Lymphatic research and biology最新文献

{"title":"Automated Measurement of Skin Thickness in Computed Tomography Images for Unilateral Lower Extremity Lymphedema.","authors":"Yukihiro Nomura, Hiroki Naganishi, Yuma Ando, Shinsuke Akita, Nobuyuki Mitsukawa","doi":"10.1089/lrb.2024.0075","DOIUrl":"https://doi.org/10.1089/lrb.2024.0075","url":null,"abstract":"<p><p><b><i>Background:</i></b> Lower extremity lymphedema (LEL) is a common complication following gynecological cancer treatment, characterized by the accumulation of protein-rich fluid owing to lymphatic system insufficiency. This condition manifests as in skin thickening, soft tissue swelling, and other complications. Therefore, this study proposes an automatic method for measuring skin thickness in lower extremity computed tomography (CT) images and assessing its effectiveness in diagnosing LEL. <b><i>Methods and Results:</i></b> We selected 56 patients with unilateral LEL based on specific diagnostic criteria, including clinical evaluation, lymphoscintigraphy, indocyanine green lymphography, and a noncontrast CT scan, which included the entire lower extremities. The CT images had a pixel spacing ranging from 0.723 to 0.976 mm, with a slice thickness of 10.0 mm. Our skin thickness measurement method involves preprocessing, such as extracting the leg, bone, muscle, and subcutaneous fat regions, defining the target slice range, and measuring the skin thickness. The lower extremity was divided into eight subregions, and the skin thickness was measured across these subregions. The overall median skin thicknesses were 0.883 ± 0.201 and 1.536 ± 0.487 mm in normal and positive subregions, respectively. The classification of LEL was based on the <i>Z</i>-score calculated for each subregion, with the median skin thickness from normal legs serving as a reference. Our classification method demonstrated an overall accuracy of 0.839, sensitivity of 0.703, and specificity of 0.937. <b><i>Conclusions:</i></b> Our automated method for measuring skin thickness in CT images shows promise in diagnosing LEL, with high accuracy and specificity. This approach enables a comprehensive evaluation of the entire leg, potentially enhancing the diagnostic process for LEL.</p>","PeriodicalId":18168,"journal":{"name":"Lymphatic research and biology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143795423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Use of Ultrasonography to Detect Lymphatic Dysfunction.","authors":"Stanley G Rockson","doi":"10.1089/lrb.2025.0039","DOIUrl":"https://doi.org/10.1089/lrb.2025.0039","url":null,"abstract":"","PeriodicalId":18168,"journal":{"name":"Lymphatic research and biology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143730497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Research Matters.","authors":"","doi":"10.1089/lrb.2025.0020","DOIUrl":"https://doi.org/10.1089/lrb.2025.0020","url":null,"abstract":"","PeriodicalId":18168,"journal":{"name":"Lymphatic research and biology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649706","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Comparative Evaluation of Depression, Life Satisfaction, and Quality of Life Between Female Patients with Lipedema and Lymphedema.","authors":"Ayşegül Yaman, Pınar Borman, Esra Gizem Koyuncu, Ayşegül Balcan Aslan, Ayça Utkan Karasu, Cansu Şahbaz Pirinççi","doi":"10.1089/lrb.2024.0117","DOIUrl":"https://doi.org/10.1089/lrb.2024.0117","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Lymphedema and lipedema are chronic conditions significantly impacting psychosocial status and quality of life (QOL). However, comparative studies on depression, life satisfaction, functional status, and QoL in these conditions are lacking. This study aims to fill this gap by providing a comparative evaluation of functional status, depression, life satisfaction, and QoL in patients with lymphedema and lipedema. <b><i>Method:</i></b> Over 12 months, 73 female patients diagnosed with pure lymphedema or lipedema were recruited according to inclusion/exclusion criteria. A range of demographic variables, including age, body mass index (BMI), disease duration, stage of disease, and exercise/smoking conditions, were recorded. The lower-extremity functional scale (LEFS), life satisfaction index (LSI), patient health questionnaire (PHQ-9), and Lymphedema QOL Questionnaire for Legs were used to assess functional status, life satisfaction, depression, and QoL, respectively, in both groups. The relationship between questionnaire scores and demographic variables was carefully evaluated. <b><i>Results:</i></b> Thirty-six individuals with lymphedema (mean age: 55.1 years) and 37 patients with lipedema (mean age: 50.7 years) were included in the study. Demographical variables were statistically similar between the groups (<i>p</i> > 0.05). Duration of disease was longer (mean: 159.3 months vs. 39.6 months) in a lipedema group than in lymphedema patients. PHQ-9 (mean:11.4 vs. 10.4) and overall QoL scores (mean: 5.06 vs. 5.47) were similar between groups, while LEFS (mean: 44 vs. 62) and LSI scores (mean: 11.5 vs. 14.3) were worse in patients with lymphedema than in a lipedema group. There were correlations between age and LEFS (<i>p</i> = 0.014, <i>r</i> = -0.40) and LSI (<i>p</i> = 0.013, <i>r</i> = -0.41) in the lymphedema group; and between BMI and LEFS (<i>p</i> = 0.013, <i>r</i> = -0.041) and QoL (<i>p</i> = 0.034, <i>r</i> = 0.37) scores; and duration of disease and PHQ-9 scores (<i>p</i> = 0.028, <i>r</i> = -0.41) in the lipedema group. <b><i>Conclusions:</i></b> Patients with lipedema have similar depression and impaired QoL as lymphedema patients. However, lymphedema patients experience more functional disability and less life satisfaction. As the BMI and duration of illness are correlated with depression and QoL, early diagnosis and early management are essential to improve disability and QoL in patients suffering from lipedema.</p>","PeriodicalId":18168,"journal":{"name":"Lymphatic research and biology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143625229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment Tools to Quantify the Physical Aspects of Lipedema: A Systematic Review.","authors":"Helen E Eason, Sharon L Kilbreath, Nicola Fearn, Elizabeth S Dylke","doi":"10.1089/lrb.2024.0102","DOIUrl":"https://doi.org/10.1089/lrb.2024.0102","url":null,"abstract":"<p><p>Lipedema diagnosis is heavily reliant on patient history. Various objective assessments have been suggested; however, a standardized measurement process is lacking. A systematic review was undertaken to identify which imaging and measurement tools are used in lipedema quantification and to review their protocols. Six databases were searched with two reviewers screening citations for inclusion. Full peer-reviewed publications that included defined lipedema diagnosis criteria, no male cases within comparative cohorts, and used an imaging or measurement tool to quantify lipedema were included. Twenty studies met the inclusion criteria using 13 different tools to quantify individual physical lipedema characteristics to either enable differential diagnosis, and/or quantify treatment effect: tape measure, perometry, durometry, tonometry, bioimpedance spectroscopy, tissue di-electric constant, ultrasound, Dual-Energy X-ray Absorptiometry, magnetic resonance imaging (MRI), noncontrast MRI lymphangiography, Indocyanine green lymphography, lymphoscintigraphy, and dynamic lymphangiography. Eight imaging and five measurement tools assessed lymphatic transport disturbances (<i>n</i> = 8), limb size/volume (<i>n</i> = 4), adipose tissue thickness/mass/volume (<i>n</i> = 3), and tissue fluid presence (<i>n</i> = 2). Multiple tools were only used in studies completed in 2020 or later. A lack of consistency exists in tool protocols, measurement locations, and outcome analysis. Limited reporting of clinimetrics with data derived from small cohorts and heterogenous populations impacted the ability to recommend tools for clinical practice and research. Various tools were used for objective lipedema assessment; however, consistency in approach was lacking. Further investigations are required to establish the validity and reliability of measurement and imaging tools, protocols, measurement points, and outcome reporting/interpretation to quantify the physical attributes of lipedema.</p>","PeriodicalId":18168,"journal":{"name":"Lymphatic research and biology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Therapeutic Ultrasound Added to Complex Decongestive Therapy in Breast Cancer-Related Lymphedema.","authors":"Mihriban Cağlı, Burcu Duyur Çakıt, Secil Pervane","doi":"10.1089/lrb.2023.0019","DOIUrl":"https://doi.org/10.1089/lrb.2023.0019","url":null,"abstract":"<p><p><b><i>Objective:</i></b> To determine the efficacy of therapeutic ultrasound (TUS) added to complex decongestive therapy (CDT) in patients with breast cancer-related lymphedema (BCRL). <b><i>Materials and Methods:</i></b> Thirty female volunteer patients who developed stage 2-3 BCRL were included in the study. The patients were randomly assigned to one of two groups: standard treatment with CDT alone and CDT + TUS. Before the study, both groups were given a training and home program consisting of remedial exercises and skin care. All patients received 15 sessions of treatment over 3 weeks. Circumferential and ultrasonographic (USG) measurements of all patients were performed before and after treatment. Treatment efficacy was evaluated based on extremity volume and soft tissue thickness. <b><i>Results:</i></b> The demographic data and volume