Utility of 99mTc-Sulfur Colloid Lymphoscintigraphy and SPECT/CT in Chylothorax and Chylous Ascites
Purpose To assess the diagnostic efficacy of 99m Tc-sulfur colloid lymphoscintigraphy in chylothorax and chylous ascites, and the utility of single-photon emission computed tomography-computed tomography (SPECT/CT) in localizing the sites of leaks. Methods Data from patients who underwent lymphoscin...
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| Veröffentlicht in: | Nuclear medicine and molecular imaging 2023-12, Vol.57 (6), p.265-274 |
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| creator | Jaleel, Jasim Nasurudeen, Syeddharvesh Babu, Anushna Sunila Gupta, Priyanka Khangembam, Bangkim Chandra Patel, Chetan Kumar, Rakesh |
| description | Purpose
To assess the diagnostic efficacy of
99m
Tc-sulfur colloid lymphoscintigraphy in chylothorax and chylous ascites, and the utility of single-photon emission computed tomography-computed tomography (SPECT/CT) in localizing the sites of leaks.
Methods
Data from patients who underwent lymphoscintigraphy for clinical suspicion of chylothorax or chylous ascites were retrospectively analyzed. Biochemical fluid analysis was taken as the reference standard. Pleural fluid triglyceride level > 110 mg/dL (with pleural fluid/serum ratio > 1) and a cholesterol level |
| doi_str_mv | 10.1007/s13139-023-00813-6 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_10654269</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2892010845</sourcerecordid><originalsourceid>FETCH-LOGICAL-c289t-308297f07fe273a2b0dcf1e3f87c3c4ff7c4bf8c928b28decae0932b13af513b3</originalsourceid><addsrcrecordid>eNp9kcFrHCEYxaW0NCHNP9CT0Esv03zq7KinEoa0DSy0kM1ZHEd3DM641ZnS-e9rdkNCe6gXle_3Ht_jIfSewCcCwK8yYYTJCiirAARhVfMKnRPRyIrVgr5-fvP6DF3m_ADlMCqB8bfojHEpKEh5jrr72Qc_rzg6LOW4M9XdEtyScBtDiL7H23U8DDEbP81-n_RhWLGeenz346bdXbU77CfcDmuI8xCT_n2cHf9LxtdFNdv8Dr1xOmR7-XRfoPsvN7v2W7X9_vW2vd5Whgo5VwwEldwBd5ZypmkHvXHEMie4YaZ2jpu6c8JIKjoqemu0BcloR5h2G8I6doE-n3wPSzfa3thpTjqoQ_KjTquK2qu_J5Mf1D7-UgSaTU0bWRw-Pjmk-HOxeVajz8aGoCdbAqmyJwUCot4U9MM_6ENc0lTyPVIlCgcOhaInyqSYc7LueRsC6rFGdapRlRrVsUbVFBE7iXKBp71NL9b_Uf0B2ZSe5w</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2890827070</pqid></control><display><type>article</type><title>Utility of 99mTc-Sulfur Colloid Lymphoscintigraphy and SPECT/CT in Chylothorax and Chylous Ascites</title><source>Springer Nature - Complete Springer Journals</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>PubMed Central</source><creator>Jaleel, Jasim ; Nasurudeen, Syeddharvesh ; Babu, Anushna Sunila ; Gupta, Priyanka ; Khangembam, Bangkim Chandra ; Patel, Chetan ; Kumar, Rakesh</creator><creatorcontrib>Jaleel, Jasim ; Nasurudeen, Syeddharvesh ; Babu, Anushna Sunila ; Gupta, Priyanka ; Khangembam, Bangkim Chandra ; Patel, Chetan ; Kumar, Rakesh</creatorcontrib><description>Purpose
To assess the diagnostic efficacy of
99m
Tc-sulfur colloid lymphoscintigraphy in chylothorax and chylous ascites, and the utility of single-photon emission computed tomography-computed tomography (SPECT/CT) in localizing the sites of leaks.
