JOURNAL DESCRIPTION
The Medical Radiology and Radiation Safety journal ISSN 1024-6177 was founded in January 1956 (before December 30, 1993 it was entitled Medical Radiology, ISSN 0025-8334). In 2018, the journal received Online ISSN: 2618-9615 and was registered as an electronic online publication in Roskomnadzor on March 29, 2018. It publishes original research articles which cover questions of radiobiology, radiation medicine, radiation safety, radiation therapy, nuclear medicine and scientific reviews. In general the journal has more than 30 headings and it is of interest for specialists working in thefields of medicine¸ radiation biology, epidemiology, medical physics and technology. Since July 01, 2008 the journal has been published by State Research Center - Burnasyan Federal Medical Biophysical Center of Federal Medical Biological Agency. The founder from 1956 to the present time is the Ministry of Health of the Russian Federation, and from 2008 to the present time is the Federal Medical Biological Agency.
Members of the editorial board are scientists specializing in the field of radiation biology and medicine, radiation protection, radiation epidemiology, radiation oncology, radiation diagnostics and therapy, nuclear medicine and medical physics. The editorial board consists of academicians (members of the Russian Academy of Science (RAS)), the full member of Academy of Medical Sciences of the Republic of Armenia, corresponding members of the RAS, Doctors of Medicine, professor, candidates and doctors of biological, physical mathematics and engineering sciences. The editorial board is constantly replenished by experts who work in the CIS and foreign countries.
Six issues of the journal are published per year, the volume is 13.5 conventional printed sheets, 88 printer’s sheets, 1.000 copies. The journal has an identical full-text electronic version, which, simultaneously with the printed version and color drawings, is posted on the sites of the Scientific Electronic Library (SEL) and the journal's website. The journal is distributed through the Rospechat Agency under the contract № 7407 of June 16, 2006, through individual buyers and commercial structures. The publication of articles is free.
The journal is included in the List of Russian Reviewed Scientific Journals of the Higher Attestation Commission. Since 2008 the journal has been available on the Internet and indexed in the RISC database which is placed on Web of Science. Since February 2nd, 2018, the journal "Medical Radiology and Radiation Safety" has been indexed in the SCOPUS abstract and citation database.
Brief electronic versions of the Journal have been publicly available since 2005 on the website of the Medical Radiology and Radiation Safety Journal: http://www.medradiol.ru. Since 2011, all issues of the journal as a whole are publicly available, and since 2016 - full-text versions of scientific articles. Since 2005, subscribers can purchase full versions of other articles of any issue only through the National Electronic Library. The editor of the Medical Radiology and Radiation Safety Journal in accordance with the National Electronic Library agreement has been providing the Library with all its production since 2005 until now.
The main working language of the journal is Russian, an additional language is English, which is used to write titles of articles, information about authors, annotations, key words, a list of literature.
Since 2017 the journal Medical Radiology and Radiation Safety has switched to digital identification of publications, assigning to each article the identifier of the digital object (DOI), which greatly accelerated the search for the location of the article on the Internet. In future it is planned to publish the English-language version of the journal Medical Radiology and Radiation Safety for its development. In order to obtain information about the publication activity of the journal in March 2015, a counter of readers' references to the materials posted on the site from 2005 to the present which is placed on the journal's website. During 2015 - 2016 years on average there were no more than 100-170 handlings per day. Publication of a number of articles, as well as electronic versions of profile monographs and collections in the public domain, dramatically increased the number of handlings to the journal's website to 500 - 800 per day, and the total number of visits to the site at the end of 2017 was more than 230.000.
The two-year impact factor of RISC, according to data for 2017, was 0.439, taking into account citation from all sources - 0.570, and the five-year impact factor of RISC - 0.352.
Medical Radiology and Radiation Safety. 2025. Vol. 70. № 4
DOI:10.33266/1024-6177-2025-70-4-87-95
E.A. Nikolaeva1, A.S. Krylov1, A.A. Ryzhkov1, 2, B.Ya. Narkevich1, A.V. Filimonov1
Indirect Radionuclide Lymphoscintigraphy in the Assessment of Upper Limb Lymphostasis after Breast Cancer Treatment
1 N.N. Blokhin National Medical Research Center of Oncology, Moscow, Russia
2 Russian Medical Academy of Continuous Professional Education, Moscow, Russia
Contact person: E.A. Nikolaeva, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
ABSTRACT
Purpose: To evaluate the significance of quantitative and qualitative parameters of lymphoscintigraphy, their correlation with each other and with the clinical stage of lymphedema in patients undergoing surgery for breast cancer with advanced lymphodissection.
