative evaluation, the patients were divided into two groups, according to the imaging methods for the site of application in the whole body records. In addition, I tried to evaluate the benefits of SPECT/low-dose CT on the area of the inguinal lymph nodes, especially in obese patients. Images were taken from a total of 5 patients. All data was imaged and subsequently processed at the Clinic of Nuclear Medicine, University Hospital Královské Vinohrady. It is evident from the processing of data from 96 patients that static data acquisition can be replaces with whole body imaging. Given the method of processing, imaging with shielding of the injection site seems to be a more suitable method. In 6,5% of these patients, the result was mildly underestimated. Unfortunately, the benefits of SPECT or SPECT/low-dose CT were not fully confirmed. I hope that this thesis will provide a comprehensive view of the performance of lymphoscintigraphy and will help to elucidate the influence of the imaging technique used on the results of semi-quantitative evaluation. Last but not least, it will help to facilitate the work of radiology assistants and doctors, and increase the comfort of examination for patients