A needle or catheter is inserted into a lymphatic vessel in either the foot or the arm. A contrast agent is injected into the lymphatic vessel. This may be around 2 to 4 millilitres of iotrolan or iodixanol solution. This is performed at a very slow rate of around 0.1 millilitres per minute. This prevents damage to the lymphatic vessel and disrupting the normal rate of lymph flow. It can take approximately 60 to 90 minutes for all the contrast medium to be injected. Once the contrast medium is injected, the catheter is removed, and the incisions are stitched and bandaged. A fluoroscope is used to follow the dye as it spreads through the lymphatic system through the legs, into the groin, and along the back of the abdominal cavity. X-rays are taken of the legs, pelvis, abdomen, and thorax areas. The next day, another set of X-rays may be taken. If a site of cancer (breast cancer or melanoma) is being studied to evaluate spreading, a mixture of blue dye and a radioactive tracer is injected next to the mass. Special cameras detect the spread of tracer along lymph channels to outlying lymph nodes. A surgeon will then use the visible blue dye or radioactivity within nodes to guide biopsy within adjacent tissues (such as the arm pit for breast cancer) to determine possible routes of cancer spread.
Lymphogram
Radiochemistry
DMSA scan
Narcology
Thyroid function tests
Bacteriology
Whole body imaging
Cytopathology