title: Development and validation of a custom made indocyanine green fluorescence lymphatic vessel imager.
abstract: Lymphoedema is a chronic progressive condition often producing significant morbidity. An in-depth understanding of an individual's lymphatic architecture is valuable both in the understanding of underlying pathology and for targeting and tailoring treatment. Severe lower limb injuries resulting in extensive loss of soft tissue require transposition of a flap consisting of muscle and/or soft tissue to close the defect. These patients are at risk of lymphoedema and little is known about lymphatic regeneration within the flap. Indocyanine green (ICG), a water-soluble dye, has proven useful for the imaging of lymphatic vessels. When injected into superficial tissues it binds to plasma proteins in lymph. By exposing the dye to specific wavelengths of light, ICG fluoresces with near-infrared light. Skin is relatively transparent to ICG fluorescence, enabling the visualization and characterization of superficial lymphatic vessels. An ICG fluorescence lymphatic vessel imager was manufactured to excite ICG and visualize real-time fluorescence as it travels through the lymphatic vessels. Animal studies showed successful ICG excitation and detection using this imager. Clinically, the imager has assisted researchers to visualize otherwise hidden superficial lymphatic pathways in patients postflap surgery. Preliminary results suggest superficial lymphatic vessels do not redevelop in muscle flaps.
authors.affiliation: South Australian Biomedical Engineering at Flinders Medical Centre, Flinders Biomedical Engineering Department, Research & Teaching, Bedford Park SA 5042, Australia.
authors.forename: Olivia J
authors.initials: OJ
authors.lastname: Pallotta
authors.affiliation: Flinders University, Department of Surgery, Lymphoedema Research Unit, Level 3, Flinders Medical Centre, Bedford Park, SA 5042, Australia.
authors.forename: Malou
authors.initials: M
authors.lastname: van Zanten
authors.affiliation: South Australian Biomedical Engineering at Flinders Medical Centre, Flinders Biomedical Engineering Department, Research & Teaching, Bedford Park SA 5042, Australia.
authors.forename: Mark
authors.initials: M
authors.lastname: McEwen
authors.affiliation: South Australian Biomedical Engineering at Flinders Medical Centre, Flinders Biomedical Engineering Department, Research & Teaching, Bedford Park SA 5042, Australia.
authors.forename: Lynne
authors.initials: L
authors.lastname: Burrow
authors.affiliation: South Australian Biomedical Engineering at Flinders Medical Centre, Flinders Biomedical Engineering Department, Research & Teaching, Bedford Park SA 5042, Australia.
authors.forename: Jack
authors.initials: J
authors.lastname: Beesley
authors.affiliation: Flinders University, Department of Surgery, Lymphoedema Research Unit, Level 3, Flinders Medical Centre, Bedford Park, SA 5042, Australia.
authors.forename: Neil
authors.initials: N
authors.lastname: Piller
mesh_terms: D000328:Adult; D000368:Aged; D000818:Animals; D004867:Equipment Design; D005260:Female; D005456:Fluorescent Dyes / Q000008:administration & dosage / Q000737:chemistry / Q000627:therapeutic use*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007208:Indocyanine Green / Q000008:administration & dosage / Q000737:chemistry / Q000627:therapeutic use*; D042601:Lymphatic Vessels / Q000473:pathology*; D008209:Lymphedema / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D061848:Optical Imaging / Q000295:instrumentation* / Q000379:methods*; D015203:Reproducibility of Results; D013552:Swine
chemical_list: D005456:Fluorescent Dyes; D007208:Indocyanine Green