The authors have nothing to acknowledge.

Tutte le procedure sono stati rivisti e approvati dal Institutional Review Board della Chungnam National University Hospital. 1. Misura con ecografia <ol><li> Impostare la postura del paziente. <ol><li> Posizionare il braccio del paziente in posizione supina, con entrambe le braccia sul letto. </li></ol></li><li> Determinare i siti di misurazione sulla parte superiore del paziente. <ol><li> Mark nel punto centrale della piega del polso, il punto intermedio tra il mediale e epicondili laterali a livello del gomito, e la scanalatura bicipitale da una penna. </li><li> Utilizzando una penna collegare direttamente questi tre punti da un righello. Segnare le due aree bersaglio sulla parte superiore del braccio e dell&#39;avambraccio (Figura 1). <ol><li> Segnare la parte prossimale, 10 centimetri in prossimità del punto di piega lungo la linea tra il gomito e solco bicipitale. </li><li> Segnare la parte distale 10 cm distalmente al punto di piega lungo la linea tra il gomito e polso. </li></ol></li></ol></li><li> Misurare lo spessore del tessuto sottocutaneo e muscolare degli arti superiori. La procedura deve essere eseguita da un ecografista esperto. <ol><li> Accendere il sistema a ultrasuoni. Inserire modalità 2D dei tessuti molli tramite la tastiera. Impostare la profondità di 5 cm. <ol><li> Scegliere il trasduttore lineare 14L5. </li><li> Applicare gel sufficienti al trasduttore ad ultrasuoni. Focus sul tessuto sottocutaneo. </li></ol></li><li> Posizionare il trasduttore ad ultrasuoni perpendicolarmente all&#39;asse ventrale arto superiore. Utilizzare l&#39;asse corto. Acquisire l&#39;immagine in cui lo spessore del gel è di almeno 1 cm e il contorno tessuto molle non è distorta. </li><li> Misurare le spessori del muscolo e del tessuto sottocutaneo. <ol><li> Disegna una linea selezionando il calibratore nel software tramite la tastiera del sistema ad ultrasuoni </li><li> Misurare lo spessore del muscolo, definita come la distanza dal punto più alto sul bordo dell&#39;osso al punto più altosulla porzione di confine della fascia (Figura 2). </li><li> Misurare lo spessore del tessuto sottocutaneo, definita come la distanza dalla pelle alla fascia. </li></ol></li></ol></li></ol> 2. Applicazione clinica di Ecografia a BCRL <ol><li> Misurare lo spessore del tessuto sottocutaneo e muscolare dell&#39;arto superiore al basale. <ol><li> Eseguire le misurazioni di base nell&#39;ordine indicato al punto 1. </li></ol></li><li> Chiedere al paziente di eseguire una serie di PRE con un 0,5 kg manubrio 14. <ol><li> Dare al paziente una calza di compressione o un bendaggio multistrato da indossare. Scegliere un 0,5 kg manubrio. </li><li> Chiedere al paziente di eseguire le PRE nel seguente ordine: (1) manubri vola, (2) tricipite estensione, (3) un braccio fila piegato-over, (4) bicipiti curl, (5) rilancio lato manubrio, e (6 ) sollevando le braccia in avanti (figura 3). <ol><li> Al paziente di completare la 6esercizi due volte al giorno, secondo il seguente calendario: 5 volte ciascuno durante la settimana 1 °, per 10 volte durante la settimana 2 °, 15 volte ciascuno durante la settimana 3 °, 20 volte ciascuno durante la 4 ° settimana, e 25 volte ciascuno durante 5 settimane th -8 ° (Figura 4). </li></ol></li></ol></li><li> Utilizzare ecografia per identificare gli effetti terapeutici della PRE rispetto alla terapia convenzionale. <ol><li> Misurare lo spessore del tessuto sottocutaneo e muscolare dell&#39;arto superiore a 4 e 8 settimane. Eseguire le misurazioni nell&#39;ordine indicato al punto 1. </li></ol></li><li> Calcolare lo spessore del tessuto sottocutaneo e muscolare al basale, 4 settimane e 8 settimane. </li><li> Analizzare i dati. <ol><li> Confrontare la differenza tra i due bracci con un t-test accoppiato. Confronta i cambiamenti nel tessuto sottocutaneo e dello spessore del muscolo utilizzando un ripetute-misure ANOVA. </li></ol></li></ol>