Methods
Data from patients who underwent lymphoscintigraphy for clinical suspicion of chylothorax or chylous ascites were retrospectively analyzed. Biochemical fluid analysis was taken as the reference standard. Pleural fluid triglyceride level > 110 mg/dL (with pleural fluid/serum ratio > 1) and a cholesterol level < 200 mg/dL (with pleural fluid/serum ratio < 1) were considered confirmatory for chylothorax. Ascitic fluid triglyceride level > 200 mg/dL with a low cholesterol level (ascites fluid/serum ratio < 1) was considered confirmatory for chylous ascites.
Results
26 patients (15 males, 57.7%) aged 9 months to 68 years were enrolled in the study. Based on the reference standard, 17 had chylothorax or chylous ascites (9 with surgical history). Lymphoscintigraphy was positive in 16 (with 1 false positive) and negative in 10 (with 2 false negatives). The sensitivity, specificity, negative predictive value, positive predictive value, and accuracy of lymphoscintigraphy were 88.2% (63.6–98.5%), 88.9% (51.8–99.7%), 80.0% (51.6–93.8%), 93.8% (70.1–99.0%), and 88.5% (69.9–97.6%), respectively. SPECT/CT could localize sites of leaks in 61.5% (8/13) with a localization rate of 77.8% (7/9) and 25.0% (1/4) in patients with surgical and nonsurgical causes, respectively.
Conclusion
99m
Tc-sulfur colloid lymphoscintigraphy is a highly efficacious noninvasive modality to diagnose chylothorax or chylous ascites with a high positive predictive value. SPECT/CT could localize the sites of leaks more frequently in patients with surgical causes.</description><identifier>ISSN: 1869-3474</identifier><identifier>EISSN: 1869-3482</identifier><identifier>DOI: 10.1007/s13139-023-00813-6</identifier><identifier>PMID: 37982099</identifier><language>eng</language><publisher>Singapore: Springer Nature Singapore</publisher><subject>Ascites ; Cardiology ; Cholesterol ; Colloids ; Computed tomography ; Imaging ; Medicine ; Medicine & Public Health ; Nuclear Medicine ; Oncology ; Original ; Original Article ; Orthopedics ; Photon emission ; Radiology ; Sulfur ; Tomography ; Triglycerides</subject><ispartof>Nuclear medicine and molecular imaging, 2023-12, Vol.57 (6), p.265-274</ispartof><rights>The Author(s), under exclusive licence to Korean Society of Nuclear Medicine 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c289t-308297f07fe273a2b0dcf1e3f87c3c4ff7c4bf8c928b28decae0932b13af513b3</cites><orcidid>0000-0002-3746-6547</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10654269/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10654269/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,723,776,780,881,27901,27902,41464,42533,51294,53766,53768</link.rule.ids></links><search><creatorcontrib>Jaleel, Jasim</creatorcontrib><creatorcontrib>Nasurudeen, Syeddharvesh</creatorcontrib><creatorcontrib>Babu, Anushna Sunila</creatorcontrib><creatorcontrib>Gupta, Priyanka</creatorcontrib><creatorcontrib>Khangembam, Bangkim Chandra</creatorcontrib><creatorcontrib>Patel, Chetan</creatorcontrib><creatorcontrib>Kumar, Rakesh</creatorcontrib><title>Utility of 99mTc-Sulfur Colloid Lymphoscintigraphy and SPECT/CT in Chylothorax and Chylous Ascites</title><title>Nuclear medicine and molecular imaging</title><addtitle>Nucl Med Mol Imaging</addtitle><description>Purpose
To assess the diagnostic efficacy of
99m
Tc-sulfur colloid lymphoscintigraphy in chylothorax and chylous ascites, and the utility of single-photon emission computed tomography-computed tomography (SPECT/CT) in localizing the sites of leaks.
Methods
Data from patients who underwent lymphoscintigraphy for clinical suspicion of chylothorax or chylous ascites were retrospectively analyzed. Biochemical fluid analysis was taken as the reference standard. Pleural fluid triglyceride level > 110 mg/dL (with pleural fluid/serum ratio > 1) and a cholesterol level < 200 mg/dL (with pleural fluid/serum ratio < 1) were considered confirmatory for chylothorax. Ascitic fluid triglyceride level > 200 mg/dL with a low cholesterol level (ascites fluid/serum ratio < 1) was considered confirmatory for chylous ascites.
