New diagnostic modalities in the evaluation of lymphedema.
Identifieur interne : 000356 ( PubMed/Corpus ); précédent : 000355; suivant : 000357New diagnostic modalities in the evaluation of lymphedema.
Auteurs : Thomas F. O'Donnell ; John C. Rasmussen ; Eva M. Sevick-MuracaSource :
- Journal of vascular surgery. Venous and lymphatic disorders [ 2213-3348 ] ; 2017.
Abstract
Currently, lymphedema (LED) is typically diagnosed clinically on the basis of a patient's history and characteristic physical findings. Whereas the diagnosis of LED is sometimes confirmed by lymphoscintigraphy (LSG), the technique is limited in both its ability to identify disease and to guide therapy. Recent advancements provide opportunities for new imaging techniques not only to assist in the diagnosis of LED, based on anatomic changes, but also to assess contractile function and to guide therapeutic intervention. The purpose of this contribution was to review these imaging techniques.
DOI: 10.1016/j.jvsv.2016.10.083
PubMed: 28214496
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<author><name sortKey="O Donnell, Thomas F" sort="O Donnell, Thomas F" uniqKey="O Donnell T" first="Thomas F" last="O'Donnell">Thomas F. O'Donnell</name>
<affiliation><nlm:affiliation>Cardiovascular Center at Tufts Medical Center, Tufts University School of Medicine, Boston, Mass. Electronic address: todonnell@tuftsmedicalcenter.org.</nlm:affiliation>
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<author><name sortKey="Rasmussen, John C" sort="Rasmussen, John C" uniqKey="Rasmussen J" first="John C" last="Rasmussen">John C. Rasmussen</name>
<affiliation><nlm:affiliation>The Center for Molecular Imaging, The Brown Foundation Institute of Molecular Medicine for the Prevention of Human Diseases at the University of Texas Health Science Center at Houston, Houston, Tex.</nlm:affiliation>
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<author><name sortKey="Sevick Muraca, Eva M" sort="Sevick Muraca, Eva M" uniqKey="Sevick Muraca E" first="Eva M" last="Sevick-Muraca">Eva M. Sevick-Muraca</name>
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<sourceDesc><biblStruct><analytic><title xml:lang="en">New diagnostic modalities in the evaluation of lymphedema.</title>
<author><name sortKey="O Donnell, Thomas F" sort="O Donnell, Thomas F" uniqKey="O Donnell T" first="Thomas F" last="O'Donnell">Thomas F. O'Donnell</name>
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<author><name sortKey="Rasmussen, John C" sort="Rasmussen, John C" uniqKey="Rasmussen J" first="John C" last="Rasmussen">John C. Rasmussen</name>
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<author><name sortKey="Sevick Muraca, Eva M" sort="Sevick Muraca, Eva M" uniqKey="Sevick Muraca E" first="Eva M" last="Sevick-Muraca">Eva M. Sevick-Muraca</name>
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<series><title level="j">Journal of vascular surgery. Venous and lymphatic disorders</title>
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<front><div type="abstract" xml:lang="en">Currently, lymphedema (LED) is typically diagnosed clinically on the basis of a patient's history and characteristic physical findings. Whereas the diagnosis of LED is sometimes confirmed by lymphoscintigraphy (LSG), the technique is limited in both its ability to identify disease and to guide therapy. Recent advancements provide opportunities for new imaging techniques not only to assist in the diagnosis of LED, based on anatomic changes, but also to assess contractile function and to guide therapeutic intervention. The purpose of this contribution was to review these imaging techniques.</div>
</front>
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<pubmed><MedlineCitation Status="In-Data-Review" Owner="NLM"><PMID Version="1">28214496</PMID>
<DateCreated><Year>2017</Year>
<Month>02</Month>
<Day>19</Day>
</DateCreated>
<DateRevised><Year>2017</Year>
<Month>03</Month>
<Day>03</Day>
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<Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">2213-3348</ISSN>
<JournalIssue CitedMedium="Internet"><Volume>5</Volume>
<Issue>2</Issue>
<PubDate><Year>2017</Year>
<Month>Mar</Month>
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</JournalIssue>
<Title>Journal of vascular surgery. Venous and lymphatic disorders</Title>
<ISOAbbreviation>J Vasc Surg Venous Lymphat Disord</ISOAbbreviation>
</Journal>
<ArticleTitle>New diagnostic modalities in the evaluation of lymphedema.</ArticleTitle>
<Pagination><MedlinePgn>261-273</MedlinePgn>
