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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...
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Published in: | Archives of plastic surgery 2022, 49(1), , pp.99-107 |
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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. |
doi_str_mv | 10.5999/aps.2021.01235 |
format | article |
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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.</description><identifier>ISSN: 2234-6163</identifier><identifier>EISSN: 2234-6171</identifier><identifier>DOI: 10.5999/aps.2021.01235</identifier><identifier>PMID: 35086318</identifier><language>eng</language><publisher>333 Seventh Avenue, 18th Floor, New York, NY 10001, USA: Thieme Medical Publishers, Inc</publisher><subject>Extremity/Lymphedema ; lymphedema ; lymphography ; superficial lymphatic system ; 성형외과학</subject><ispartof>Archives of Plastic Surgery, 2022, 49(1), , pp.99-107</ispartof><rights>The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonCommercial License, permitting unrestricted noncommercial use, distribution, and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes. (https://creativecommons.org/licenses/by-nc/4.0/)</rights><rights>Copyright © 2022 The Korean Society of Plastic and Reconstructive Surgeons 2022</rights><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c502t-a4fd8573d319b7db0f7b738580e3b1946f44f2f5225e51cfe72206fe98d166e63</citedby><cites>FETCH-LOGICAL-c502t-a4fd8573d319b7db0f7b738580e3b1946f44f2f5225e51cfe72206fe98d166e63</cites><orcidid>0000-0001-8867-5237 ; 0000-0003-1422-2205 ; 0000-0002-4298-9828 ; 0000-0002-3267-5884 ; 0000-0001-8614-5195 ; 0000-0002-6073-6832 ; 0000-0002-9467-2021 ; 0000-0002-8816-6309</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8795642/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8795642/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35086318$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://www.kci.go.kr/kciportal/ci/sereArticleSearch/ciSereArtiView.kci?sereArticleSearchBean.artiId=ART002805479$$DAccess content in National Research Foundation of Korea (NRF)$$Hfree_for_read</backlink></links><search><creatorcontrib>Oh, Anna</creatorcontrib><creatorcontrib>Kajita, Hiroki</creatorcontrib><creatorcontrib>Imanishi, Nobuaki</creatorcontrib><creatorcontrib>Sakuma, Hisashi</creatorcontrib><creatorcontrib>Takatsume, Yoshifumi</creatorcontrib><creatorcontrib>Okabe, Keisuke</creatorcontrib><creatorcontrib>Aiso, Sadakazu</creatorcontrib><creatorcontrib>Kishi, Kazuo</creatorcontrib><title>Three-dimensional analysis of dermal backflow in cancer-related lymphedema using photoacoustic lymphangiography</title><title>Archives of plastic surgery</title><addtitle>Arch Plast Surg</addtitle><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.</description><subject>Extremity/Lymphedema</subject><subject>lymphedema</subject><subject>lymphography</subject><subject>superficial lymphatic system</subject><subject>성형외과학</subject><issn>2234-6163</issn><issn>2234-6171</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>0U6</sourceid><sourceid>DOA</sourceid><recordid>eNp1kk2L2zAQhk1p6S7bvfZYfGwPTvVhydKlsCz9CCwUSnoWsjSKldiWKzlb8u-rxNvQPVQHjZh559FIvEXxFqMVk1J-1FNaEUTwCmFC2YvimhBaVxw3-OXlzOlVcZvSDuXFEeMMvy6uKEOCUyyui7DpIkBl_QBj8mHUfanzdkw-lcGVFuKQU602e9eH36UfS6NHA7GK0OsZbNkfh6kDC4MuD8mP23Lqwhy0CYc0e7OU9bj1YRv11B3fFK-c7hPcPsWb4ueXz5v7b9XD96_r-7uHyjBE5krXzgrWUEuxbBvbIte0DRVMIKAtljV3de2IY4QwYNg4aAhB3IEUFnMOnN4UHxbuGJ3aG6-C9ue4DWof1d2PzVpJSRDlMmvXi9YGvVNT9IOOx3PDORHiVumYH9ODchQhog1tBXG1RahtObNMgHRWM-FMZn1aWNOhHcAaGOeo-2fQ55XRd3mmRyUayXhNMuD9EyCGXwdIsxp8MtD3eoT8p4pwQoUQWJzeuFqkJoaUIrjLNRipk0FUNog6GUSdDZIb3v073EX-1w5ZUC2CufMwgNqFQ8xuSP8D_gFDScfq</recordid><startdate>202201</startdate><enddate>202201</enddate><creator>Oh, Anna</creator><creator>Kajita, Hiroki</creator><creator>Imanishi, Nobuaki</creator><creator>Sakuma, Hisashi</creator><creator>Takatsume, Yoshifumi</creator><creator>Okabe, Keisuke</creator><creator>Aiso, Sadakazu</creator><creator>Kishi, Kazuo</creator><general>Thieme