<ol>
	<li>Lasinski, B. B. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Complete+decongestive+therapy+for+treatment+of+lymphedema.">Complete decongestive therapy for treatment of lymphedema.</a> Seminars in Oncology Nursing. 29 (1), 20-27 (2013).</li><li>Clark, B., Sitzia, J., Harlow, W. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Incidence+and+risk+of+arm+oedema+following+treatment+for+breast+cancer:+a+three-year+follow-up+study.">Incidence and risk of arm oedema following treatment for breast cancer: a three-year follow-up study.</a> Q J Med. 98 (5), 343-348 (2005).</li><li>Hayes, S. C., Speck, R. M., Reimet, E., Stark, A., Schmitz, K. H. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Does+the+effect+of+weight+lifting+on+lymphedema+following+breast+cancer+differ+by+diagnostic+method:+results+from+a+randomized+controlled+trial.">Does the effect of weight lifting on lymphedema following breast cancer differ by diagnostic method: results from a randomized controlled trial.</a> Breast Cancer Res Treat. 130 (1), 227-234 (2011).</li><li>Fu, M. R., Ridner, S. H., Armer, J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Post-breast+cancer+lymphedema:+part+1.">Post-breast cancer lymphedema: part 1.</a> Am J Nurs. 109 (7), 48-54 (2009).</li><li>Rockson, S. G. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Ultrasonography+in+the+Evaluation+of+Breast+Cancer-Related+Lymphedema.">Ultrasonography in the Evaluation of Breast Cancer-Related Lymphedema.</a> Lymphatic Research and Biology. 14 (1), 1 (2016).</li><li>Suehiro, K., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Significance+of+Ultrasound+Examination+of+Skin+and+Subcutaneous+Tissue+in+Secondary+Lower+Extremity+Lymphedema.">Significance of Ultrasound Examination of Skin and Subcutaneous Tissue in Secondary Lower Extremity Lymphedema.</a> Ann Vasc Dis. 6 (2), 180-188 (2013).</li><li>Lee, J. H., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Ultrasonographic+Evaluation+of+Therapeutic+Effects+of+Complex+Decongestive+Therapy+in+Breast+Cancer-Related+Lymphedema.">Ultrasonographic Evaluation of Therapeutic Effects of Complex Decongestive Therapy in Breast Cancer-Related Lymphedema.</a> Ann Rehabil Med. 37 (5), 683-689 (2013).</li><li>DiSipio, T., Rye, S., Newman, B., Hayes, S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Incidence+of+unilateral+arm+lymphoedema+after+breast.">Incidence of unilateral arm lymphoedema after breast.</a> Lancet Oncol. 14 (6), 500-515 (2013).</li><li>Stanton, A. W., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Lymphatic+drainage+in+the+muscle+and+subcutis+of+the+arm+after+breast+cancer+treatment.">Lymphatic drainage in the muscle and subcutis of the arm after breast cancer treatment.</a> Breast Cancer Res Treat. 117 (3), 549-557 (2008).</li><li>Godoy, M. F. G., Pereira, M. R., Oliani, A. H., Godoy, J. M. P. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Synergic+Effect+of+Compression+Therapy+and+Controlled+Active+Exercises+Using+a+Facilitating+Device+in+the+Treatment+of+Arm+Lymphedema.">Synergic Effect of Compression Therapy and Controlled Active Exercises Using a Facilitating Device in the Treatment of Arm Lymphedema.</a> Int J Med Sci. 9 (4), 280-284 (2012).</li><li>Cormie, P., Pumpa, K., Galv&#227;o, D. A., Turner, E., Spry, N., Saunders, C., Zissiadis, Y., Newton, R. U. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Is+it+safe+and+efficacious+for+women+with+lymphedema+secondary+to+breast+cancer+to+lift+heavy+weights+during+exercise:+a+randomised+controlled+trial.">Is it safe and efficacious for women with lymphedema secondary to breast cancer to lift heavy weights during exercise: a randomised controlled trial.</a> J Cancer Surviv. 7 (3), 413-424 (2013).</li><li>Bok, S. K., Jeon, Y., Hwang, P. S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Ultrasonographic+evaluation+of+the+effects+of+progressive+resistive+exercise+in+breast+cancer-related+lymphedema.">Ultrasonographic evaluation of the effects of progressive resistive exercise in breast cancer-related lymphedema.</a> Lymphatic Research and Biology. 14 (1), 18-24 (2016).</li><li>Milne, H. M., Wallman, K. E., Gordon, S., Courneya, K. S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Effects+of+a+combined+aerobic+and+resistance+exercise+program+in+breast+cancer+survivors:+a+randomized+controlled+trial.">Effects of a combined aerobic and resistance exercise program in breast cancer survivors: a randomized controlled trial.</a> Breast Cancer Res Treat. 108 (2), 279-288 (2008).</li><li>Schmitz, K. H., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Weight+lifting+for+women+at+risk+for+breast-cancer-related+lymphedema.">Weight lifting for women at risk for breast-cancer-related lymphedema.</a> JAMA. 304 (24), 2699-2705 (2010).</li><li>Kiel, K. D., Rademacker, A. W. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Early-stage+breast+cancer:+Arm+edema+after+wide+excision+and+breast+irradiation.">Early-stage breast cancer: Arm edema after wide excision and breast irradiation.</a> Radiology. (1), 279-283 (1996).</li></ol>