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<Abstract><AbstractText Label="OBJECTIVE" NlmCategory="OBJECTIVE">Currently, lymphedema (LED) is typically diagnosed clinically on the basis of a patient's history and characteristic physical findings. Whereas the diagnosis of LED is sometimes confirmed by lymphoscintigraphy (LSG), the technique is limited in both its ability to identify disease and to guide therapy. Recent advancements provide opportunities for new imaging techniques not only to assist in the diagnosis of LED, based on anatomic changes, but also to assess contractile function and to guide therapeutic intervention. The purpose of this contribution was to review these imaging techniques.</AbstractText>
<AbstractText Label="METHODS" NlmCategory="METHODS">Literature for each technique is reviewed and discussed, and the evidence for each of these new diagnostic techniques was assessed on several criteria to determine if each could (1) establish whether disease is present, (2) determine the severity of the disease process, (3) define the pathophysiologic mechanism of the disease process, (4) demonstrate whether intervention is possible as well as what type, and (5) objectively grade the response to therapy.</AbstractText>
<AbstractText Label="RESULTS" NlmCategory="RESULTS">LSG is currently the standard test to confirm LED. Duplex ultrasound (DUS) is a simple, readily available noninvasive test that can identify LED by specific tissue characteristics as well as the response to therapy. Magnetic resonance imaging and computed tomography scans similarly demonstrate the alterations in epidermal and subcutaneous tissue, but the latter can also detect obstructing neoplasms as a cause of secondary LED. Moreover, magnetic resonance lymphangiography details lymphatic vessels and nodes and their function. Newer fluorescence imaging techniques provide opportunities to image lymphatic anatomy and function. Visible microlymphangiography by fluorescein sodium is limited by tissue light absorption to imaging depths of 200 μm. Near-infrared fluorescence lymphatic imaging, a newer test using intradermal injection of indocyanine green, can penetrate several centimeters of tissue and can visualize the initial and conducting lymphatics, the lymph node basins, and the active function of lymphangions (the key module) in exquisite detail.</AbstractText>
<AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">The availability and the noninvasive nature of DUS should make this modality the first choice for establishing the diagnosis of LED based on tissue changes. Further studies comparing DUS with LSG, however, are needed. The costs of magnetic resonance imaging and computed tomography limit their adoption as a means to regularly assess the lymphatics. Whereas lymphatic truncal anatomy and transit times can be delineated by the older technique of LSG, near-infrared fluorescence lymphatic imaging is rapid, highly sensitive, and repeatable and provides exquisite detail for lymphatic vessel anatomy and function of the lymphangions as well as the response to therapy.</AbstractText>
<CopyrightInformation>Copyright © 2016 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.</CopyrightInformation>
</Abstract>
<AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>O'Donnell</LastName>
<ForeName>Thomas F</ForeName>
<Initials>TF</Initials>
<Suffix>Jr</Suffix>
<AffiliationInfo><Affiliation>Cardiovascular Center at Tufts Medical Center, Tufts University School of Medicine, Boston, Mass. Electronic address: todonnell@tuftsmedicalcenter.org.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Rasmussen</LastName>
<ForeName>John C</ForeName>
<Initials>JC</Initials>
<AffiliationInfo><Affiliation>The Center for Molecular Imaging, The Brown Foundation Institute of Molecular Medicine for the Prevention of Human Diseases at the University of Texas Health Science Center at Houston, Houston, Tex.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Sevick-Muraca</LastName>
<ForeName>Eva M</ForeName>
<Initials>EM</Initials>
<AffiliationInfo><Affiliation>The Center for Molecular Imaging, The Brown Foundation Institute of Molecular Medicine for the Prevention of Human Diseases at the University of Texas Health Science Center at Houston, Houston, Tex.</Affiliation>
</AffiliationInfo>
</Author>
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<Language>eng</Language>
<GrantList CompleteYN="Y"><Grant><GrantID>R01 HL092923</GrantID>
<Acronym>HL</Acronym>
<Agency>NHLBI NIH HHS</Agency>
<Country>United States</Country>
</Grant>
<Grant><GrantID>R21 HL132598</GrantID>
<Acronym>HL</Acronym>
<Agency>NHLBI NIH HHS</Agency>
<Country>United States</Country>
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<Grant><GrantID>U54 CA136404</GrantID>
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<Agency>NCI NIH HHS</Agency>
<Country>United States</Country>
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<PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType>
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<ArticleDate DateType="Electronic"><Year>2017</Year>
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<MedlineTA>J Vasc Surg Venous Lymphat Disord</MedlineTA>
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