Correlation of ICG lymphography and lymphoscintigraphy severity stage in secondary upper limb lymphedema. 2020

Jin A Yoon, and Myung Jun Shin, and Yong Beom Shin, and Keunyoung Kim, and Heeseung Park, and Taewoo Kang, and In Joo Kong, and Hyojeong Kim, and Min Suk Park, and Joo Hyoung Kim
Department of Rehabilitation Medicine, Pusan National University School of Medicine and Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea.

OBJECTIVE To examine the correlation between lymphedema severity stages on lymphoscintigraphy and on indocyanine green (ICG) lymphography in patients with secondary lymphedema after breast cancer. METHODS This retrospective study was conducted on patients who underwent both lymphoscintigraphy and ICG lymphography for the evaluation of secondary lymphedema after breast cancer. The images were classified into type I - V according to the Arm Dermal Backflow (ADB) stage and modified MD Anderson Cancer Center (MDACC) stage on ICG lymphography and lymphoscintigraphy images on the basis of how lymphatic flow was preserved and how dermal back flow was extended. The correlation between scales was analysed. RESULTS A total of 47 patients were referred to our hospital for the evaluation of secondary lymphedema after breast cancer. There was no significant difference between lymphoscintigraphy severity scale and ADB stage (anterior and posterior). The lymphoscintigraphy severity scale and modified MDACC stage were significantly different. In the correlation analysis, lymphoscintigraphy and ADB (anterior) stage (r = 0.83), lymphoscintigraphy and ADB (posterior) stage (r = 0.86) and lymphoscintigraphy and modified MDACC stage (r = 0.85) exhibited very strong positive correlations. Intra-rater agreement between lymphoscintigraphy and ADB (anterior) stage and lymphoscintigraphy and ADB (posterior) was substantial (κ=0.62 and κ=0.69, respectively) and fair (κ = 0.36) between lymphoscintigraphy and modified MDACC stage. CONCLUSIONS Lymphoscintigraphy severity stage and ADB stage on ICG lymphography showed very strong positive correlation and substantial agreement. These two modalities can work synergistically to evaluate lymphedema severity.

UI MeSH Term Description Entries
D007208 Indocyanine Green A tricarbocyanine dye that is used diagnostically in liver function tests and to determine blood volume and cardiac output. Cardio-Green,Cardiogreen,Ujoveridin,Vofaverdin,Vophaverdin,Wofaverdin,Cardio Green,Green, Indocyanine
D008209 Lymphedema Edema due to obstruction of lymph vessels or disorders of the lymph nodes. Milroy's Disease,Congenital Familial Lymphedema,Congenital Hereditary Lymphedema,Early Onset Lymphedema,Hereditary Lymphedema,Hereditary Lymphedema 1,Hereditary Lymphedema Type I,Lymphedema, Early-Onset,Lymphedema, Hereditary, Ia,Milroy Disease,Nonne-Milroy Disease,Nonne-Milroy Lymphedema,Nonne-Milroy-Meige Disease,Primary Congenital Lymphedema,Congenital Hereditary Lymphedemas,Congenital Lymphedema, Primary,Congenital Lymphedemas, Primary,Early Onset Lymphedemas,Early-Onset Lymphedema,Early-Onset Lymphedemas,Hereditary Lymphedema 1s,Hereditary Lymphedema, Congenital,Hereditary Lymphedemas,Hereditary Lymphedemas, Congenital,Lymphedema, Congenital Hereditary,Lymphedema, Early Onset,Lymphedema, Hereditary,Lymphedema, Nonne-Milroy,Lymphedema, Primary Congenital,Lymphedemas,Lymphedemas, Congenital Hereditary,Lymphedemas, Early Onset,Lymphedemas, Early-Onset,Lymphedemas, Hereditary,Lymphedemas, Primary Congenital,Milroys Disease,Nonne Milroy Disease,Nonne Milroy Lymphedema,Nonne Milroy Meige Disease,Primary Congenital Lymphedemas
D008220 Lymphography Radiographic study of the lymphatic system following injection of dye or contrast medium. Lymphangiography,Lymphangiographies,Lymphographies
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D001943 Breast Neoplasms Tumors or cancer of the human BREAST. Breast Cancer,Breast Tumors,Cancer of Breast,Breast Carcinoma,Cancer of the Breast,Human Mammary Carcinoma,Malignant Neoplasm of Breast,Malignant Tumor of Breast,Mammary Cancer,Mammary Carcinoma, Human,Mammary Neoplasm, Human,Mammary Neoplasms, Human,Neoplasms, Breast,Tumors, Breast,Breast Carcinomas,Breast Malignant Neoplasm,Breast Malignant Neoplasms,Breast Malignant Tumor,Breast Malignant Tumors,Breast Neoplasm,Breast Tumor,Cancer, Breast,Cancer, Mammary,Cancers, Mammary,Carcinoma, Breast,Carcinoma, Human Mammary,Carcinomas, Breast,Carcinomas, Human Mammary,Human Mammary Carcinomas,Human Mammary Neoplasm,Human Mammary Neoplasms,Mammary Cancers,Mammary Carcinomas, Human,Neoplasm, Breast,Neoplasm, Human Mammary,Neoplasms, Human Mammary,Tumor, Breast
D004396 Coloring Agents Chemicals and substances that impart color including soluble dyes and insoluble pigments. They are used in INKS; PAINTS; and as INDICATORS AND REAGENTS. Coloring Agent,Dye,Dyes,Organic Pigment,Stain,Stains,Tissue Stain,Tissue Stains,Organic Pigments,Pigments, Inorganic,Agent, Coloring,Inorganic Pigments,Pigment, Organic,Pigments, Organic,Stain, Tissue,Stains, Tissue
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000078331 Correlation of Data Determination of whether or not two variables are correlated. This means to study whether an increase or decrease in one variable corresponds to an increase or decrease in the other variable. Correlation Studies,Correlation Study,Data Correlation,Data Correlations,Studies, Correlation,Study, Correlation
D012189 Retrospective Studies Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons. Retrospective Study,Studies, Retrospective,Study, Retrospective

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