AI Article Synopsis
- Secondary lymphedema often arises after cancer surgeries or treatments, and (micro) surgical procedures like lymphovenous bypass offer potential relief for those not responding to standard therapies.
- A comprehensive literature search identified 129 studies employing six different imaging methods to detect lymphatic vessels in both healthy and lymphedema-affected individuals.
- Near-infrared fluorescence lymphangiography (NIRF-L) is emerging as a preferred tool for surgical planning over traditional lymphoscintigraphy, while methods like magnetic resonance lymphography (MRL), high-frequency ultrasound, and photoacoustic imaging (PAI) have varying degrees of effectiveness and practical challenges that warrant further research.
Article Abstract
Background: Secondary lymphedema is a common complication after surgical or radiotherapeutic cancer treatment. (Micro) surgical intervention such as lymphovenous bypass and vascularized lymph node transfer is a possible solution in patients who are refractory to conventional treatment. Adequate imaging is needed to identify functional lymphatic vessels and nearby veins for surgical planning.
Methods: A systematic literature search of the Embase, MEDLINE ALL via Ovid, Web of Science Core Collection and Cochrane CENTRAL Register of Trials databases was conducted in February 2022. Studies reporting on lymphatic vessel detection in healthy subjects or secondary lymphedema of the limbs or head and neck were analyzed.
Results: Overall, 129 lymphatic vessel imaging studies were included, and six imaging modalities were identified. The aim of the studies was diagnosis, severity staging, and/or surgical planning.
Conclusion: Due to its utility in surgical planning, near-infrared fluorescence lymphangiography (NIRF-L) has gained prominence in recent years relative to lymphoscintigraphy, the current gold standard for diagnosis and severity staging. Magnetic resonance lymphography (MRL) gives three-dimensional detailed information on the location of both lymphatic vessels and veins and the extent of fat hypertrophy; however, MRL is less practical for routine presurgical implementation due to its limited availability and high cost. High frequency ultrasound imaging can provide high resolution imaging of lymphatic vessels but is highly operator-dependent and accurate identification of lymphatic vessels is difficult. Finally, photoacoustic imaging (PAI) is a novel technique for visualization of functional lymphatic vessels and veins. More evidence is needed to evaluate the utility of PAI in surgical planning.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9726677 | PMC |
| http://dx.doi.org/10.1245/s10434-022-12552-7 | DOI Listing |
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