Quartuccio N, Agugliaro F, Alongi P, Sturiale L, Arnone G, Corrao S, et al.
Current medical imaging. Date of publication 2022 May 25;volume ():.
1. Curr Med Imaging. 2022 May 25. doi: 10.2174/1573405618666220525141721. [Epub
ahead of print]
A systematic review comparing lymphoscintigraphy and magnetic resonance imaging
techniques in the assessment of peripheral lymphedema.
Quartuccio N(1), Agugliaro F(2), Alongi P(1), Sturiale L(1), Arnone G(1), Corrao
S(2)(3).
Author information:
(1)Nuclear Medicine Unit, ARNAS Ospedali Civico, Di Cristina e Benfratelli,
Palermo, Italy.
(2)Department of Health Promotion Sciences, Maternal and Infant Care, Internal
Medicine and Medical Specialties, [PROMISE], University of Palermo, 90127
Palermo, Italy.
(3)Department of Internal Medicine, National Relevance and High Specialization
Hospital Trust, ARNAS Ospedali Civico, Di Cristina, Benfratelli, Palermo, Italy.
BACKGROUND: Peripheral lymphedema represents a disabilitating condition affecting
the lymphatic system of the limbs resulting from impaired drainage and excessive
lymphatic fluid accumulation in the interstitial spaces. Lymphoscintigraphy
stands as the imaging modality of the first choice to investigate patients with
peripheral lymphedema. Nevertheless, in recent times, magnetic resonance imaging
(MRI) techniques have also been applied to assess patients with lymphedema.
OBJECTIVE: The present systematic review aimed to appraise the available evidence
providing a head-to-head comparison between lymphoscintigraphy and MRI techniques
in peripheral lymphedema.
METHOD: A systematic literature search was performed using the PubMed database
and Cochrane Central Register of Controlled Trials (CENTRAL). The eligibility
criteria for the articles to be included in the qualitative synthesis were: 1) a
study cohort or a subset of patients with a clinical diagnosis of peripheral
lymphedema (either upper or lower limb); 2) execution of both MR imaging and
lymphoscintigraphy in the same subset of patients. The methodological quality of
the studies was assessed by an investigator using the "Quality Assessment of
Diagnostic Accuracy Studies" tool, v. 2 (QUADAS-2).
RESULTS: Overall, 11 studies were ultimately included in the quantitative
analysis. No meta-analysis was performed due to the heterogeneous patient
samples, the different study aims of the retrieved literature, and the limited
number of available articles. In the diagnosis of upper limb extremity
lymphedema, the sensitivity of MRI techniques appears superior to that of
lymphoscintigraphy. Comparative studies in the lower limbs are still scarce but
suggest that MRI may increase the diagnostic accuracy for lymphedema.
CONCLUSION: The available literature on patients with lymphedema evaluated with
both lymphoscintigraphy and MRI does not allow definite conclusions on the
superiority of one imaging technique over the other one. Further studies
including well-selected patient samples are still necessary to compare the
accuracy of these imaging modalities. Since MRI techniques seem to provide
complementary findings to lymphoscintigraphy, it would be conceivable to acquire
both imaging exams in patients with peripheral lymphedema. Furthermore, studies
evaluating the clinical impact of adding MRl to the diagnostic workup are
warranted.
Copyright© Bentham Science Publishers; For any queries, please email at
epub@benthamscience.net.
DOI: 10.2174/1573405618666220525141721
PMID: 35619272
