Imaging Modalities for Evaluating Lymphedema

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 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.

Ultrasound in Microsurgery: Current Applications and New Frontiers

“…Lymphovenous bypass surgery (LVB), also known as lymphovenous anastomosis (LVA), has become an established supermicrosurgical technique for the treatment of lymphedema through delayed lymphatic reconstruction as well as prevention of lymphedema through immediate lymphatic reconstruction [ 42 , 43 , 44 , 45 , 46 , 47 , 48 ]. Multiple imaging techniques are utilized throughout the diagnosis and workup of lymphedema patients including lymphoscintigraphy, indocyanine green (ICG) lymphography, magnetic resonance lymphography, and ultrasound [ 49 , 50 , 51 , 52 , 53 , 54 ]. Indocyanine green lymphography, first described for lymphedema evaluation in 2007, has become the most utilized imaging modality both for lymphedema evaluation, operative decision-making, and preoperative planning of LVB [ 54 , 55 , 56 , 57 , 58 , 59 ].…”

Congenital Vascular and Lymphatic Diseases

“…Complementarily, ultrasonography differentiates lymphedema from other causes of limb swelling, such as deep vein thrombosis. 135 Doppler ultrasonography further enhances diagnostic capabilities by assessing blood flow, particularly in complex cases. While there is no curative therapy for lymphedema, a common management method is complete decongestive lymphedema therapy.…”