Medical Publishers, Inc</general><general>Korean Society of Plastic and Reconstructive Surgeons</general><general>대한성형외과학회</general><scope>0U6</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><scope>ACYCR</scope><orcidid>https://orcid.org/0000-0001-8867-5237</orcidid><orcidid>https://orcid.org/0000-0003-1422-2205</orcidid><orcidid>https://orcid.org/0000-0002-4298-9828</orcidid><orcidid>https://orcid.org/0000-0002-3267-5884</orcidid><orcidid>https://orcid.org/0000-0001-8614-5195</orcidid><orcidid>https://orcid.org/0000-0002-6073-6832</orcidid><orcidid>https://orcid.org/0000-0002-9467-2021</orcidid><orcidid>https://orcid.org/0000-0002-8816-6309</orcidid></search><sort><creationdate>202201</creationdate><title>Three-dimensional analysis of dermal backflow in cancer-related lymphedema using photoacoustic lymphangiography</title><author>Oh, Anna ; Kajita, Hiroki ; Imanishi, Nobuaki ; Sakuma, Hisashi ; Takatsume, Yoshifumi ; Okabe, Keisuke ; Aiso, Sadakazu ; Kishi, Kazuo</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c502t-a4fd8573d319b7db0f7b738580e3b1946f44f2f5225e51cfe72206fe98d166e63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Extremity/Lymphedema</topic><topic>lymphedema</topic><topic>lymphography</topic><topic>superficial lymphatic system</topic><topic>성형외과학</topic><toplevel>online_resources</toplevel><creatorcontrib>Oh, Anna</creatorcontrib><creatorcontrib>Kajita, Hiroki</creatorcontrib><creatorcontrib>Imanishi, Nobuaki</creatorcontrib><creatorcontrib>Sakuma, Hisashi</creatorcontrib><creatorcontrib>Takatsume, Yoshifumi</creatorcontrib><creatorcontrib>Okabe, Keisuke</creatorcontrib><creatorcontrib>Aiso, Sadakazu</creatorcontrib><creatorcontrib>Kishi, Kazuo</creatorcontrib><collection>Thieme Connect Journals Open Access</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><collection>Korean Citation Index</collection><jtitle>Archives of plastic surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Oh, Anna</au><au>Kajita, Hiroki</au><au>Imanishi, Nobuaki</au><au>Sakuma, Hisashi</au><au>Takatsume, Yoshifumi</au><au>Okabe, Keisuke</au><au>Aiso, Sadakazu</au><au>Kishi, Kazuo</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Three-dimensional analysis of dermal backflow in cancer-related lymphedema using photoacoustic lymphangiography</atitle><jtitle>Archives of plastic surgery</jtitle><addtitle>Arch Plast Surg</addtitle><date>2022-01</date><risdate>2022</risdate><volume>49</volume><issue>1</issue><spage>99</spage><epage>107</epage><pages>99-107</pages><issn>2234-6163</issn><eissn>2234-6171</eissn><abstract>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.</abstract><cop>333 Seventh Avenue, 18th Floor, New York, NY 10001, USA</cop><pub>Thieme Medical Publishers, Inc</pub><pmid>35086318</pmid><doi>10.5999/aps.2021.01235</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0001-8867-5237</orcidid><orcidid>https://orcid.org/0000-0003-1422-2205</orcidid><orcidid>https://orcid.org/0000-0002-4298-9828</orcidid><orcidid>https://orcid.org/0000-0002-3267-5884</orcidid><orcidid>https://orcid.org/0000-0001-8614-5195</orcidid><orcidid>https://orcid.org/0000-0002-6073-6832</orcidid><orcidid>https://orcid.org/0000-0002-9467-2021</orcidid><orcidid>https://orcid.org/0000-0002-8816-6309</orcidid><oa>free_for_read</oa></addata></record> |
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subjects | Extremity/Lymphedema lymphedema lymphography superficial lymphatic system 성형외과학 |
title | Three-dimensional analysis of dermal backflow in cancer-related lymphedema using photoacoustic lymphangiography |
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