The authors have nothing to disclose.

Le valutazioni di BCRL possono essere condotte attraverso varie tecniche, tra cui circonferenze del braccio di misurazione del nastro, misura dello spostamento d&#39;acqua, la spettroscopia bioimpedenza, perometry (volumetro optoelettronica), linfoscintigrafia, la diagnosi medico, o gonfiore self-report da parte del paziente. Tuttavia, non esistono standard per la misurazione della BCRL; la diagnosi e la durata del trattamento può essere determinato empiricamente in vari modi, a seconda della clinica. <p class="jov...

Linfedema è definita come una condizione di localizzato ricca di proteine ritenzione idrica e gonfiore dei tessuti causate da un 1,2 sistema linfatico compromessa. Come linfedema progredisce, fibrociti e / o adipociti proliferano nelle zone colpite, che porta a cambiamenti nella struttura della pelle e del tessuto sottocutaneo e una maggiore vulnerabilità alle infezioni batteriche e fungine 3,4. L&#39;osservazione di questi cambiamenti in varie parti degli arti può chiarire ulteriormente la gravità e l&#39;estensione del linfedema. Il sistema linfatico sottofasciale contribuisce alla gravità del linfedema più del sistema linfatico epifasciale. Recenti ricerche hanno riguardato principalmente l&#39;uso dell&#39;ecografia nella diagnosi di linfedema 5,6. L&#39;ecografia è un metodo relativamente poco costoso per osservare le caratteristiche dei tessuti molli. Un precedente studio ha riportato che linfedema può essere attendibilmente diagnosticato con ecografia confrontando tha spessore del tessuto cutaneo e sottocutaneo e anche valutando la conformità del tessuto sottocutaneo in un ambiente 7,8 clinica. Inoltre, ecografia è ampiamente usato in clinica per la sua facile accessibilità, di sicurezza da esposizione a radiazioni, ed economicità 5,6. A dispetto di questi benefici, gli studi sulla ecografia per linfedema solo sono stati concentrati sulla diagnosi, non sulla valutazione degli interventi terapeutici. Pertanto, lo studio mirato a determinare non solo l&#39;utilità dell&#39;ecografia nel chiarire gli effetti di PRE sulla BCRL, ma anche se ultrasonografia ha un significato clinico come test di follow-up nel confermare l&#39;efficacia del trattamento. Questo studio è stato condotto per stabilire il protocollo per ultrasuoni eseguiti per esaminare linfedema.