Material and methods: 285 patients with lymphedema were examined from October 2022 to July 2023. After intradermal injection of the radiopharmaceutical 99mTc-nanotope (particle size 5-80 nm) into the first interdigital spaces of both hands, 40 MBq per point, exercises with a rubber expander were performed for 30 minutes. Planar images were obtained 2 hours after injection on a gamma camera and a qualitative description of the images was performed. The quantitative asymmetry index (QIA) was also used, for which the areas of interest were outlined in ovals and shifted to the contralateral side: forearm, shoulder, axillary and subclavicular zones.
Results: In the first degree, lymph nodes of all groups are more often detected (p<0.001), there is no reflux in the shoulder and forearm (p<0.001), more often with intact lymph ducts. In the second degree, reflux in the shoulder and forearm is significantly more often visualized (p<0.001). In the third degree, lymph nodes of all groups are more often not detected and reflux into the subcutaneous lymph networks of the shoulder and forearm is not visualized (p<0.001), more often without visualization of the lymph ducts. The disease was statistically significantly diagnosed at an earlier stage at a younger age (p=0.01). Also, a more severe degree of lymphedema was detected with an increase in BMI (p<0.001). Statistically significantly, with a previous history of remote radiation therapy, lymph nodes in the supra/subclavian region were detected less frequently (p=0.007). In the presence of reflux in the forearm area, the median of the QIA values in the forearm area was significantly higher than in the absence of reflux: Me=5 versus Me=1. In the presence of reflux in the shoulder area, the QIA in the forearm area was significantly higher than in the absence of reflux: Me=3 versus Me=1, respectively. Also, in the presence of reflux in the shoulder area, the median of the QIA in the forearm area was significantly higher than in the absence of reflux: Me=6 versus Me=2, respectively.
Conclusions: Statistically significant correlation indicators were obtained between quantitative and qualitative parameters of lymphoscintigraphy with each other and with the clinical stage of lymphedema, which made it possible to develop criteria for staging the severity of lymphostasis based on them. Lymphoscintigraphy also allows you to determine the nature of the increase in the volume of the upper limb (lymphatic, fibrous), which is a necessary criterion for choosing a plan of rehabilitation measures.
Keywords: lymphostasis, lymphoscintigraphy, radionuclide diagnostics
For citation: Nikolaeva EA, Krylov AS, Ryzhkov AA, Narkevich BYa, Filimonov AV. Indirect Radionuclide Lymphoscintigraphy in the Assessment of Upper Limb Lymphostasis after Breast Cancer Treatment. Medical Radiology and Radiation Safety. 2025;70(4):87–95. (In Russian). DOI:10.33266/1024-6177-2025-70-4-87-95
References
- Soyder A, Taştaban E, Özbaş S, Boylu Ş, Özgün H. Frequency of Early-Stage Lymphedema and Risk Factors in Postoperative Patients with Breast Cancer. J Breast Health. 2014 Apr 1;10(2):92-97. doi: 10.5152/tjbh.2014.1973. PMID: 28331651; PMCID: PMC5351476.
- Cemal Y., Pusic A., Mehrara B.J. Preventative Measures for Lymphedema: Separating Fact from Fiction. J. Am. Coll. Surg. 2011;213:543–551. doi: 10.1016/j.jamcollsurg.2011.07.001.
- McLaughlin SA, Wright MJ, Morris KT, Giron GL, Sampson MR, Brockway JP, et al. Prevalence of lymphedema in women with breast cancer 5 years after sentinel lymph node biopsy or axillary dissection: objective measurements. J Clin Oncol. 2008;26:5213–5219. doi: 10.1200/JCO.2008.16.3725.
- Executive Committee of the International Society of Lymphology The Diagnosis and Treatment of Peripheral Lymphedema: 2020 Consensus Document of the International Society of Lymphology. Lymphology. 2020;53:3–19.
- Lee T.S., Morris C.M., Czerniec S.A., Mangion A.J. Does Lymphedema Severity Affect Quality of Life? Simple Question. Challenging Answers. Lymphat. Res. Biol. 2018;16:85–91. doi: 10.1089/lrb.2016.0049.
- Hwang JM, Hwang JH, Kim TW, Lee SY, Chang HJ, Chu IH. Long-term effects of complex decongestive therapy in breast cancer patients with arm lymphedema after axillary dissection. Ann Rehabil Med. 2013;37:690–697. doi: 10.5535/arm.2013.37.5.690.
- Norman SA, Localio AR, Potashnik SL, Simoes Torpey HA, Kallan MJ, Weber AL, et al. Lymphedema in breast cancer survivors: incidence, degree, time course, treatment, and symptoms. J Clin Oncol. 2009;27:390–397. doi: 10.1200/JCO.2008.17.9291.
