Abstract
Tan I-C, Maus EA, Rasmussen LC, Marshall MV, Adams KE, Fife CE, Smith LA, Chan W,
Sevick-Muraca EM. Assessment of lymphatic contractile function after manual lymphatic
drainage using near-infrared fluorescence imaging.
Objective
To investigate the feasibility of assessing the efficacy of manual lymphatic drainage
(MLD), a method for lymphedema (LE) management, by using near-infrared (NIR) fluorescence
imaging.
Design
Exploratory pilot study.
Setting
Primary care unit.
Participants
Subjects (N=10; age, 18–68y) with a diagnosis of grade I or II LE and 12 healthy control
subjects (age, 22–59y).
Intervention
Indocyanine green (25 μg in 0.1 mL each) was injected intradermally in bilateral arms
or legs of subjects. Diffused excitation light illuminated the limbs, and NIR fluorescence
images were collected by using custom-built imaging systems. Subjects received MLD
therapy, and imaging was performed pre- and posttherapy.
Main Outcome Measures
Apparent lymph velocities and periods between lymphatic propulsion events were computed
from fluorescence images. Data collected pre- and post-MLD were compared and evaluated
for differences.
Results
By comparing pre-MLD lymphatic contractile function against post-MLD lymphatic function,
results showed that average apparent lymph velocity increased in both the symptomatic
(+23%) and asymptomatic (+25%) limbs of subjects with LE and control limbs (+28%)
of healthy subjects. The average lymphatic propulsion period decreased in symptomatic
(−9%) and asymptomatic (−20%) limbs of subjects with LE, as well as in control limbs
(−23%).
Conclusions
We showed that NIR fluorescence imaging could be used to quantify immediate improvement
of lymphatic contractile function after MLD.
Key Words
List of Abbreviations:
ANOVA (analysis of variance), CDT (complete decongestive therapy), ICG (indocyanine green), LE (lymphedema), MLD (manual lymphatic drainage), NIR (near-infrared), PCD (pneumatic compression device)To read this article in full you will need to make a payment
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Article info
Footnotes
Supported in part by the Longaberger Foundation through an American Cancer Society Research Scholar Grant (no. RSG-06-213-01-LR) and the National Institutes of Health (grant nos. R01 HL092923 and U54 CA136404).
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.
Reprints are not available from the author.
Identification
Copyright
© 2011 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