<table><tbody><tr><td>ACUSON S2000</td><td>Siemens</td><td>10041461</td><td></td></tr><tr><td>Eco Gel 99</td><td>Seung Won Medical Corp.</td><td></td><td></td></tr></tbody></table>

ultrasonographic evaluation of breast cancer-related lymphedema

Linfedema è una delle più comuni complicanze dopo chirurgia del cancro al seno. Ci sono molti strumenti diagnostici per linfedema, ma nessun metodo standard ancora esiste. Progressive Resistenza Esercizio (PRE) dovrebbe migliorare linfedema senza gonfiore aggiuntivo. Questo studio ha mostrato effetti terapeutici di PRE sul linfedema mediante ecografia per misurare la variazione di spessore del muscolo e del tessuto sottocutaneo. Lo spessore del tessuto sottocutaneo è diminuito di più nel gruppo PRE che nel gruppo non-PRE. L&#39;ecografia è ampiamente usato in molte cliniche per la sua facile accessibilità, la sicurezza, ed economicità. L&#39;ecografia è uno dei migliori strumenti per la diagnosi e la determinazione l&#39;efficacia del trattamento sul linfedema al seno per cancro (BCRL).

Questo studio ha incluso 32 pazienti con diagnosi di BCRL. Lo spessore del muscolo e del tessuto sottocutaneo e le circonferenze degli arti superiori prossimale e distale sono stati misurati al basale, 4 settimane e 8 settimane dopo PRE. Esaminatori misurato la circonferenza degli arti superiori con un nastro misura, e quindi lo spessore del muscolo e del tessuto sottocutaneo sono stati misurati mediante ecografia. I pazienti sono stati divisi casualmente in un gruppo PRE e un gruppo non...

Watch this Scientific Journal Video about Ultrasonographic Evaluation of Breast Cancer-related Lymphedema at JoVE.com

Ultrasonographic Evaluation of Breast Cancer-related Lymphedema

Questo studio ha utilizzato l&#39;ecografia per la diagnosi e test di follow-up per confermare l&#39;efficacia del trattamento di progressiva resistenza esercizio (PRE) in linfedema al seno per cancro (BCRL). L&#39;ecografia può essere applicato in modo efficace per garantire la diagnosi e il trattamento del linfedema.

Ecografica Valutazione del seno Linfedema correlati al cancro

Lymphedema is one of the most common complications after breast cancer surgery. There are many diagnostic tools for lymphedema, but no standard method yet ...

ultrasonographic-evaluation-of-breast-cancer-related-lymphedema

Research

JoVE Journal

Cancer Research

9.3K Views.  Chungnam National University Hospital (CNUH).  Questo studio ha utilizzato l'ecografia per la diagnosi e test di follow-up per confermare l'efficacia del trattamento di progressiva resistenza esercizio (PRE) in linfedema al seno per cancro (BCRL). L'ecografia può essere applicato in modo efficace per garantire la diagnosi e il trattamento del linfedema. 

Video: Ultrasonographic Evaluation of Breast Cancer-related Lymphedema

Non-invasive Optical Imaging of the Lymphatic Vasculature of a Mouse

The lymphatic vascular system is an important component of the circulatory system that maintains fluid homeostasis, provides immune surveillance, and mediates fat absorption in the gut. Yet despite its critical function, there is comparatively little understanding of how the lymphatic system adapts to serve these functions in health and disease1. Recently, we have demonstrated the ability to dynamically image lymphatic architecture and lymph "pumping" action in normal human subjects as well as in persons suffering lymphatic dysfunction using trace administration of a near-infrared fluorescent (NIRF) dye and a custom, Gen III-intensified imaging system2-4. NIRF imaging showed dramatic changes in lymphatic architecture and function with human disease. It remains unclear how these changes occur and new animal models are being developed to elucidate their genetic and molecular basis. In this protocol, we present NIRF lymphatic, small animal imaging5,6 using indocyanine green (ICG), a dye that has been used for 50 years in humans7, and a NIRF dye-labeled cyclic albumin binding domain (cABD-IRDye800) peptide that preferentially binds mouse and human albumin8. Approximately 5.5 times brighter than ICG, cABD-IRDye800 has a similar lymphatic clearance profile and can be injected in smaller doses than ICG to achieve sufficient NIRF signals for imaging8. Because both cABD-IRDye800 and ICG bind to albumin in the interstitial space8, they both may depict active protein transport into and within the lymphatics. Intradermal (ID) injections (5-50 &mu;l) of ICG (645 &mu;M) or cABD-IRDye800 (200 &mu;M) in saline are administered to the dorsal aspect of each hind paw and/or the left and right side of the base of the tail of an isoflurane-anesthetized mouse. The resulting dye concentration in the animal is 83-1,250 &mu;g/kg for ICG or 113-1,700 &mu;g/kg for cABD-IRDye800. Immediately following injections, functional lymphatic imaging is conducted for up to 1 hr using a customized, small animal NIRF imaging system. Whole animal spatial resolution can depict fluorescent lymphatic vessels of 100 microns or less, and images of structures up to 3 cm in depth can be acquired9. Images are acquired using V++ software and analyzed using ImageJ or MATLAB software. During analysis, consecutive regions of interest (ROIs) encompassing the entire vessel diameter are drawn along a given lymph vessel. The dimensions for each ROI are kept constant for a given vessel and NIRF intensity is measured for each ROI to quantitatively assess "packets" of lymph moving through vessels.

