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Medicina
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Imaging Technology of the Lymphatic System
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Imaging Technology of the Lymphatic System

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Surgery".

Deadline for manuscript submissions: closed (31 July 2023) | Viewed by 7040

Special Issue Editors

Dr. Akitatsu Hayashi

E-Mail Website
Guest Editor
Department of Lymphedema Center, Kameda General Hospital, Chiba 296-0041, Japan
Interests: lymphedema; lymphography; indocyanine green
Prof. Dr. Joon Pio Hong

E-Mail Website
Guest Editor
Department of Plastic and Reconstructive Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea
Interests: microsurgery; lymphedema; supermicrosurgery; diabetic foot; wound healing; lower extremity reconstruction
Dr. Giuseppe Visconti

E-Mail Website
Guest Editor
Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
Interests: supermicrosurgery; lymphatic surgery; breast surgery; breast reconstruction

Special Issue Information

Dear Colleagues,

The lymphatic system has been thought to be more difficult to “make visible”. It is normally not apparent to the naked eye even during surgery, and its organization as a one-way transport network means that the entire system cannot be easily visualized with a simple injection. This is why imaging techniques for visualization of the lymphatic system are less well developed than those for the imaging of blood vessels.

Visualization of the lymphatic system is clinically necessary during diagnosis or treatment of lymphedema and other lymphatic disorders; it is used for identifying and monitoring lymphedema and for locating lymphatic structures so they can be spared during surgical procedures. Continued advancements in lymphatic imaging technology will be critical for the optimization of diagnostic methods for lymphatic disorders and the evaluation of novel therapies targeting the lymphatic system.

The aim and scope of this Special Issue is to discuss current and future imaging technologies and techniques of lymphatic systems, which offer better solutions for the diagnosis and treatment of lymphedema and other lymphatic disorders.

We are soliciting preclinical studies (anatomical, technical reports) and clinical studies (PROM, outcome, registry data, epidemiological), with a focus on original articles. For the submission of reviews, reporting according to the PRISMA guidelines is required.

Dr. Akitatsu Hayashi
Prof. Dr. Joon Pio Hong
Dr. Giuseppe Visconti
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Medicina is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2200 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

 

Keywords

  • imaging
  • technologies
  • visualization
  • lymphatic vessels
  • lymph node
  • lymphatic function
  • lymphography

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Published Papers (3 papers)