Results
26 patients (15 males, 57.7%) aged 9 months to 68 years were enrolled in the study. Based on the reference standard, 17 had chylothorax or chylous ascites (9 with surgical history). Lymphoscintigraphy was positive in 16 (with 1 false positive) and negative in 10 (with 2 false negatives). The sensitivity, specificity, negative predictive value, positive predictive value, and accuracy of lymphoscintigraphy were 88.2% (63.6–98.5%), 88.9% (51.8–99.7%), 80.0% (51.6–93.8%), 93.8% (70.1–99.0%), and 88.5% (69.9–97.6%), respectively. SPECT/CT could localize sites of leaks in 61.5% (8/13) with a localization rate of 77.8% (7/9) and 25.0% (1/4) in patients with surgical and nonsurgical causes, respectively.
Conclusion
99m
Tc-sulfur colloid lymphoscintigraphy is a highly efficacious noninvasive modality to diagnose chylothorax or chylous ascites with a high positive predictive value. SPECT/CT could localize the sites of leaks more frequently in patients with surgical causes.</description><subject>Ascites</subject><subject>Cardiology</subject><subject>Cholesterol</subject><subject>Colloids</subject><subject>Computed tomography</subject><subject>Imaging</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Nuclear Medicine</subject><subject>Oncology</subject><subject>Original</subject><subject>Original Article</subject><subject>Orthopedics</subject><subject>Photon emission</subject><subject>Radiology</subject><subject>Sulfur</subject><subject>Tomography</subject><subject>Triglycerides</subject><issn>1869-3474</issn><issn>1869-3482</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><recordid>eNp9kcFrHCEYxaW0NCHNP9CT0Esv03zq7KinEoa0DSy0kM1ZHEd3DM641ZnS-e9rdkNCe6gXle_3Ht_jIfSewCcCwK8yYYTJCiirAARhVfMKnRPRyIrVgr5-fvP6DF3m_ADlMCqB8bfojHEpKEh5jrr72Qc_rzg6LOW4M9XdEtyScBtDiL7H23U8DDEbP81-n_RhWLGeenz346bdXbU77CfcDmuI8xCT_n2cHf9LxtdFNdv8Dr1xOmR7-XRfoPsvN7v2W7X9_vW2vd5Whgo5VwwEldwBd5ZypmkHvXHEMie4YaZ2jpu6c8JIKjoqemu0BcloR5h2G8I6doE-n3wPSzfa3thpTjqoQ_KjTquK2qu_J5Mf1D7-UgSaTU0bWRw-Pjmk-HOxeVajz8aGoCdbAqmyJwUCot4U9MM_6ENc0lTyPVIlCgcOhaInyqSYc7LueRsC6rFGdapRlRrVsUbVFBE7iXKBp71NL9b_Uf0B2ZSe5w</recordid><startdate>20231201</startdate><enddate>20231201</enddate><creator>Jaleel, Jasim</creator><creator>Nasurudeen, Syeddharvesh</creator><creator>Babu, Anushna Sunila</creator><creator>Gupta, Priyanka</creator><creator>Khangembam, Bangkim Chandra</creator><creator>Patel, Chetan</creator><creator>Kumar, Rakesh</creator><general>Springer Nature Singapore</general><general>Springer Nature B.V</general><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-3746-6547</orcidid></search><sort><creationdate>20231201</creationdate><title>Utility of 99mTc-Sulfur Colloid Lymphoscintigraphy and SPECT/CT in Chylothorax and Chylous Ascites</title><author>Jaleel, Jasim ; Nasurudeen, Syeddharvesh ; Babu, Anushna Sunila ; Gupta, Priyanka ; Khangembam, Bangkim Chandra ; Patel, Chetan ; Kumar, Rakesh</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c289t-308297f07fe273a2b0dcf1e3f87c3c4ff7c4bf8c928b28decae0932b13af513b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Ascites</topic><topic>Cardiology</topic><topic>Cholesterol</topic><topic>Colloids</topic><topic>Computed tomography</topic><topic>Imaging</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Nuclear Medicine</topic><topic>Oncology</topic><topic>Original</topic><topic>Original Article</topic><topic>Orthopedics</topic><topic>Photon emission</topic><topic>Radiology</topic><topic>Sulfur</topic><topic>Tomography</topic><topic>Triglycerides</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Jaleel, Jasim</creatorcontrib><creatorcontrib>Nasurudeen, Syeddharvesh</creatorcontrib><creatorcontrib>Babu, Anushna