To help determine if cancer has spread to the lymph nodes and lymph vessels your oncologist may order a lymphangiogram. The lymph nodes and vessels are not usually seen on a normal x-ray, so a dye or radioactive compound is injected into the nodes. X-rays are taken to see if there are any blockages indicating the presence of cancer.
What to expect
The test is performed as an outpatient procedure in a hospital radiology department, one of our outpatient facilities or in the oncologist's office.
Before the test
You'll be given instructions before your appointment.
- Do not eat or drink for several hours before the test
- Arrive early for your test because you will need to fill out paperwork
- Bring identification and your insurance information
- You'll be asked about bleeding problems or any allergic reactions to x-ray contrast material or iodine containing substances
- You may be offered a sedative to help you relax
- You'll be put in a special chair or on an x-ray table.
If the site of a cancer tumor is being studied to evaluate spreading, a mixture of blue dye and a radioactive tracer is injected next to the tumor; otherwise the dye is injected into your feet. When the dye is injected into the feet, here's what you can expect:
- The skin of each foot is cleansed and sterilized.
- A small amount of blue dye is injected between the toes into the webbing.
- After 15 minutes, the technician will look for bluish lines that should begin to appear on the top of the foot. This defines the lymphatics.
- You'll be given a local anesthetic.
- A small incision is made into one of the larger blue lines.
- A needle or catheter is inserted into a lymphatic channel in each foot.
- A contrast dye is injected into each foot at a very slow rate, in most cases about 60-90 minutes. There may be a feeling of pressure as the contrast dye is injected, and there may be some discomfort behind the knees and in the groin area.
- A special x-ray machine called a fluoroscope projects the images on a TV monitor as it follows the dye.
- As the dye spreads through the lymphatic system up the legs, into the groin, and along the back of the abdominal cavity, images are projected on the monitor.
- Special cameras detect the spread of the dye and tracer along the lymph channels to outlying nodes.
- Once the contrast dye has been completely injected, the catheter is removed and the incisions are stitched and bandaged.
- X-rays are taken of the legs, pelvis, abdomen, and chest areas.
- You may be asked to return the next day for another set of x-rays.
Once you are home you can expect that:
- The incision site will be sore for a few days.
- The blue dye will color the urine and stool for about 48 hours.
- Your skin and possibly vision will take on a bluish cast temporarily.