Three-dimensional analysis of dermal backflow in cancer-related lymphedema using photoacoustic lymphangiography
Background Dermal backflow (DBF), which refers to lymphatic reflux due to lymphatic valve insufficiency, is a diagnostic finding in lymphedema. However, the three-dimensional structure of DBF remains unknown. Photoacoustic lymphangiography (PAL) is a new technique that enables the visualization of t...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Thieme Medical Publishers, Inc.
2022-01-01
|
| Series: | Archives of Plastic Surgery |
| Subjects: | |
| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.5999/aps.2021.01235 |
| _version_ | 1811302957139886080 |
|---|---|
| author | Anna Oh Hiroki Kajita Nobuaki Imanishi Hisashi Sakuma Yoshifumi Takatsume Keisuke Okabe Sadakazu Aiso Kazuo Kishi |
| author_facet | Anna Oh Hiroki Kajita Nobuaki Imanishi Hisashi Sakuma Yoshifumi Takatsume Keisuke Okabe Sadakazu Aiso Kazuo Kishi |
| author_sort | Anna Oh |
| collection | DOAJ |
| description | Background Dermal backflow (DBF), which refers to lymphatic reflux due to lymphatic valve insufficiency, is a diagnostic finding in lymphedema. However, the three-dimensional structure of DBF remains unknown. Photoacoustic lymphangiography (PAL) is a new technique that enables the visualization of the distribution of light-absorbing molecules, such as hemoglobin or indocyanine green (ICG), and can provide three-dimensional images of superficial lymphatic vessels and the venous system. This study reports the use of PAL to visualize DBF structures in the extremities of patients with lymphedema after cancer surgery.
Methods Patients with a clinical or lymphographic diagnosis of lymphedema who previously underwent surgery for cancer at one of two participating hospitals were included in this study. PAL was performed using the PAI-05 system. ICG was administered subcutaneously in the affected hand or foot, and ICG fluorescence lymphography was performed using a nearinfrared camera system prior to PAL.
Results Between April 2018 and January 2019, 21 patients were enrolled and examined using PAL. The DBF was composed of dense, interconnecting, three-dimensional lymphatic vessels. It was classified into three patterns according to the composition of the lymphatic vessels: a linear structure of lymphatic collectors (pattern 1), a network of lymphatic capillaries and lymphatic collectors in an underlying layer (pattern 2), and lymphatic capillaries and precollectors with no lymphatic collectors (pattern 3).
Conclusions PAL showed the structure of DBF more precisely than ICG fluorescence lymphography. The use of PAL to visualize DBF assists in understanding the pathophysiology and assessing the severity of cancer-related lymphedema. |
| first_indexed | 2024-04-13T07:38:36Z |
| format | Article |
| id | doaj.art-f3002ac3b82f4d00bb65d58e9fda58fc |
| institution | Directory Open Access Journal |
| issn | 2234-6163 2234-6171 |
| language | English |
| last_indexed | 2024-04-13T07:38:36Z |
| publishDate | 2022-01-01 |
| publisher | Thieme Medical Publishers, Inc. |
| record_format | Article |
| series | Archives of Plastic Surgery |
| spelling | doaj.art-f3002ac3b82f4d00bb65d58e9fda58fc2022-12-22T02:56:00ZengThieme Medical Publishers, Inc.Archives of Plastic Surgery2234-61632234-61712022-01-0149019910710.5999/aps.2021.012353949Three-dimensional analysis of dermal backflow in cancer-related lymphedema using photoacoustic lymphangiographyAnna Oh0Hiroki Kajita1Nobuaki Imanishi2Hisashi Sakuma3Yoshifumi Takatsume4Keisuke Okabe5Sadakazu Aiso6Kazuo Kishi7Department of Plastic and Reconstructive Surgery, Keio University School of Medicine, Tokyo, JapanDepartment of Plastic and Reconstructive Surgery, Keio University School of Medicine, Tokyo, JapanDepartment of Anatomy, Keio University School of Medicine, Tokyo, JapanDepartment of Plastic and Reconstructive Surgery, Tokyo Dental College Ichikawa General Hospital, Ichikawa, JapanDepartment of Anatomy, Keio University School of Medicine, Tokyo, JapanDepartment of Plastic and Reconstructive Surgery, Keio University School of Medicine, Tokyo, JapanDepartment of Anatomy, Keio University School