- Nagy BI, Mohos B, Tzou CJ. Imaging Modalities for Evaluating Lymphedema. Medicina (Kaunas). 2023 Nov 16;59(11):2016. doi: 10.3390/medicina59112016. PMID: 38004065; PMCID: PMC10673374.
- Polomska A.K., Proulx S.T. Imaging Technology of the Lymphatic System. Adv. Drug Deliv. Rev. 2020;170:294–311. doi: 10.1016/j.addr.2020.08.013.
- Kramer E.L. Lymphoscintigraphy: Defining a Clinical Role. Lymphat. Res. Biol. 2004;2:32–37. doi: 10.1089/1539685041690454.
- Tartaglione G. Advantages of the intradermal lymphoscintigraphy. World J Radiol 2024; 16(7): 241-246 DOI: https://dx.doi.org/10.4329/wjr.v16.i7.241.
- Cusnir R, Leresche M, Pilloud C, Straub M. An investigation of aspects of radiochemical purity of 99mTc-labelled human serum albumin nanocolloid. EJNMMI Radiopharm Chem. 2021 Oct 11;6(1):35. doi: 10.1186/s41181-021-00147-8. PMID: 34633572; PMCID: PMC8505548.
- Hwang JH, Choi JY, Lee JY, Hyun SH, Choi Y, Choe YS, et al. Lymphscintigraphy predicts response to complex physical therapy in patients with early stage extremity lymphedema. Lymphology. 2007;40:172–176.
- Yoo J, Choi JY, Hwang JH, Kim DI, Kim YW, Choe YS, et al. Prognostic value of lymphoscintigraphy in patients with gynecological cancer-related lymphedema. J Surg Oncol. 2014;109:760–763. doi: 10.1002/jso.23588.
- Stanton AW, Modi S, Mellor RH, Peters AM, Svensson WE, Levick JR, et al. A quantitative lymphoscintigraphic evaluation of lymphatic function in the swollen hands of women with lymphoedema following breast cancer treatment. Clin Sci (Lond) 2006;110:553–561. doi: 10.1042/CS20050277.
- Yoo JN, Cheong YS, Min YS, Lee SW, Park HY, Jung TD. Validity of Quantitative Lymphoscintigraphy as a Lymphedema Assessment Tool for Patients With Breast Cancer. Ann Rehabil Med. 2015 Dec;39(6):931-40. doi: 10.5535/arm.2015.39.6.931. Epub 2015 Dec 29. PMID: 26798607; PMCID: PMC4720769.
- Pecking AP, Alberini JL, Wartski M, Edeline V, Cluzan RV. Relationship between lymphoscintigraphy and clinical findings in lower limb lymphedema (LO): toward a comprehensive staging. Lymphology. 2008;41:1–10.
- Vargo M, Aldrich M, Donahue P, Iker E, Koelmeyer L, Crescenzi R, Cheville A. Current diagnostic and quantitative techniques in the field of lymphedema management: a critical review. Med Oncol. 2024 Sep 5;41(10):241. doi: 10.1007/s12032-024-02472-9. PMID: 39235664; PMCID: PMC11377676.
- Gebruers N, Truijen S, Engelborghs S, De Deyn PP. Volumetric evaluation of upper extremities in 250 healthy persons. Clin Physiol Funct Imaging. 2007;27:17–22. doi: 10.1111/j.1475-097X.2007.00708.x.
- Szuba A, Strauss W, Sirsikar SP, Rockson SG. Quantitative radionuclide lymphoscintigraphy predicts outcome of manual lymphatic therapy in breast cancer-related lymphedema of the upper extremity. Nucl Med Commun. 2002;23:1171–1175. doi: 10.1097/00006231-200212000-00004.
- Dalia RM, Martins GR, Barbosa R, de Lima CF, Siqueira CF. Qualitative and quantitative lymphoscintigraphy in the evaluation of lower limbs lymphedema. Braz Arch Biol Technol. 2005;48:159–162.
- Chachaj A., Piller N., Boccardo F., Szuba A. In: Lymphedema: General Pathophysiology, Prevention, and Management in Invasive Cancer BT—Cancer Metastasis Through the Lymphovascular System. Leong S.P., Nathanson S.D., Zager J.S., editors. Springer International Publishing; Cham, Germany: 2022. pp. 261–271
PDF (RUS) Full-text article (in Russian)
Conflict of interest. The authors declare no conflict of interest.
Financing. The study had no sponsorship.
Contribution. Article was prepared with equal participation of the authors.
Article received: 20.03.2025. Accepted for publication: 25.04.2025.