Near-infrared fluorescence imaging of lymphatics in head and neck lymphedema.
BACKGROUND
Lymphedema is a complication that may occur after surgical resection and radiation treatment in a number of cancer types and is especially debilitating in regions where treatment options are limited. Although upper and lower extremity lymphedema may be effectively treated with manual lymphatic drainage (MLD) therapies and devices that use compression to direct proximal flow of lymph fluids, head and neck lymphedema is more challenging.


RESULTS
Herein, we describe the compassionate use of an investigatory technique of near-infrared (NIR) fluorescence imaging to understand the lymphatic anatomy and function, help direct MLD, and use 3-dimensional (3D) surface profilometry to monitor response to therapy in a patient with head and neck lymphedema after surgery and radiation treatment.


CONCLUSIONS
NIR fluorescence imaging provides a mapping of functional lymph vessels for direction of efficient MLD therapy in the head and neck. Additional studies are needed to assess the efficacy of MLD therapy when directed by NIR fluorescence imaging.
Division of Cardiology and Hyperbaric Medicine, Department of Internal Medicine at The University of Texas Health Science Center, Houston, Texas, USA. erik.a.maus@uth.tmc.edu
Erik A
EA
Maus
I-Chih
IC
Tan
John C
JC
Rasmussen
Milton V
MV
Marshall
Caroline E
CE
Fife
Latisha A
LA
Smith
Renie
R
Guilliod
Eva M
EM
Sevick-Muraca
D057176:Compassionate Use Trials; D004322:Drainage; D005456:Fluorescent Dyes; D005471:Fluoroscopy; D006801:Humans; D007208:Indocyanine Green; D008209:Lymphedema / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D008297:Male; D008875:Middle Aged
D005456:Fluorescent Dyes; D007208:Indocyanine Green