A new indocyanine green lymphography protocol for assessment of lymphedema in the head and neck

Hiroo Suami; Katrina Gaitatzis; Helen Mackie; Belinda Thompson; Fiona T. Blake; Dion Forstner; Puma Sundaresan; Roman Skoracki; Louise Koelmeyer

doi:10.1002/ohn.1355

A new indocyanine green lymphography protocol for assessment of lymphedema in the head and neck

Hiroo Suami^*, Katrina Gaitatzis, Helen Mackie, Belinda Thompson, Fiona T. Blake, Dion Forstner, Puma Sundaresan, Roman Skoracki, Louise Koelmeyer

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

3 Citations (Scopus)

5 Downloads (Pure)

Abstract

Head and neck cancer and its treatment may result in lymphedema, however, no specific imaging criteria have been assigned to diagnose this condition. This study reports an ICG lymphography protocol for investigating changes in individuals experiencing swelling post-neck dissection. ICG lymphography was performed in 10 healthy participants and 16 individuals who complained of facial or neck swelling following treatment for head and neck cancer. Four ICG injection sites were proposed to demonstrate 3 lymphatic territories draininig to upper cervical, submandibular, and submental nodes. In healthy controls, 3 lymphatic drainage pathways were demonstrated in the ipsilateral neck. In individuals post-neck dissection, dermal backflow was present and 2 additional drainage pathways were visualized to the paraspinal and axillary regions. This study proposes an anatomy-based protocol for ICG lymphography and interpretations of imaging findings in patients post-neck dissection surgery. ICG lymphography offers a diagnostic imaging tool for head and neck lymphedema.

Original language	English
Pages (from-to)	1302-1306
Number of pages	5
Journal	Otolaryngology - Head and Neck Surgery (United States)
Volume	173
Issue number	5
Early online date	14 Jul 2025
DOIs	https://doi.org/10.1002/ohn.1355
Publication status	Published - Nov 2025

Bibliographical note

Copyright the Author(s) 2025. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.

Keywords

head and neck cancer
indocyanine green
lymphedema
lymphography
neck dissection

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10.1002/ohn.1355Licence: CC BY-NC

Publisher version (open access)Final published version, 1.43 MBLicence: CC BY-NC

Cite this

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title = "A new indocyanine green lymphography protocol for assessment of lymphedema in the head and neck",

abstract = "Head and neck cancer and its treatment may result in lymphedema, however, no specific imaging criteria have been assigned to diagnose this condition. This study reports an ICG lymphography protocol for investigating changes in individuals experiencing swelling post-neck dissection. ICG lymphography was performed in 10 healthy participants and 16 individuals who complained of facial or neck swelling following treatment for head and neck cancer. Four ICG injection sites were proposed to demonstrate 3 lymphatic territories draininig to upper cervical, submandibular, and submental nodes. In healthy controls, 3 lymphatic drainage pathways were demonstrated in the ipsilateral neck. In individuals post-neck dissection, dermal backflow was present and 2 additional drainage pathways were visualized to the paraspinal and axillary regions. This study proposes an anatomy-based protocol for ICG lymphography and interpretations of imaging findings in patients post-neck dissection surgery. ICG lymphography offers a diagnostic imaging tool for head and neck lymphedema.",

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author = "Hiroo Suami and Katrina Gaitatzis and Helen Mackie and Belinda Thompson and Blake, \{Fiona T.\} and Dion Forstner and Puma Sundaresan and Roman Skoracki and Louise Koelmeyer",

note = "Copyright the Author(s) 2025. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.",

year = "2025",

month = nov,

doi = "10.1002/ohn.1355",

language = "English",

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AU - Suami, Hiroo

AU - Gaitatzis, Katrina

AU - Mackie, Helen

AU - Thompson, Belinda

AU - Blake, Fiona T.

AU - Forstner, Dion

AU - Sundaresan, Puma

AU - Skoracki, Roman

AU - Koelmeyer, Louise

N1 - Copyright the Author(s) 2025. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.

PY - 2025/11

Y1 - 2025/11

N2 - Head and neck cancer and its treatment may result in lymphedema, however, no specific imaging criteria have been assigned to diagnose this condition. This study reports an ICG lymphography protocol for investigating changes in individuals experiencing swelling post-neck dissection. ICG lymphography was performed in 10 healthy participants and 16 individuals who complained of facial or neck swelling following treatment for head and neck cancer. Four ICG injection sites were proposed to demonstrate 3 lymphatic territories draininig to upper cervical, submandibular, and submental nodes. In healthy controls, 3 lymphatic drainage pathways were demonstrated in the ipsilateral neck. In individuals post-neck dissection, dermal backflow was present and 2 additional drainage pathways were visualized to the paraspinal and axillary regions. This study proposes an anatomy-based protocol for ICG lymphography and interpretations of imaging findings in patients post-neck dissection surgery. ICG lymphography offers a diagnostic imaging tool for head and neck lymphedema.

AB - Head and neck cancer and its treatment may result in lymphedema, however, no specific imaging criteria have been assigned to diagnose this condition. This study reports an ICG lymphography protocol for investigating changes in individuals experiencing swelling post-neck dissection. ICG lymphography was performed in 10 healthy participants and 16 individuals who complained of facial or neck swelling following treatment for head and neck cancer. Four ICG injection sites were proposed to demonstrate 3 lymphatic territories draininig to upper cervical, submandibular, and submental nodes. In healthy controls, 3 lymphatic drainage pathways were demonstrated in the ipsilateral neck. In individuals post-neck dissection, dermal backflow was present and 2 additional drainage pathways were visualized to the paraspinal and axillary regions. This study proposes an anatomy-based protocol for ICG lymphography and interpretations of imaging findings in patients post-neck dissection surgery. ICG lymphography offers a diagnostic imaging tool for head and neck lymphedema.

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KW - indocyanine green

KW - lymphedema

KW - lymphography

KW - neck dissection

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DO - 10.1002/ohn.1355

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SN - 0194-5998

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JO - Otolaryngology - Head and Neck Surgery (United States)

JF - Otolaryngology - Head and Neck Surgery (United States)

IS - 5

ER -

A new indocyanine green lymphography protocol for assessment of lymphedema in the head and neck

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