Quantitative Lymph Imaging for Assessment of Lymph Function using Indocyanine Green Fluorescence Lymphography

Unno, Naoki; Nishiyama, Motohiro; Suzuki, Minoru; Yamamoto, Naoto; Inuzuka, Kazunori; Sagara, Daisuke; Tanaka, Hiroki; Konno, Hiroyuki

doi:10.1016/j.ejvs.2008.04.013

Cited by 149 publications

(117 citation statements)

References 24 publications

Supporting

Mentioning

114

Contrasting

Unclassified

Order By: Relevance

“…14 NIR imaging with an FDA-approved fluorescent dye, indocyanine green (ICG), has recently emerged as a novel method for quantitative assessment of lymphatic function in animals and humans; 3,[15][16][17][18] a technique in which ICG is injected intradermally, excited with a laser diode, and imaged with an NIR-sensitive detector as it is taken up by the lymphatic system. 19,20 NIR lymphatic imaging, although in its infancy, has shown great promise to enhance the understanding of functional lymphatic transport characteristics both in health and disease, as the technology has the potential to develop into an earlystage diagnostic of lymphatic dysfunction.…”

Section: Introductionmentioning

confidence: 99%

Sensitivity analysis of near-infrared functional lymphatic imaging

2012

View full text Add to dashboard Cite

Abstract. Near-infrared imaging of lymphatic drainage of injected indocyanine green (ICG) has emerged as a new technology for clinical imaging of lymphatic architecture and quantification of vessel function, yet the imaging capabilities of this approach have yet to be quantitatively characterized. We seek to quantify its capabilities as a diagnostic tool for lymphatic disease. Imaging is performed in a tissue phantom for sensitivity analysis and in hairless rats for in vivo testing. To demonstrate the efficacy of this imaging approach to quantifying immediate functional changes in lymphatics, we investigate the effects of a topically applied nitric oxide (NO) donor glyceryl trinitrate ointment. Premixing ICG with albumin induces greater fluorescence intensity, with the ideal concentration being 150 μg∕mL ICG and 60 g∕L albumin. ICG fluorescence can be detected at a concentration of 150 μg∕mL as deep as 6 mm with our system, but spatial resolution deteriorates below 3 mm, skewing measurements of vessel geometry. NO treatment slows lymphatic transport, which is reflected in increased transport time, reduced packet frequency, reduced packet velocity, and reduced effective contraction length. NIR imaging may be an alternative to invasive procedures measuring lymphatic function in vivo in real time.

show abstract

Section: Introductionmentioning

confidence: 99%

Sensitivity analysis of near-infrared functional lymphatic imaging

2012

View full text Add to dashboard Cite

show abstract

“…In our institute, the time-activity curve of the lower limbs was used to assess lymph function using dynamic lymphoscintigraphy. 14 In the lower limb, where the radionuclide was injected into the foot and the time-activity curves of the knee and groin were created, the time at which the counts rose was determined to be the SAT. 14 In cases in which the SLNs are located at a distance from the primary focus, we could determine the time at which the counts rose as the SAT.…”

Section: Discussionmentioning

confidence: 99%

Measurement of cutaneous lymphatic flow rates in patients with skin cancer: area extraction method

Fujiwara

Sawada

Kasuya

et al. 2014

The Journal of Dermatology

View full text Add to dashboard Cite

Some recent reports have revealed that the long scintigraphic appearance time (SAT), defined as the time between radionuclide injection and first sentinel lymph node (SLN) visualization in lymphoscintigraphy, is a negative predictive parameter of nodal metastasis in patients with melanoma. However, most of the methods used to measure the SAT were ambiguous because they utilized visualization in lymphoscintigraphy. We herein introduce a novel method by which to measure the SAT and lymphatic flow rate. The data of 33 patients with primary skin cancer were used. Sequential images were obtained using dynamic lymphoscintigraphy, and a time-activity curve of the SLN was created. The time at which the counts reached plateau was newly defined as an alternative to the SAT and was termed the scintigraphic saturation time (SST). The figure obtained by division of the distance by the SST was newly defined as an alternative to the lymphatic flow rate and termed the lymphatic transit rate (LTR). The SST was clearly determined. It ranged from 220 to 1430 s (mean, 805 s). Pathological examination revealed nodal metastasis in five patients. In 28 patients without metastasis, the mean LTR was in the order of lower limbs (4.07 AE 0.35 cm/min), upper limbs (2.67 AE 0.33 cm/min), trunk (1.79 AE 0.47 cm/min), and head and neck (1.11 AE 0.22 cm/min). The LTRs were higher in patients with nodal metastasis than those without. This method may be effective for accurate measurement of the SAT and lymphatic flow rate.

show abstract

“…Volume is measured by 3 methods including tape measurements, perometry, and water displacement. These measurements of volume illustrate the presence and severity of the condition (Unno et al, 2008). Tape measurements are most accurate when done at precisely defined intervals and when taken by the same individual, ultimately using geometric formulas to determine the total volume.…”

Section: Diagnosis Of Lymphedemamentioning

confidence: 99%

“…Water displacement measurements are taken by immersing the limb in a large cylinder and determining the volume of water displaced, or pushed out of the cylinder. However, measuring volume cannot differentiate lymphedema from other types of edema and is a technique best used as follow up for treatment of lymphedema rather then diagnosis (Unno et al, 2008).…”

Section: Diagnosis Of Lymphedemamentioning

confidence: 99%

“…Since lymphedema is the result of interstitial fluid build up these imaging techniques are often used to determine the cause of the condition as well as lymphedema that is a result of an untreated cancer (Astrom et al, 2001;Deltombe et al, 2007;Unno et al, 2008) Bioimpedance Spectroscopy (BIS) measures water content in tissues by passing a small, harmless, electrical current through the limb in order to measure the impedance to current flow. The higher the water content in the area the lower the resistance.…”

Section: Diagnosis Of Lymphedemamentioning

confidence: 99%

See 1 more Smart Citation

Arm Lymphedema as a Consequence of Breast Cancer Therapy

Wernicke¹,

Goltser²

2012

Novel Strategies in Lymphedema

View full text Add to dashboard Cite

Lymphedema is a swelling caused by the abnormal accumulation of lymphatic fluid in the skin. Lymphedema can be caused by burns, injury, surgery, radiation therapy or cancer treatment that cancer survivors undergo. Risk of developing lymphedema is high especially in those with breast or prostate cancer. It is hereditary and can appear without warning at any time of life and is related to obesity and circulatory problems. If not treated, lymphedema can be painful and lead to life-threatening infections. This book will help physicians who deal with lymphedema. It will help you understand how the lymphatic system works, how lymphedema is diagnosed, how to cope with the challenges of lymphedema, how to find treatment, and how to deal with insurance issues.Novel Strategies in Lymphedema is for those with, or at risk of, developing lymphedema, and the healthcare professionals who care for them.

show abstract

Quantitative Lymph Imaging for Assessment of Lymph Function using Indocyanine Green Fluorescence Lymphography

Abstract: ICG fluorescence lymphography has the potential to become an alternative lymphatic imaging technique to assess lymph function.

Cited by 149 publications

References 24 publications

Sensitivity analysis of near-infrared functional lymphatic imaging

Sensitivity analysis of near-infrared functional lymphatic imaging

Measurement of cutaneous lymphatic flow rates in patients with skin cancer: area extraction method

Arm Lymphedema as a Consequence of Breast Cancer Therapy

Contact Info

Product

Resources

About