Recently developed imaging techniques using near-infrared fluorescence (NIRF) may help elucidate the role the lymphatic system plays in cancer metastasis, immune response, wound repair, and other lymphatic-associated diseases.

Non invasiva di imaging ottico del sistema vascolare linfatico di un mouse

The lymphatic  vascular system is an important component of the circulatory system that  maintains fluid homeostasis, provides immune surveillance, and ...

Ricerca

Immunologia e infezioni

Analysis of Lymph Node Volume by Ultra-High-Frequency Ultrasound Imaging in the Braf/Pten Genetically Engineered Mouse Model of Melanoma

Tyr::CreER+,BrafCA/+,Ptenlox/lox&#160;genetically engineered mice (Braf/Pten mice) are widely used as an in vivo model of metastatic melanoma. Once a primary tumor has been induced by tamoxifen treatment, an increase in metastatic burden is observed within 4-6 weeks after induction. This paper shows how Ultra-High-Frequency UltraSound (UHFUS) imaging can be exploited to monitor the increase in metastatic involvement of the inguinal lymph nodes by measuring the increase in their volume.
The UHFUS system is used to scan anesthetized mice with a UHFUS linear probe (22-55 MHz, axial resolution 40 &#181;m). B-mode images from the inguinal lymph nodes (both left and right sides) are acquired in a short-axis view, positioning the animals in dorsal recumbency. Ultrasound records are acquired using a 44 &#181;m step size on a motorized mechanical arm. Afterward, two-dimensional (2D) B-mode acquisitions are imported into the software platform for ultrasound image post-processing, and inguinal lymph nodes are identified and segmented semi-automatically in the acquired cross-sectional 2D images. Finally, a total reconstruction of the three-dimensional (3D) volume is automatically obtained along with the rendering of the lymph node volume, which is also expressed as an absolute measurement.
This non-invasive in vivo technique is very well tolerated and allows the scheduling of multiple imaging sessions on the same experimental animal over 2 weeks. It is, therefore, ideal to assess the impact of pharmacological treatment on metastatic disease.

Melanoma is a very aggressive disease that quickly spreads to other organs. This protocol describes the application of ultra-high-frequency ultrasound imaging, coupled with 3D rendering, to monitor the volume of the inguinal lymph nodes in the Braf/Pten mouse model of metastatic melanoma.

Analisi del volume dei linfonodi mediante imaging ecografico ad altissima frequenza nel modello murino geneticamente modificato braf/Pten del melanoma

Tyr::CreER+,BrafCA/+,Ptenlox/lox&#160;genetically engineered mice (Braf/Pten mice) are widely used as an in vivo model of metastatic melanoma. Once a ...

Ricerca sul cancro

Tracking the Mammary Architectural Features and Detecting Breast Cancer with Magnetic Resonance Diffusion Tensor Imaging