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Research

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9 pages, 2207 KiB  
Article
Utilization of Noncontrast Magnetic Resonance Lymphangiography for Selection of Effective Surgical Method in Breast Cancer-Related Lymphedema
by Joseph Kyu-hyung Park, Nakwon Choi, Jaewon Beom, Jae-Young Lim, Yusuhn Kang, Sun-Young Nam and Yujin Myung
Medicina 2023, 59(9), 1656; https://doi.org/10.3390/medicina59091656 - 14 Sep 2023
Cited by 1 | Viewed by 2714
Abstract
Background and Objectives: When considering surgery for patients with breast cancer-related lymphedema (BCRL), it is crucial to determine which surgery will be most effective for the patient and establish the indications for each surgery. Our study retrospectively compared the results of preoperative noncontrast [...] Read more.
Background and Objectives: When considering surgery for patients with breast cancer-related lymphedema (BCRL), it is crucial to determine which surgery will be most effective for the patient and establish the indications for each surgery. Our study retrospectively compared the results of preoperative noncontrast MR lymphangiography (NMRL) performed on the lymphedematous limb of patients before surgery, with the aim of analyzing whether preoperative NMRL can be used as a criterion for determining the type of surgery. Materials and Methods: From January 2020 to June 2022, a total of 138 patients with lymphedema underwent surgery at Seoul National University Bundang Hospital. All patients underwent preoperative NMRL imaging and were classified into stages 1–3 based on the MRI severity index using the authors’ previous reference. Three types of surgery, LVA, LVA + liposuction, and LVA + VLNT, were conducted on all patients. The effectiveness of the surgery was evaluated one year postoperatively using the interlimb volume difference before and after surgery, the fluid volume of the edematous limb measured by bioimpedance spectroscopy, and the subjective satisfaction of the patients through the Lymph Q questionnaire. Results: In this study, out of a total of 138 patients, 26 (19%) were MRI stage 1, 62 (45%) were stage 2, and 50 (36%) were stage 3. Of the 83 patients who underwent LVA surgery, the greatest decrease in interlimb volume difference was observed in stage 2 patients, and subjective satisfaction was also the most effective in stage 2. In the case of LVA + liposuction patients, a significant volume decrease and a high satisfaction were observed in stage 3 patients. In the case of LVA + VLNT patients, there was no difference in volume decrease according to the stage, but a greater decrease in body fluid volume was observed as the MRI severity index score increased through BIA. Conclusions: In conclusion, this study demonstrates that NMRL imaging is a useful modality for determining the most effective surgical method and predicting the surgical outcome in patients with lymphedema. This highlights the importance of using NMRL in the treatment planning of lymphedema patients. Full article
(This article belongs to the Special Issue Imaging Technology of the Lymphatic System)
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9 pages, 844 KiB  
Article
Edematous Dermal Thickening on Magnetic Resonance Imaging as a Biomarker for Lymphatic Surgical Outcomes
by JacqueLyn R. Kinney, Sara Babapour, Erin Kim, Rosie Friedman, Dhruv Singhal, Bernard T. Lee and Leo L. Tsai
Medicina 2023, 59(8), 1369; https://doi.org/10.3390/medicina59081369 - 26 Jul 2023
Cited by 1 | Viewed by 1489
Abstract
Background and Objectives: One of the surgical treatments for breast cancer-related lymphedema (BCRL) is debulking lipectomy. The aim of this study is to investigate whether dermal thickness could be utilized as an objective indicator of post-operative changes following debulking. Materials and Methods [...] Read more.
Background and Objectives: One of the surgical treatments for breast cancer-related lymphedema (BCRL) is debulking lipectomy. The aim of this study is to investigate whether dermal thickness could be utilized as an objective indicator of post-operative changes following debulking. Materials and Methods: A retrospective review of BCRL patients who underwent debulking lipectomy was conducted. MRI-based dermal thickness was measured by two separate trained readers at 16 regions of the upper extremity. Pre- and post-operative reduction in dermal thickness was compared across the affected and unaffected (control) arms for each patient. The Wilcoxon rank sum test was used to assess for significant change. Univariate linear regression was used to assess the relationship between dermal thickness reduction and changes to LYMPH-Q scores, L-Dex scores, and relative volume change. Results: Seventeen patients were included in our analysis. There was significant reduction in dermal thickness at 5/16 regions in the affected arm. Dermal thickness change was significantly correlated with LYMPH-Q scores, L-Dex scores, and relative volume change in 2/16 limb compartments. There was predominant dermal thickening in the dorsal compartment of the upper arm and in the ventral and ulnar compartments of the forearm. Conclusions: Dermal thickness shows promising utility in tracking post-operative debulking procedures for breast cancer-related lymphedema. Further studies with larger patient populations and a variety of imaging modalities are required to continue to develop a clinically objective and reproducible method of post-surgical lymphedema staging and monitoring. Full article
(This article belongs to the Special Issue Imaging Technology of the Lymphatic System)
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Review

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17 pages, 7774 KiB  
Review
Imaging Modalities for Evaluating Lymphedema
by Bendeguz Istvan Nagy, Balazs Mohos and Chieh-Han John Tzou
Medicina 2023, 59(11), 2016; https://doi.org/10.3390/medicina59112016 - 16 Nov 2023
Cited by 7 | Viewed by 2338
Abstract
Lymphedema is a progressive condition. Its therapy aims to reduce edema, prevent its progression, and provide psychosocial aid. Nonsurgical treatment in advanced stages is mostly insufficient. Therefore—in many cases—surgical procedures, such as to restore lymph flow or excise lymphedema tissues, are the only [...] Read more.
Lymphedema is a progressive condition. Its therapy aims to reduce edema, prevent its progression, and provide psychosocial aid. Nonsurgical treatment in advanced stages is mostly insufficient. Therefore—in many cases—surgical procedures, such as to restore lymph flow or excise lymphedema tissues, are the only ways to improve patients’ quality of life. Imaging modalities: Lymphoscintigraphy (LS), near-infrared fluorescent (NIRF) imaging—also termed indocyanine green (ICG) lymphography (ICG-L)—ultrasonography (US), magnetic resonance lymphangiography (MRL), computed tomography (CT), photoacoustic imaging (PAI), and optical coherence tomography (OCT) are standardized techniques, which can be utilized in lymphedema diagnosis, staging, treatment, and follow-up. Conclusions: The combined use of these imaging modalities and self-assessment questionnaires deliver objective parameters for choosing the most suitable surgical therapy and achieving the best possible postoperative outcome. Full article
(This article belongs to the Special Issue Imaging Technology of the Lymphatic System)
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