measurements of the patients were similar at the beginning of treatment. There was a statistically significant decrease in the affected extremity in both groups in posttreatment circumferential measurements. However, the reductions in volume difference and volume difference percentage were significantly higher in the CDT + TUS group (<i>p</i> = 0.001 and <i>p</i> = 0.002, respectively). In the USG measurements, a greater decrease was observed in the soft tissue thickness below the elbow in the CDT + TUS group compared with the CDT alone group (<i>p</i> = 0.003). <b><i>Conclusion:</i></b> In the treatment of BCRL, TUS added to CDT resulted in a reduction in lymphedema. We consider that when added to CDT, TUS can increase the efficacy of treatment by reducing lymphedema in stages 2 and 3 lymphedema cases.</p>","PeriodicalId":18168,"journal":{"name":"Lymphatic research and biology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of Elastographic Parameters in Patients with Breast Cancer-Related Lymphedema and Examination of Their Relationship with Clinical Data.","authors":"Merve Demirci, Canan Sanal, Ilker Yagcı, Gulseren Akyuz","doi":"10.1089/lrb.2024.0088","DOIUrl":"https://doi.org/10.1089/lrb.2024.0088","url":null,"abstract":"<p><p><b><i>Background:</i></b> To evaluate the stiffness of the skin and subcutaneous tissues of the arm and forearm of patients with breast cancer-related lymphedema using shear-wave elastography (SWE) and to investigate the relationship between the patients' symptoms. <b><i>Methods and Results:</i></b> Both lymphedematous and unaffected upper extremities of 72 patients (72 lymphedematous and 72 unaffected extremities) and 72 upper extremities of 36 controls (72 healthy extremities) were included in the study. The stiffness of the skin and subcutaneous tissues of all extremities was evaluated with SWE. The patients' pain, tension, weight, and stiffness symptoms associated with lymphedema were questioned using a numerical scale. The patients' functionality and participation in daily life activities were evaluated. The skin stiffness of the affected extremity was higher and the subcutaneous tissue stiffness was lower in patients than in controls (<i>p</i> < 0.05). The skin stiffness of the affected forearm was higher and the subcutaneous tissue stiffness of the affected arm and forearm was lower than their healthy extremities (<i>p</i> < 0.05). Quick Disabilities of Arm, Shoulder, and Hand and Life Impact Scale; were negatively correlated with arm and forearm subcutaneous tissue stiffness and positively correlated with forearm skin stiffness. The decrease in subcutaneous tissue stiffness of the arm was associated with heaviness sensation, the increase in skin stiffness of the forearm was associated with tightness, and the decrease in subcutaneous tissue stiffness of the forearm was associated with tightness, heaviness, and stiffness sensations. <b><i>Conclusion:</i></b> The results of this study suggest that SWE measurements can be useful for diagnosis and follow-up of patients.</p>","PeriodicalId":18168,"journal":{"name":"Lymphatic research and biology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A New Secondary Chronic Lymphedema Rat Model Improved by High-Fat Diet.","authors":"Chan Xing, Jie Sun, Yaqian Liu, Jialin Zhou, Xue Bai, Jun Li, Haidong Zhao","doi":"10.1089/lrb.2024.0051","DOIUrl":"https://doi.org/10.1089/lrb.2024.0051","url":null,"abstract":"<p><p><b><i>Purpose:</i></b> Secondary chronic lymphedema is a complication that seriously affects the quality of life of cancers survivors which is urgent to be studied. However, the current animal models generally have some defects such as short duration that affect the research process. To acquire an animal model which is easier to accomplish as well as higher success rate is the main goal of our experiment. <b><i>Methods:</i></b> The hind limb model of rats with secondary chronic lymphedema was established by near infrared fluorescence-guided lymphatic system destruction combined with high-fat diet innovation. The model was evaluated by limb circumference, volume, near-infrared fluorescence imaging of lymphatic vessels, and a series of histopathological staining. <b><i>Results:</i></b> The model was successfully established by operation combined with a high-fat diet and kept persistent effective lasting up to 16 weeks. Compared with the normal diet group, the high-fat group received a higher success rate (77.77% vs. 55.55%), a more obvious degree of limb swelling, and a more significant level of subcutaneous inflammatory factor infiltration at the edema site. Based on it, we kept research and found out that there was no significant difference in the process of subcutaneous fibrosis between the two groups. <b><i>Conclusions:</i></b> High-fat diet may improve secondary chronic lymphedema rat model success rate as well as effectiveness by changing the level of inflammatory infiltration in the site of lymphedema.