Breast cancer is the most common cause of cancer among women worldwide. Early detection of breast cancer has a critical role in improving the quality of life and survival of breast cancer patients. In this paper a new approach for the detection of breast cancer is described, based on tracking the mammary architectural elements using diffusion tensor imaging (DTI). 
The paper focuses on the scanning protocols and image processing algorithms and software that were designed to fit the diffusion properties of the mammary fibroglandular tissue and its changes during malignant transformation. The final output yields pixel by pixel vector maps that track the architecture of the entire mammary ductal glandular trees and parametric maps of the diffusion tensor coefficients and anisotropy indices. 
The efficiency of the method to detect breast cancer was tested by scanning women volunteers including 68 patients with breast cancer confirmed by histopathology findings. Regions with cancer cells exhibited a marked reduction in the diffusion coefficients and in the maximal anisotropy index as compared to the normal breast tissue, providing an intrinsic contrast for delineating the boundaries of malignant growth. Overall, the sensitivity of the DTI parameters to detect breast cancer was found to be high, particularly in dense breasts, and comparable to the current standard breast MRI method that requires injection of a contrast agent. Thus, this method offers a completely non-invasive, safe and sensitive tool for breast cancer detection.

We describe how to obtain parametric and vector maps of the diffusion tensor of the breast using magnetic resonance imaging. The protocol and final output following imaging processing are tailored for tracking breast architectural features and detecting breast malignancy.

Monitoraggio delle mammarie caratteristiche architettoniche e Rilevamento cancro al seno con risonanza magnetica del tensore di diffusione Imaging

Breast cancer is the most common cause of cancer among women worldwide. Early detection of breast cancer has a critical role in improving the quality of ...

Medicina

High-frequency Ultrasound Imaging of Mouse Cervical Lymph Nodes

High-frequency ultrasound (HFUS) is widely employed as a non-invasive method for imaging internal anatomic structures in experimental small animal systems. HFUS has the ability to detect structures as small as 30 &#181;m, a property that has been utilized for visualizing superficial lymph nodes in rodents in brightness (B)-mode. Combining power Doppler with B-mode imaging allows for measuring circulatory blood flow within lymph nodes and other organs. While HFUS has been utilized for lymph node imaging in a number of mouse&#160; model systems, a detailed protocol describing HFUS imaging and characterization of the cervical lymph nodes in mice has not been reported. Here, we show that HFUS can be adapted to detect and characterize cervical lymph nodes in mice. Combined B-mode and power Doppler imaging can be used to detect increases in blood flow in immunologically-enlarged cervical nodes. We also describe the use of B-mode imaging to conduct fine needle biopsies of cervical lymph nodes to retrieve lymph tissue for histological&#160; analysis. Finally, software-aided steps are described to calculate changes in lymph node volume and to visualize changes in lymph node morphology following image reconstruction. The ability to visually monitor changes in cervical lymph node biology over time provides a simple and powerful technique for the non-invasive monitoring of cervical lymph node alterations in preclinical mouse models of oral cavity disease.

This protocol describes the application of high-frequency ultrasound (HFUS) for imaging mouse cervical lymph nodes. This technique optimizes visualization and quantification of cervical lymph node morphology, volume and blood flow. Image-guided biopsy of cervical lymph nodes and processing of lymph tissue for histological evaluation is also demonstrated.

Ad alta frequenza di Ecografia del mouse cervicali Linfonodi

High-frequency ultrasound (HFUS) is widely employed as a non-invasive method for imaging internal anatomic structures in experimental small animal ...

Integrating Augmented Reality Tools in Breast Cancer Related Lymphedema Prognostication and Diagnosis

Breast cancer related lymphedema (BCRL) is a detrimental condition characterized by fluid accumulation in the upper limb in breast cancer patients subjected to axillary surgery and/or radiations. Its etiology is multifactorial and include also tumor-specific pathological features, such as lymphovascular invasion (LVI) and extranodal extension (ENE). To date, no widely employed guidelines for the early diagnosis of BCRL are available. Here, we illustrate a protocol for a digitally assisted BCRL assessment using a 3D laser scanner (3DLS) and a tablet computer. It has been specifically optimized in a discovery cohort of high-risk breast cancer patients. This study provides a proof-of-principle that augmented reality tools, such as 3DLS, can be incorporated into the clinical workup of BCRL to allow for a precise, reproducible, reliable, and cheap diagnosis.

Breast cancer related lymphedema is frequent in breast cancer survivors, but there are not widely employed guidelines for its diagnosis and quantification. Here, we introduce a reliable and cost-effective protocol to define, quantify, and compare upper limb volume in breast cancer patients.

Integrazione degli strumenti di realtà aumentata nella linfostica e diagnosi legate al cancro al seno

Breast cancer related lymphedema (BCRL) is a detrimental condition characterized by fluid accumulation in the upper limb in breast cancer patients ...

