Ultra High-frequency Ultrasonographic Imaging with 70 MHz Scanner for Visualization of the Lymphatic Vessels

Hayashi, Akitatsu; Giacalone, Guido; Yamamoto, Takumi; Belva, Florence; Visconti, Giuseppe; Hayashi, Nobuko; Handa, Mayumi; Yoshimatsu, Hironobu; Salgarello, Marzia

doi:10.1097/gox.0000000000002086

Cited by 100 publications

(83 citation statements)

References 30 publications

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“…The target lymphatic vessels were visible with high contrast against the background and could be clearly differentiated from blood vessels due to spectral absorption differences between hemoglobin and indocyanine green. As previously described [16], this differentiation can be confirmed by gently pressing the 3D probe against the skin: the image of only the vein, not the lymphatic, will disappear, to reappear when pressure is lifted. Although we could also evaluate lymphatic patency by ultra-high frequency ultrasound [16], this technique is limited to a depth of 1 cm, which precludes application in more proximal segments of an affected limb and in advanced stages of lymphedema.…”

Section: Msot Differentiates Between Distinct Types Of Vessels Includsupporting

confidence: 52%

Bedside 3D Visualization of Lymphatic Vessels with a Handheld Multispectral Optoacoustic Tomography Device

Giacalone¹,

Yamamoto

Belva³

et al. 2020

JCM

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Identification of lymphatics by Indocyanine Green (ICG) lymphography in patients with severe lymphedema is limited due to the overlying dermal backflow. Nor can the method detect deep and/or small vessels. Multispectral optoacoustic tomography (MSOT), a real-time three-dimensional (3D) imaging modality which allows exact spatial identification of absorbers in tissue such as blood and injected dyes can overcome these hurdles. However, MSOT with a handheld probe has not been performed yet in lymphedema patients. We conducted a pilot study in 11 patients with primary and secondary lymphedema to test whether lymphatic vessels could be detected with a handheld MSOT device. In eight patients, we could not only identify lymphatics and veins but also visualize their position and contractility. Furthermore, deep lymphatic vessels not traceable by ICG lymphography and lymphatics covered by severe dermal backflow, could be clearly identified by MSOT. In three patients, two of which had advanced stage lymphedema, only veins but no lymphatic vessels could be identified. We found that MSOT can identify and image lymphatics and veins in real-time and beyond the limits of near-infrared technology during a single bedside examination. Given its easy use and high accuracy, the handheld MSOT device is a promising tool in lymphatic surgery.

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Section: Msot Differentiates Between Distinct Types Of Vessels Includsupporting

confidence: 52%

Bedside 3D Visualization of Lymphatic Vessels with a Handheld Multispectral Optoacoustic Tomography Device

Giacalone¹,

Yamamoto

Belva³

et al. 2020

JCM

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“…The CDU technology is continuing to evolve, assisting surgeons to visualize very superficial structure with more clarity, elevate thin flaps, and identify lymphatic vessels via high-frequency CDUs. 38,39 Conclusion CDU is a valuable and powerful tool for any reconstructive surgeons who are interested in performing microsurgery or supermicrosurgery. In our systematic review, we found that there are a limited number of literatures on the role of CDU in reconstructive surgery.…”

Section: Discussionmentioning

confidence: 99%

The Role of Duplex Ultrasound in Microsurgical Reconstruction: Review and Technical Considerations

Cho

Kwon

Pak

et al. 2020

J Reconstr Microsurg

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Background With the technological advances, microsurgery has evolved to the era of supermicrosurgery since its inception. With the popularization of these flaps, proficiency in using tools such as color Doppler ultrasound (CDU) has become crucial. Despite the increased interest, studies regarding the role of ultrasound in microsurgical reconstruction are scarce. Therefore, in this study, we discussed currently available imaging modalities for reconstructive surgeons, types of ultrasound, and the role of ultrasound in microsurgical reconstruction, and made recommendations for ultrasound use in reconstructive surgery. Methods We performed a computerized search of ultrasound in reconstructive surgery using the MEDLINE database. Data regarding ultrasound indications, usage, and outcomes were collected. Results Of the 115 articles identified, the majority was written on nonreconstructive ultrasound uses (51.4%). For the reconstructive uses, mapping of perforators was the most common usage (39.1%), followed by flap monitoring and volume measurement. In addition, we found that there are a limited number of literature on the role of CDU in reconstructive surgery, especially on its intraoperative and postoperative use. Conclusion CDU is a valuable and powerful tool for any reconstructive surgeons who are interested in performing microsurgery or supermicrosurgery. As the demand of customized flaps using superthin flaps, perforator-to-perforator anastomosis, and supermicrosurgery increases, understanding and becoming versatile in CDU will be critical. We hope our experience with using ultrasound and refinements that we made are helpful for those who would like to include it as a part of their armamentarium.

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“…Ultra-high frequency ultrasound preoperative planning of the rerouting method for lymphaticovenular anastomosis in incisions devoid of vein Dear Editor, Supermicrosurgical lymphaticovenular anastomosis (LVA) represents a valid surgical option for the treatment of peripheral lymphedema (Scaglioni, Fontein, Arvanitakis, & Giovanoli, 2017). However, the shunts should be performed using still functional lymphatics channels and favorable recipient venules (Hayashi et al, 2019;Visconti, Hayashi, Bianchi, & Salgarello, 2019;Visconti, Salgarello, & Hayashi, 2018;Visconti, Yamamoto, Hayashi, & Hayashi, 2017).…”

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confidence: 99%

“…(Below, right) The venule was rerouted through a subcutaneous tunnel into the lymphatic incision to perform the LVA. LVA, lymphaticovenular anastomosis venule to use (Hayashi et al, 2019;Visconti et al, 2017Visconti et al, , 2018Visconti et al, , 2019.…”

mentioning

confidence: 99%

“…In this letter we describe our method to perform LVA when the recipient venules are not found nearby the lymphatic channels during the preoperative planning. Since 2016 we perform LVA preoperative planning for patients with upper and lower extremity lymphedema, using rest-stress lymphoscintigraphy, indocyanine green lymphography, and ultra-high frequency ultrasound in order to locate functional lymphatic channels and favorable recipient venules (Hayashi et al, 2019;Visconti et al, 2017Visconti et al, , 2018Visconti et al, , 2019.…”

mentioning

confidence: 99%

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Ultra‐high frequency ultrasound preoperative planning of the rerouting method for lymphaticovenular anastomosis in incisions devoid of vein

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Ultra High-frequency Ultrasonographic Imaging with 70 MHz Scanner for Visualization of the Lymphatic Vessels

Abstract: Supplemental Digital Content is available in the text.

Cited by 100 publications

References 30 publications

Bedside 3D Visualization of Lymphatic Vessels with a Handheld Multispectral Optoacoustic Tomography Device

Bedside 3D Visualization of Lymphatic Vessels with a Handheld Multispectral Optoacoustic Tomography Device

The Role of Duplex Ultrasound in Microsurgical Reconstruction: Review and Technical Considerations

Ultra‐high frequency ultrasound preoperative planning of the rerouting method for lymphaticovenular anastomosis in incisions devoid of vein

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