Near-infrared lymphography as a minimally invasive modality for imaging lymphatic reconstitution in a rat orthotopic hind limb transplantation model

Buretta, Kate J.; Brat, Gabriel; Christensen, James H.; Ibrahim, Zuhaib; Grahammer, Johanna; Furtmüller, Georg J.; Suami, Hiroo; Cooney, Damon S.; Lee, W. P.Andrew; Brandacher, Gerald; Sacks, Justin M.

doi:10.1111/tri.12150

Cited by 16 publications

(12 citation statements)

References 56 publications

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“…22-25 In addition, the patency of lymphovenous anastomosis was studied in rat models and lymphatic structural changes after surgical manipulation were investigated using ICG fluorescence lymphography. 15,26-29 Different patterns of ICG fluorescence lymphography in lymphedema patients were investigated in relation to pathological changes in the lymphatic vessel. 30 Future animal research must also focus more on the lymphatic vessels and therefore the baseline ICG image of the lymphatic system as discussed in this study would be expected to contribute to this aspect.…”

Section: Discussionmentioning

confidence: 99%

Lymphatic Territories (Lymphosomes) in the Rat: An Anatomical Study for Future Lymphatic Research

Suami¹,

Scaglioni²

2017

Plastic &Amp; Reconstructive Surgery

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Background Understanding the precise anatomy in experimental animals is crucial to correct design of research projects. Rats are commonly used for scientific research in plastic surgery because of their availability in academic institutions, moderate cost and sizable vessels for microsurgical procedures. In past publications about rat anatomy, lymphatic mapping has been limited and incomplete. The aim of this study was to comprehensively map the superficial lymphatic system in the rat. Methods Twenty-seven Sprague–Dawley rats were used for this study. Indocyanine green (ICG) fluorescence lymphography was used to identify the lymphatic vessels and lymph nodes. Under general anaesthesia, ICG was injected intradermally at multiple spots along the dorsal and medial midlines, front and hind paws, and tail. The course of the lymphatic vessels was traced on the skin with marker pen and photographed. The superficial lymphatic vessels in each rat were sketched on a graphic template and all the templates were superimposed using graphic software to define the relationship between the lymphatic vessel and sentinel node. Results ICG fluorescence lymphography was able to demonstrate the superficial lymphatic vessels in the rat. Six groups of regional lymph node/s were identified and lymphatic pathways to those nodes delineated. Our lymphosome concept was successfully applied to the rat, with six lymphosomes identified. Conclusions We succeeded in performing superficial lymphatic mapping in the rat. Our anatomical findings can provide further information about the lymphatic system in the normal state and promote understanding of pathological changes generated by surgical manipulation for future studies.

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Section: Discussionmentioning

confidence: 99%

Lymphatic Territories (Lymphosomes) in the Rat: An Anatomical Study for Future Lymphatic Research

Suami¹,

Scaglioni²

2017

Plastic &Amp; Reconstructive Surgery

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“…It combines with serum proteins in vivo and fluoresces under excitation at 760–820 nm . With the development of ICG fluorescence imaging, it has recently been used to detect lymph nodes via the lymphatic duct in the fields of breast and digestive tract surgery as well as to detect vascular flow in other surgical fields . Within the field of liver surgery, ICG fluorescence imaging applications have been reported for the detection of HCC or metastases .…”

Section: Discussionmentioning

confidence: 99%

“…12 With the development of ICG fluorescence imaging, it has recently been used to detect lymph nodes via the lymphatic duct in the fields of breast and digestive tract surgery 13,14 as well as to detect vascular flow in other surgical fields. 15,16 Within the field of liver surgery, ICG fluorescence imaging applications have been reported for the detection of HCC or metastases. 17,18 In addition, it has been used for pancreatic cancer, 19 detection of biliary leakage 20 and evaluation of hepatic congested areas 21 and vascular flow 22 after liver transplantation through contrast of the biliary tract.…”

Section: Discussionmentioning

confidence: 99%

Residual cancerous lesion and vein tumour thrombus identified intraoperatively using a fluorescence navigation system in liver surgery