of Medicine, Tokyo, JapanDepartment of Plastic and Reconstructive Surgery, Keio University School of Medicine, Tokyo, JapanBackground Dermal backflow (DBF), which refers to lymphatic reflux due to lymphatic valve insufficiency, is a diagnostic finding in lymphedema. However, the three-dimensional structure of DBF remains unknown. Photoacoustic lymphangiography (PAL) is a new technique that enables the visualization of the distribution of light-absorbing molecules, such as hemoglobin or indocyanine green (ICG), and can provide three-dimensional images of superficial lymphatic vessels and the venous system. This study reports the use of PAL to visualize DBF structures in the extremities of patients with lymphedema after cancer surgery. Methods Patients with a clinical or lymphographic diagnosis of lymphedema who previously underwent surgery for cancer at one of two participating hospitals were included in this study. PAL was performed using the PAI-05 system. ICG was administered subcutaneously in the affected hand or foot, and ICG fluorescence lymphography was performed using a nearinfrared camera system prior to PAL. Results Between April 2018 and January 2019, 21 patients were enrolled and examined using PAL. The DBF was composed of dense, interconnecting, three-dimensional lymphatic vessels. It was classified into three patterns according to the composition of the lymphatic vessels: a linear structure of lymphatic collectors (pattern 1), a network of lymphatic capillaries and lymphatic collectors in an underlying layer (pattern 2), and lymphatic capillaries and precollectors with no lymphatic collectors (pattern 3). Conclusions PAL showed the structure of DBF more precisely than ICG fluorescence lymphography. The use of PAL to visualize DBF assists in understanding the pathophysiology and assessing the severity of cancer-related lymphedema.http://www.thieme-connect.de/DOI/DOI?10.5999/aps.2021.01235lymphedemalymphographysuperficial lymphatic system |
| spellingShingle | Anna Oh Hiroki Kajita Nobuaki Imanishi Hisashi Sakuma Yoshifumi Takatsume Keisuke Okabe Sadakazu Aiso Kazuo Kishi Three-dimensional analysis of dermal backflow in cancer-related lymphedema using photoacoustic lymphangiography Archives of Plastic Surgery lymphedema lymphography superficial lymphatic system |
| title | Three-dimensional analysis of dermal backflow in cancer-related lymphedema using photoacoustic lymphangiography |
| title_full | Three-dimensional analysis of dermal backflow in cancer-related lymphedema using photoacoustic lymphangiography |
| title_fullStr | Three-dimensional analysis of dermal backflow in cancer-related lymphedema using photoacoustic lymphangiography |
| title_full_unstemmed | Three-dimensional analysis of dermal backflow in cancer-related lymphedema using photoacoustic lymphangiography |
| title_short | Three-dimensional analysis of dermal backflow in cancer-related lymphedema using photoacoustic lymphangiography |
| title_sort | three dimensional analysis of dermal backflow in cancer related lymphedema using photoacoustic lymphangiography |
| topic | lymphedema lymphography superficial lymphatic system |
| url | http://www.thieme-connect.de/DOI/DOI?10.5999/aps.2021.01235 |
| work_keys_str_mv | AT annaoh threedimensionalanalysisofdermalbackflowincancerrelatedlymphedemausingphotoacousticlymphangiography AT hirokikajita threedimensionalanalysisofdermalbackflowincancerrelatedlymphedemausingphotoacousticlymphangiography AT nobuakiimanishi threedimensionalanalysisofdermalbackflowincancerrelatedlymphedemausingphotoacousticlymphangiography AT hisashisakuma threedimensionalanalysisofdermalbackflowincancerrelatedlymphedemausingphotoacousticlymphangiography AT yoshifumitakatsume threedimensionalanalysisofdermalbackflowincancerrelatedlymphedemausingphotoacousticlymphangiography AT keisukeokabe threedimensionalanalysisofdermalbackflowincancerrelatedlymphedemausingphotoacousticlymphangiography AT sadakazuaiso threedimensionalanalysisofdermalbackflowincancerrelatedlymphedemausingphotoacousticlymphangiography AT kazuokishi threedimensionalanalysisofdermalbackflowincancerrelatedlymphedemausingphotoacousticlymphangiography |