</p>","PeriodicalId":18168,"journal":{"name":"Lymphatic research and biology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143449152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characteristic Computed Tomography Findings in Female Patients with Secondary Genital Lymphedema.","authors":"Ryusuke Sumiya, Takashi Kageyama, Hayahito Sakai, Reiko Tsukuura, Takumi Yamamoto","doi":"10.1089/lrb.2024.0006","DOIUrl":"https://doi.org/10.1089/lrb.2024.0006","url":null,"abstract":"<p><p><b><i>Background:</i></b> Female genital lymphedema (FGL) is a challenging disease, and appropriate preoperative evaluation is crucial before surgical treatments. Computed tomography (CT) is expected useful for FGL evaluation, but little is known. This study aimed to clarify characteristic CT findings of FGL with a case report of CT findings-guided lymphaticovenous anastomosis (LVA). <b><i>Methods:</i></b> Medical charts of secondary lower extremity lymphedema patients who underwent CT and indocyanine green (ICG) lymphography were reviewed. Genital regions with dermal backflow patterns on ICG lymphography were diagnosed as FGL. Prevalence of characteristic CT findings of lymphedema was compared between genitalia regions with and without FGL. A case of genital lymphedema treated with LVA under the guidance of CT findings was presented. <b><i>Results:</i></b> A total of 51 patients (32 with FGL, and 19 without FGL) were included in this study. Genital ICG included stages 0/I/II/III/IV/V in 19 (37.3%)/5 (9.8%)/11 (21.6%)/9 (17.6%)/7 (13.7%)/0 (0%) cases, respectively. Characteristic CT findings included thick skin in 14 (27.5%), thick fascia in 17 (33.3%), high density of the superficial fat in 11 (21.6%), high density of the deep fat in 13 (25.5%), fluid collection in 8 (15.7%), detectable inguinal lymph node in 42 (82.4%), and honeycomb appearance in 7 regions (13.7%). Between genital regions with and without FGL, there were statistically significant differences in all the characteristic CT findings (<i>p</i> < 0.05). <b><i>Conclusions:</i></b> Characteristic CT findings of secondary FGL were identified. Preoperative CT evaluation may be useful for selecting appropriate LVA sites for optimal results.</p>","PeriodicalId":18168,"journal":{"name":"Lymphatic research and biology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hypoxia Impairs Migration of Human Dermal Lymph Endothelial Cells: Implications for Lymphedema Pathogenesis.","authors":"Chihiro Matsui, Hiroshi Koide, Hatan Mortada, Reiko Tsukuura, Toko Miyazaki, Hayahito Sakai, Hiroshi Mizuno, Takumi Yamamoto","doi":"10.1089/lrb.2024.0019","DOIUrl":"https://doi.org/10.1089/lrb.2024.0019","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Lymphedema, characterized by abnormal lymph circulation, is a chronic debilitating condition often associated with chronic inflammation and hypoxia in lymphedematous tissue. Previously, using videocapillaroscopy, we found that the severity of lymphedema damages vasa vasorum vessels on the surface of lymph vessels, significantly compromising the oxygen supply environment to lymph endothelial cells. While previous research has indicated the inhibitory effects of hypoxic conditions on the proliferation of human dermal lymph endothelial cells (HDLECs), the impact on HDLEC migration remains unclear. This study aims to investigate the migration ability of HDLECs under hypoxic conditions, shedding light on the potential mechanisms underlying lymphedema progression and offering insights into therapeutic strategies. <b><i>Materials and Methods and Results:</i></b> Purchased HDLECs were cultured under normoxic (2% O₂) and hypoxic (1% O₂) conditions. Migration assays were performed using a scratch assay to assess the migratory capabilities of HDLECs. The experiment monitored cell migration over a period of 6 hours. Experiments were performed in triplicate. HDLECs were cultured to full confluence before the scratch assay. The results revealed a significant reduction in HDLEC migration under hypoxic conditions compared to normoxic conditions after 6 hours (<i>p</i> < 0.001). This suggests that hypoxic environments directly impair HDLEC migration. <b><i>Conclusion:</i></b> Hypoxia negatively affects HDLEC migration, potentially exacerbating lymphedema. Protecting vasa vasorum may preserve HDLEC migration and lymphangiogenesis. Further exploration of hypoxia-HDLEC interactions is crucial for understanding lymphedema pathogenesis and developing therapies.</p>","PeriodicalId":18168,"journal":{"name":"Lymphatic research and biology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143391291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}