What is the most reliable: lymp MRI or Lymphoscintigraphy?

[Bluedolffin]

what is the most reliable ?

[whisker5]

The indocyanine fluroscopy is the newest innovation. It is what the UK surgeons use to locate vessels prior to operating. It shows small superficial lymph vessels - they glow! I had that and a lymphoscintigraphy when I went to Belgium. The lymphoscintigraphy (with MRI) shows slightly deeper vessels and nodes to give an overview of lymphatics your limb. It is a fuzzier picture but shows slightly different things to the ICG fluroscopy I think.

[Bluedolffin in reply to whisker5]

Ok thanks for your info. I heard MRI shows other stuff that are good as well. Iam not sure anymore then.

[whisker5 in reply to Bluedolffin]

I had an MRI as PART of my lymphoscintigraphy.

What are you unsure of/having to make a decision about?

[Bluedolffin in reply to whisker5]

I don't know which one is the best to determine if you are primary or secondary case?

[whisker5 in reply to Bluedolffin]

I don't know whether they'd be able to tell you with 100% certainty. Why do you want to find out if it's primary or secondary? Is it to do with LVA surgery?

[Bluedolffin in reply to whisker5]

Yes

[Bluedolffin in reply to whisker5]

Yes

[goppyb]

Hi Bluedolffin,

Either can be used to show if you are primary or secondary. MRI lymphography (or MRL) can image much deeper than fluoroscopy, but MRL is a static scan. That means it gives a snapshot of how the lymphatics are looking, before the operation (+/- after).

Fluoroscopy only allows you to image to a depth of a couple of centimetres but gives a dynamic image (i.e. in video - you may actually be able to see lymphatics pulsating and decide how well they are working). The poorer depth penetration isn't important because the lymphatics that surgeons operate on are just under the skin. A big advantage of fluoroscopy is that the device is portable and can be taken into the operating theatre, so can physically guide the surgeon as to where to cut to find a suitable lymphatic (an MRL, on the other hand, can give you a picture taken earlier but not physically show you on the patients body where that actually corresponds to).

To my mind fluoroscopy is therefore much preferable - but it is very expensive hardware and most hospitals do not have it. (MRI is also very expensive! But, because it has so many uses other than imaging lymphatics, it is more likely to already be present in a hospital and therefore there isn't any added expense to carrying out MRL in such places).

I hope that helps!

[Bluedolffin in reply to goppyb]

Well MRI costs 300 euros at the hospital in Paris. They don't have the fluoroscopy in Ireland nor in France. Travelling to Belgium, uk or Italy is essential. According to what u are saying MRI looks like old fashioned tool.

[whisker5]

Older, but shows what's going on deeper down. As far as I know, all the UK surgeons won't operate if lymph vessels don't show up under fluroscopy. Giacalone will sometimes delve a bit deeper if necessary-so he needs to see more of whole picture. Hope that helps.

[Bluedolffin]

hey guys, thanks for your help. I cancelled my MRI and will have a fluoroscopy + possibly a lymphscintogram. It is gonna hurt but it is for the best !