A Novel Way of Standardization of ICG Lymphangiography Reporting

Abstract

Background Indocyanine green (ICG) lymphangiography is being increasingly employed to assess the severity of lymphedema, locate the areas of patent linear lymphatics and dermal backflow and plan treatment. This study suggests a novel method of reporting ICG findings in extremities to enable easy understanding among surgeons and physiotherapists and avoid repeat testing when a patient visits a disparate lymphedema center or clinician. Methods A reporting protocol was developed in the lymphedema clinic of the plastic surgery department, and patients were asked to bring along the report in every subsequent review. The ICG findings were recorded on the fluorescence imaging system as well. The report was prepared by one and analyzed by two different clinicians without repeating the test on 10 consecutive patients. Results The interrater reliability of findings in the report was found to be 98.7% among the three clinicians. Conclusion The reporting system was found to be illustratable and reproducible

Indocyanine Green Lymphography in Conservative Lymphedema Therapy: A Scoping Review

“…Five studies proposed novel ICG staging systems and assessed their reproducibility 45,48,58,71,74. Additionally, Chandrappa and others43 explored interrater reliability of a reporting protocol for communicating ICG lymphography findings among health professionals. One study explored the relationship between ICG severity stage and altered lymphatic drainage pathways, linking staging level to a proposed conservative therapy plan 16…”

“…Comparison of ICG Staging Systems. ICG lymphography staging systems were the focus of exploration in 12 studies, 43,45,48,52,58,71,74,[77][78][79][80]82 with 10 different staging systems proposed. Of these 10 systems, only 1 was applied to both upper and lower limbs, 46 with the remaining 9 specific to a limb or body region.…”

Advances in optical molecular imaging for neural visualization

“…Unlike the medical device market, clinical Frontiers in Bioengineering and Biotechnology frontiersin.org approval has only been granted for a select few fluorescent agents, namely, fluorescein (FS), methylene blue (MB), 5-aminolevulinic acid (5-ALA), and indocyanine green (ICG). These agents have been clinically approved for uses such as tumor labeling (Waqas et al, 2017), angiography (Chotard et al, 2019), ureterography (Kaplan-Marans et al, 2019), sentinel lymph node identification (Chandrappa et al, 2020;Zhang et al, 2022) and cholangiography (Pardo Aranda et al, 2023). Compared to tubular structures such as blood vessels, ureters, and bile ducts, the bundled structure of nerve fibers makes it challenging for fluorescent agents to color, thus in vivo, imaging is difficult to achieve (Figures 2A,B).…”

Effects of Intermittent Pneumatic Compression on Lower Limb Lymphedema in Patients with Type 2 Diabetes Mellitus: A Pilot Randomized Controlled Trial

“…While a promising tool that has recently emerged for arm volume measurement is a three-dimensional laser scanner (3DLS) [ 23 , 24 , 25 ]. This device allows the real-time digital reconstruction of three-dimensional objects and shows great performances in terms of accuracy, non-invasiveness, and cost-effectiveness [ 26 ]. Moreover, the 3DLS detects extremely small variations of volume including the presence and reduction of gibbousness and swelling (e.g., a consequence of bandages, press therapy, manual lymph drainage) [ 25 ].…”

“…In fact, this imaging technique allows the regional lymph nodes visualization and deep lymphatic nodes localization; nevertheless, this approach is difficult to be applied in the common clinical practice [ 15 ]. The indocyanine green (ICG) lymphangiography is a newly developed diagnostic approach that consents to delineating the lymphatics vessels, without any radioactive exposure [ 26 ].…”