Visualization of Lymphatic Vessels Using Photoacoustic Imaging
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- Kajita Hiroki
- Department of Plastic and Reconstructive Surgery, Keio University School of Medicine, Tokyo, Japan
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- Suzuki Yushi
- Department of Plastic and Reconstructive Surgery, Keio University School of Medicine, Tokyo, Japan
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- Sakuma Hisashi
- Department of Plastic and Reconstructive Surgery, Keio University School of Medicine, Tokyo, Japan Department of Plastic and Reconstructive Surgery, Tokyo Dental College Ichikawa General Hospital, Tokyo, Japan
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- Imanishi Nobuaki
- Department of Anatomy, Keio University School of Medicine, Tokyo, Japan
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- Tsuji Tetsuya
- Department of Rehabilitation Medicine, Keio University School of Medicine, Tokyo, Japan
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- Jinzaki Masahiro
- Department of Radiology, Keio University School of Medicine, Tokyo, Japan
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- Aiso Sadakazu
- Department of Anatomy, Keio University School of Medicine, Tokyo, Japan SIT Research Laboratories, Shibaura Institute of Technology, Tokyo, Japan Management Division, Luxonus, Inc., Kanagawa, Japan
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- Kishi Kazuo
- Department of Plastic and Reconstructive Surgery, Keio University School of Medicine, Tokyo, Japan
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Abstract
<p>Lymphedema occurs when interstitial fluid and fibroadipose tissues accumulate abnormally because of decreased drainage of lymphatic fluid as a result of injury, infection, or congenital abnormalities of the lymphatic system drainage pathway. An accurate anatomical map of the lymphatic vasculature is needed not only for understanding the pathophysiology of lymphedema but also for surgical planning. However, because of their limited spatial resolution, no imaging modalities are currently able to noninvasively provide a clear visualization of the lymphatic vessels. Photoacoustic imaging is an emerging medical imaging technique that provides unique scalability of optical resolution and acoustic depth of penetration. Moreover, light-absorbing biomolecules, including oxy- and deoxyhemoglobin, lipids, water, and melanin, can be imaged. Using exogenous contrast agents that are taken up by lymphatic vessels, e.g., indocyanine green, photoacoustic lymphangiography, which has a higher spatial resolution than previous imaging modalities, is possible. Using a new prototype of a photoacoustic imaging system with a wide field of view developed by a Japanese research group, high-resolution three-dimensional structural information of the vasculatures was successfully obtained over a large area in both healthy and lymphedematous extremities. Anatomical information on the lymphatic vessels and adjacent veins provided by photoacoustic lymphangiography is helpful for the management of lymphedema. In particular, such knowledge will facilitate the planning of microsurgical lymphaticovenular anastomoses to bypass the excess fluid component by joining with the circulatory system peripherally. Although challenges remain to establish its implementation in clinical practice, photoacoustic lymphangiography may contribute to improved treatments for lymphedema patients in the near future.</p>
Journal
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- The Keio Journal of Medicine
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The Keio Journal of Medicine 70 (4), 82-92, 2020
The Keio Journal of Medicine