Sunila</creatorcontrib><creatorcontrib>Gupta, Priyanka</creatorcontrib><creatorcontrib>Khangembam, Bangkim Chandra</creatorcontrib><creatorcontrib>Patel, Chetan</creatorcontrib><creatorcontrib>Kumar, Rakesh</creatorcontrib><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Nuclear medicine and molecular imaging</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Jaleel, Jasim</au><au>Nasurudeen, Syeddharvesh</au><au>Babu, Anushna Sunila</au><au>Gupta, Priyanka</au><au>Khangembam, Bangkim Chandra</au><au>Patel, Chetan</au><au>Kumar, Rakesh</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Utility of 99mTc-Sulfur Colloid Lymphoscintigraphy and SPECT/CT in Chylothorax and Chylous Ascites</atitle><jtitle>Nuclear medicine and molecular imaging</jtitle><stitle>Nucl Med Mol Imaging</stitle><date>2023-12-01</date><risdate>2023</risdate><volume>57</volume><issue>6</issue><spage>265</spage><epage>274</epage><pages>265-274</pages><issn>1869-3474</issn><eissn>1869-3482</eissn><abstract>Purpose
To assess the diagnostic efficacy of
99m
Tc-sulfur colloid lymphoscintigraphy in chylothorax and chylous ascites, and the utility of single-photon emission computed tomography-computed tomography (SPECT/CT) in localizing the sites of leaks.
Methods
Data from patients who underwent lymphoscintigraphy for clinical suspicion of chylothorax or chylous ascites were retrospectively analyzed. Biochemical fluid analysis was taken as the reference standard. Pleural fluid triglyceride level > 110 mg/dL (with pleural fluid/serum ratio > 1) and a cholesterol level < 200 mg/dL (with pleural fluid/serum ratio < 1) were considered confirmatory for chylothorax. Ascitic fluid triglyceride level > 200 mg/dL with a low cholesterol level (ascites fluid/serum ratio < 1) was considered confirmatory for chylous ascites.
Results
26 patients (15 males, 57.7%) aged 9 months to 68 years were enrolled in the study. Based on the reference standard, 17 had chylothorax or chylous ascites (9 with surgical history). Lymphoscintigraphy was positive in 16 (with 1 false positive) and negative in 10 (with 2 false negatives). The sensitivity, specificity, negative predictive value, positive predictive value, and accuracy of lymphoscintigraphy were 88.2% (63.6–98.5%), 88.9% (51.8–99.7%), 80.0% (51.6–93.8%), 93.8% (70.1–99.0%), and 88.5% (69.9–97.6%), respectively. SPECT/CT could localize sites of leaks in 61.5% (8/13) with a localization rate of 77.8% (7/9) and 25.0% (1/4) in patients with surgical and nonsurgical causes, respectively.
Conclusion
99m
Tc-sulfur colloid lymphoscintigraphy is a highly efficacious noninvasive modality to diagnose chylothorax or chylous ascites with a high positive predictive value. SPECT/CT could localize the sites of leaks more frequently in patients with surgical causes.</abstract><cop>Singapore</cop><pub>Springer Nature Singapore</pub><pmid>37982099</pmid><doi>10.1007/s13139-023-00813-6</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0002-3746-6547</orcidid></addata></record> |
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| source | Springer Nature - Complete Springer Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central |
| subjects | Ascites Cardiology Cholesterol Colloids Computed tomography Imaging Medicine Medicine & Public Health Nuclear Medicine Oncology Original Original Article Orthopedics Photon emission Radiology Sulfur Tomography Triglycerides |
| title | Utility of 99mTc-Sulfur Colloid Lymphoscintigraphy and SPECT/CT in Chylothorax and Chylous Ascites |
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