Technetium tc-99m tilmanocept, diagnostic, up to 0.5 millicuries
HCPCS code
Name of the Procedure:
Common Name(s): Tc-99m Tilmanocept Scintigraphy
Technical/Medical Term(s): Technetium Tc-99m Tilmanocept Imaging, Lymphoscintigraphy
Summary
Tc-99m Tilmanocept is a diagnostic imaging procedure used to evaluate lymphatic function. A small amount of Technetium Tc-99m, a radioactive tracer, is injected and visualized using a special camera to help identify lymph nodes and determine the presence of certain diseases.
Purpose
Tc-99m Tilmanocept imaging is primarily used to:
- Identify sentinel lymph nodes in cancer patients, particularly those with breast cancer or melanoma.
- Guide surgical planning by mapping lymphatic drainage.
- Detect abnormal lymphatic function or blockages.
Indications
- Patients with diagnosed breast cancer or melanoma.
- Determination of sentinel lymph nodes for surgical removal or biopsy.
- Evaluation of unexplained lymphatic swelling or blockages.
Preparation
- Patients may be advised to fast for a few hours before the procedure.
- Patients should inform their doctor of all medications and allergies.
- Pre-procedure assessments may include a physical exam and blood tests.
Procedure Description
- A small syringe is used to inject Tc-99m Tilmanocept near the tumor or area of interest.
- The patient waits for the tracer to travel to the lymph nodes, typically taking 15-60 minutes.
- During this time, a gamma camera captures images of the tracer’s path and the nodes it gathers in.
- The images are analyzed to identify sentinel lymph nodes.
- The procedure usually does not require anesthesia.
Duration
The entire procedure typically takes about 1-2 hours, including waiting time for the tracer to distribute.
Setting
The procedure is performed in a hospital’s nuclear medicine department or an outpatient imaging center.
Personnel
- A nuclear medicine technologist administers the tracer and captures images.
- A radiologist interprets the images.
- Occasionally, a surgeon may be involved to coordinate the findings with surgical planning.
Risks and Complications
- Rare allergic reactions to the tracer.
- Slight discomfort or pain at the injection site.
- Minimal radiation exposure, considered very low risk.
Benefits
- Provides accurate mapping of lymph nodes, aiding in the appropriate surgical approach.
- Non-invasive, with minimal discomfort.
- Can detect lymphatic abnormalities early to guide timely intervention.
Recovery
- There are generally no significant side effects, allowing immediate resumption of daily activities.
- Follow-up appointments may be scheduled based on imaging results.
Alternatives
- Sentinel lymph node biopsy without preoperative imaging can be more invasive.
- Other imaging modalities like MRI or CT scans, which might not offer the same precision for lymph node mapping.
- Ultrasound, which is less effective in mapping lymph flow.
Patient Experience
- Patients might experience slight discomfort during the injection.
- The procedure is generally painless and does not cause significant discomfort afterwards.
- Pain management is seldom required, and comfort measures are typically limited to addressing any mild post-injection soreness.