Header

UZH-Logo

Maintenance Infos

Preoperative Mapping of Lymphatic Vessels by Multispectral Optoacoustic Tomography


Grünherz, Lisanne; Gousopoulos, Epameinondas; Barbon, Carlotta; Uyulmaz, Semra; Lafci, Berkan; Razansky, Daniel; Boss, Andreas; Giovanoli, Pietro; Lindenblatt, Nicole (2022). Preoperative Mapping of Lymphatic Vessels by Multispectral Optoacoustic Tomography. Lymphatic Research and Biology, 20(6):659-664.

Abstract

Background: In lymphatic reconstructive surgery, visualization of lymph vessels is of paramount importance. Indocyanine green (ICG) lymphography is the current gold standard in preoperative lymphatic imaging. However, visualization of lymph vessels is often limited by an overlying dermal backflow of ICG, becoming particularly prominent in advanced lymphedema stages. Multispectral optoacoustic tomography (MSOT) has recently been introduced as a promising noninvasive tool for lymphatic imaging. Methods and Results: A single-center proof-of-concept study with a prospective observational design was conducted at the Department of Plastic Surgery and Hand Surgery of the University Hospital Zurich. Between February 2021 and August 2021, seven patients with different grades of lymphedema were analyzed by the MSOT Acuity system before undergoing lymphovenous anastomosis (LVA). Conventional ICG lymphography served as comparison. MSOT succeeded to accurately depict blood and lymphatic vessels at different locations in six patients, including areas of dermal backflow. The MSOT signal of lymph vessels further correlated well with their macroscopic appearance. Conclusion: We could successfully visualize lymphatic vessels in patients with lymphedema by MSOT and establish the new method for preoperative mapping and selection of incision sites for LVA. Regardless of dermal backflow patterns, MSOT proved to be a valuable approach for identifying and clearly discerning between lymphatic and blood vessels.

Abstract

Background: In lymphatic reconstructive surgery, visualization of lymph vessels is of paramount importance. Indocyanine green (ICG) lymphography is the current gold standard in preoperative lymphatic imaging. However, visualization of lymph vessels is often limited by an overlying dermal backflow of ICG, becoming particularly prominent in advanced lymphedema stages. Multispectral optoacoustic tomography (MSOT) has recently been introduced as a promising noninvasive tool for lymphatic imaging. Methods and Results: A single-center proof-of-concept study with a prospective observational design was conducted at the Department of Plastic Surgery and Hand Surgery of the University Hospital Zurich. Between February 2021 and August 2021, seven patients with different grades of lymphedema were analyzed by the MSOT Acuity system before undergoing lymphovenous anastomosis (LVA). Conventional ICG lymphography served as comparison. MSOT succeeded to accurately depict blood and lymphatic vessels at different locations in six patients, including areas of dermal backflow. The MSOT signal of lymph vessels further correlated well with their macroscopic appearance. Conclusion: We could successfully visualize lymphatic vessels in patients with lymphedema by MSOT and establish the new method for preoperative mapping and selection of incision sites for LVA. Regardless of dermal backflow patterns, MSOT proved to be a valuable approach for identifying and clearly discerning between lymphatic and blood vessels.

Statistics

Citations

Dimensions.ai Metrics
5 citations in Web of Science®
4 citations in Scopus®
Google Scholar™

Altmetrics

Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Diagnostic and Interventional Radiology
04 Faculty of Medicine > University Hospital Zurich > Clinic for Reconstructive Surgery
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:December 2022
Deposited On:07 Mar 2022 14:31
Last Modified:27 Apr 2024 01:36
Publisher:Mary Ann Liebert
ISSN:1539-6851
OA Status:Closed
Publisher DOI:https://doi.org/10.1089/lrb.2021.0067
PubMed ID:35230197
Full text not available from this repository.