Head and neck (HN) cancer survivors are particularly susceptible to lymphedema with a reported incidence of 75%. Treatment of HN lymphedema (HNL) consists of manual lymphatic drainage and compression. In this FDA-approved study, we used near-infrared fluorescence lymphatic imaging (NIRFLI) to assess the response of HNL to a single session of sequential, pneumatic compression therapy (PCT) and after two weeks of daily PCT.
Following informed consent, 5 HNL subjects were enrolled into this study which consisted of two imaging sessions where each subject received six intradermal injections of 25µg of ICG in 0.1ml saline. Immediately after injection, NIRFLI was performed by illuminating the HN with excitation light and collecting the resultant fluorescent signal using a custom imaging system. After initial imaging, each subject underwent a single PCT session after which NIRFLI was again performed. Subjects were provided a pneumatic compression device for daily use over two weeks, after which imaging was repeated.
Abnormal dermal lymphatic backflow was observed in all subjects. Enhanced lymphatic uptake was observed in all subjects following a single PCT session. After two weeks of PCT, NIRFLI revealed the complete resolution of dermal backflow in one subject, the reduction of dermal backflow in two subjects, and no apparent lymphatic change in two subjects though both reported subjective improvements in swallowing or speaking.
PCT therapy may be an effective method to treat HNL. Additional studies are needed to assess long term clinical and quality of life impact.
This study was funded in part by Tactile Medical.
John C. Rasmussen, Melissa B. Aldrich, Banghe Zhu, J. Rodney Morrow, Carolina Guitierrez, Syed Naqvi, Rod J. Karni, and Eva M Sevick-Muraca, "Impact of pneumatic compression therapy on lymphatics in head and neck lymphedema (Conference Presentation)," Proc. SPIE 10578, Medical Imaging 2018: Biomedical Applications in Molecular, Structural, and Functional Imaging, 105780W (Presented at SPIE Medical Imaging: February 12, 2018; Published: 14 March 2018); https://doi.org/10.1117/12.2293539.5751395534001.
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