Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Dec;53(3):377-380.
doi: 10.1055/s-0040-1716436. Epub 2020 Nov 19.

A Novel Way of Standardization of ICG Lymphangiography Reporting

Ashok Basur Chandrappa  1 , Ritu Batth  1 , Srikanth Vasudevan  1 , Anantheswar Yellambalase N  1 , Dinkar Sreekumar  1
Affiliations

A Novel Way of Standardization of ICG Lymphangiography Reporting

Ashok Basur Chandrappa et al. Indian J Plast Surg. 2020 Dec.

Abstract

Background Indocyanine green (ICG) lymphangiography is being increasingly employed to assess the severity of lymphedema, locate the areas of patent linear lymphatics and dermal backflow and plan treatment. This study suggests a novel method of reporting ICG findings in extremities to enable easy understanding among surgeons and physiotherapists and avoid repeat testing when a patient visits a disparate lymphedema center or clinician. Methods A reporting protocol was developed in the lymphedema clinic of the plastic surgery department, and patients were asked to bring along the report in every subsequent review. The ICG findings were recorded on the fluorescence imaging system as well. The report was prepared by one and analyzed by two different clinicians without repeating the test on 10 consecutive patients. Results The interrater reliability of findings in the report was found to be 98.7% among the three clinicians. Conclusion The reporting system was found to be illustratable and reproducible.

Keywords: ICG reporting; lymphedema; standardization.

PubMed Disclaimer

Conflict of interest statement

Earlier PresentationConflicts of Interest None. None declared.

Figures

Fig. 1
Fig. 1
Lymphedema classification based on ICG lymphangiography (Source: Chang DW, Suami H, Skoracki R. A prospective analysis of 100 consecutive lymphovenous bypass cases for treatment of extremity lymphedema. Plast Reconstr Surg 2013; 132:1305–14).
Fig. 2
Fig. 2
Linear lymphatics.
Fig. 3
Fig. 3
Splash pattern of dermal backflow.
Fig. 4
Fig. 4
Stardust pattern of dermal backflow.
Fig. 5
Fig. 5
Diffuse pattern of dermal backflow.
Fig. 6
Fig. 6
Marking the zones in upper limbs.
Fig. 7
Fig. 7
The proposed reporting system sheet.
See this image and copyright information in PMC

References

    1. Suami H, Heydon-White A, Mackie H, Czerniec S, Koelmeyer L, Boyages J. A new indocyanine green fluorescence lymphography protocol for identification of the lymphatic drainage pathway for patients with breast cancer-related lymphoedema. BMC Cancer. 2019;19(01):985. - PMC - PubMed
    1. Narushima M, Yamamoto T, Ogata F, Yoshimatsu H, Mihara M, Koshima I. Indocyanine green lymphography findings in limb lymphedema. J Reconstr Microsurg. 2016;32(01):72–79. - PubMed
    1. Henze E, Schelbert H R, Collins J D, Najafi A, Barrio J R, Bennett L R. Lymphoscintigraphy with Tc-99m-labeled dextran. J Nucl Med. 1982;23(10):923–929. - PubMed
    1. Szuba A, Shin W S, Strauss H W, Rockson S. The third circulation: radionuclide lymphoscintigraphy in the evaluation of lymphedema. J Nucl Med. 2003;44(01):43–57. - PubMed
    1. Tomczak H, Nyka W, Lass P. Lymphoedema: lymphoscintigraphy versus other diagnostic techniques–a clinician’s point of view. Nucl Med Rev Cent East Eur. 2005;8(01):37–43. - PubMed