This article is a U.S. Government work and is in the public domain in the U.S.A.
Imaging of the lymphatic system: new horizons†
Article first published online: 8 DEC 2006
This article is a U.S. Government work and is in the public domain in the U.S.A. Published in 2006 by John Wiley & Sons, Ltd.
Contrast Media & Molecular Imaging
Volume 1, Issue 6, pages 230–245, November/December 2006
How to Cite
Barrett, T., Choyke, P. L. and Kobayashi, H. (2006), Imaging of the lymphatic system: new horizons. Contrast Media Mol Imaging, 1: 230–245. doi: 10.1002/cmmi.116
- Issue published online: 8 DEC 2006
- Article first published online: 8 DEC 2006
- Manuscript Accepted: 21 OCT 2006
- Manuscript Revised: 19 OCT 2006
- Manuscript Received: 5 SEP 2006
- Intramural Research Program of the NIH
- National Cancer Institute
- Center for Cancer Research
- Lymphatic imaging;
- sentinel node imaging;
- contrast agent;
The lymphatic system is a complex network of lymph vessels, lymphatic organs and lymph nodes. Traditionally, imaging of the lymphatic system has been based on conventional imaging methods like computed tomography (CT) and magnetic resonance imaging (MRI), whereby enlargement of lymph nodes is considered the primary diagnostic criterion for disease. This is particularly true in oncology, where nodal enlargement can be indicative of nodal metastases or lymphoma. CT and MRI on their own are, however, anatomical imaging methods. Newer imaging methods such as positron emission tomography (PET), dynamic contrast-enhanced MRI (DCE-MRI) and color Doppler ultrasound (CDUS) provide a functional assessment of node status. None of these techniques is capable of detecting flow within the lymphatics and, thus, several intra-lymphatic imaging methods have been developed. Direct lymphangiography is an all-but-extinct method of visualizing the lymphatic drainage from an extremity using oil-based iodine contrast agents. More recently, interstitially injected intra-lymphatic imaging, such as lymphoscintigraphy, has been used for lymphedema assessment and sentinel node detection. Nevertheless, radionuclide-based imaging has the disadvantage of poor resolution. This has lead to the development of novel systemic and interstitial imaging techniques which are minimally invasive and have the potential to provide both structural and functional information; this is a particular advantage for cancer imaging, where anatomical depiction alone often provides insufficient information. At present the respective role each modality plays remains to be determined. Indeed, multi-modal imaging may be more appropriate for certain lymphatic disorders. The field of lymphatic imaging is ever evolving, and technological advances, combined with the development of new contrast agents, continue to improve diagnostic accuracy. Published in 2006 by John Wiley & Sons, Ltd.