Fang

et al. 2019

ANZ Journal of Surgery

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Aim The main aims of this study are to investigate the clinical application value of using indocyanine green fluorescence imaging for ensuring complete resection of tumour tissue during hepatectomy and to evaluate the diagnostic efficacy of near‐infrared (NIR) fluorescence imaging system using indocyanine green in hepatectomy. Methods After undergoing liver resection at the Affiliated Hospital of Southwest Medical University from July 2017 to May 2018, 35 eligible patients were included in this study. The liver surface and resection margin were intraoperatively assessed by intraoperative ultrasonography and NIR fluorescence imaging, after intravenous administration of indocyanine green (0.5 mg/kg) 72–96 h prior to surgery. The intraoperative observations were compared with the pathological findings in the liver. Results In the 35 patients, a total of 53 lesions were found, of which 42 were malignant lesions. The analysis results showed that the sensitivity and accuracy of detection using NIR fluorescence imaging were significantly higher than with intraoperative ultrasonography (P < 0.05). However, there was no difference between contrast‐enhanced helical computed tomography and NIR fluorescence imaging in finding lesions (P > 0.05). In addition, 11 new suspicious lesions were detected only by NIR fluorescence imaging in the liver surface and resection margin during surgery, four of which were hepatocellular carcinoma. We also detected four vein tumour thrombi using the NIR fluorescence navigation system. Conclusions The NIR fluorescence navigation system enables the identification of small tumours, residual cancer tissues in resection margin and venous tumour embolies in real time and enhances the accuracy and integrity of liver resection.

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“…We injected 0.02 ml of 5 mg/ml indocyanine green (ICG) (Diagnogreen, Daiichi-Sankyo, Tokyo, Japan) intradermally into the rats’ hind toes using a 30-gauge needle. 14 Six rats were observed from POD 0 to POD 28. Fluorescence images were taken up to 120 minutes after the ICG injections.…”

Section: Methodsmentioning

confidence: 99%

Enhancement of Lymphatic Vessels in the Superficial Layer in a Rat Model of a Lymphedematous Response

Matsumoto

Kosaka

Suami

et al. 2018

Plastic and Reconstructive Surgery - Global Open

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Background:The morphologic and histologic behavior of lymphatic vessels in lymphedema has not been well analyzed using laboratory animals. The purpose of the present study was to elucidate the regeneration process of lymphatic vessels after acute lymphedema in a rat model.Methods:The acute lymphedema was induced by an amputation and a replantation surgery on a rat hind limb. Recovery of lymphatic flow was traced using fluorescent lymphography with dye injection. The morphology and number of lymphatic vessels were immunohistochemically detected and quantified in both superficial and deep layers.Results:The swelling was the most severe, and the number of lymphatic vessels in the superficial layer was significantly and maximally increased on postoperative day 3. Backflows and overflows were also detectable in the superficial layer on postoperative day 3. The number of lymphatic vessels had decreased but remained significantly higher than that in the controls on postoperative day 14, when the swelling decreased to the levels in the controls. In contrast, the number of lymphatic vessels in the deep layer showed a tendency toward increased numbers; however, it was not statistically significant on postoperative day 3, 7, or 14.Conclusions:We have obtained solid evidence showing the differential potency of lymphatic vessels between the superficial and the deep layers after temporal lymphedematous induction. Further analysis of lymphedematous responses in animal models could provide new insights into the challenges associated with the clinical treatment of lymphedema.

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Near-infrared lymphography as a minimally invasive modality for imaging lymphatic reconstitution in a rat orthotopic hind limb transplantation model

Cited by 16 publications

References 56 publications

Lymphatic Territories (Lymphosomes) in the Rat: An Anatomical Study for Future Lymphatic Research

Lymphatic Territories (Lymphosomes) in the Rat: An Anatomical Study for Future Lymphatic Research

Residual cancerous lesion and vein tumour thrombus identified intraoperatively using a fluorescence navigation system in liver surgery

Enhancement of Lymphatic Vessels in the Superficial Layer in a Rat Model of a Lymphedematous Response

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