A Revised Method for Inducing Secondary Lymphedema in the Hindlimb of Mice

Animal models are of paramount importance in the research of lymphedema in order to understand the pathophysiology of the disease but also to explore potential treatment options. This mouse model allows researchers to induce significant lymphedema lasting at least 8 weeks. Lymphedema is induced using a combination of fractioned radiotherapy and surgical ablation of lymphatics. This model requires that the mice get a dose of 10 Gray (Gy) radiation before and after surgery. The surgical part of the model involves ligation of three lymph vessels and extraction of two lymph nodes from the mouse hindlimb. Having access to microsurgical tools and a microscope is essential, due to the small anatomical structures of mice. The advantage of this model is that it results in statistically significant lymphedema, which provides a good basis for evaluating different treatment options. It is also a great and easily available option for microsurgical training. The limitation of this model is that the procedure can be time consuming, especially if not practiced in advance. The model results in objectively quantifiable lymphedema in mice, without causing severe morbidity and has been tested in three separate projects.

This animal model enables researchers to induce statistically significant secondary lymphedema in the hindlimb of mice, lasting at least 8 weeks. The model can be used to study the pathophysiology of lymphedema and to investigate novel treatment options.

Un metodo rivisto per indurre il linfomal secondario nell'Hindlimb dei topi

Animal models are of paramount importance in the research of lymphedema in order to understand the pathophysiology of the disease but also to explore ...

A Murine Tail Lymphedema Model

Lymphedema is extremity swelling caused by lymphatic dysfunction. The affected limb enlarges because of accumulation of fluid, adipose, and fibrosis. There is no cure for this disease. A mouse tail model that uses a focal full thickness skin excision near the base of the tail, resulting in tail swelling, has been used to study lymphedema. However, this model may result in vascular comprise and consequent tail necrosis and early tail swelling resolution, limiting its clinical translatability. The chronic murine tail lymphedema model induces sustained lymphedema over 15 weeks and a reliable perfusion to the tail. Enhancements of the traditional murine tail lymphedema model include 1) precise full thickness excision and lymphatic clipping using a surgical microscope, 2) confirmation of post-operative arterial and venous perfusion using high resolution laser speckle, and 3) functional assessment using indocyanine green near infrared laser lymphangiography. We also use tissue nanotransfection technology (TNT) for novel non-viral, transcutaneous, focal delivery of genetic cargo to the mouse tail vasculature.

Lymphedema is extremity swelling caused by lymphatic dysfunction. We describe a chronic murine tail model of lymphedema and the novel use of tissue nanotransfection technology (TNT) for genetic cargo delivery to the tail.

Un modello di linfedema della coda murina

Lymphedema is extremity swelling caused by lymphatic dysfunction. The affected limb enlarges because of accumulation of fluid, adipose, and fibrosis. ...

Tecnica per l'esame ecografico delle ghiandole salivari della sindrome di Sjogren

Ultrasonographic Evaluation of Salivary Glands for Sjogren's Syndrome: Diagnostic and Monitoring Insights

Sjogren's syndrome (SS) is a chronic autoimmune condition commonly affecting the exocrine glands, causing oral or ocular dryness and extraglandular manifestations including arthralgia, cytopenia, and lymphoma. The presence of autoantibodies against SSA/Ro, labial salivary gland biopsy, ocular staining, Schirmer's test, or salivary flow assessment are included in the current classification criteria of SS. However, the availability and invasiveness of these procedures limit their widespread use in clinical settings. Salivary gland ultrasonography (SGUS) is a non-invasive imaging modality for the evaluation of the salivary gland parenchyma and is increasingly utilized to aid diagnosis and monitoring in SS. 
This article presents the protocol of SGUS for image acquisition at the parotid and submandibular glands. The objective is to present a standardized, reproducible, and practical approach to diagnostic SGUS for SS in daily clinical settings. Major salivary glands are scanned in a stepwise approach, beginning at the angle of the mandible for the superficial lobe of the parotid gland, followed by the deep lobe below the ramus of the mandible. Submandibular areas are then scanned for the submandibular glands. The steps in obtaining salivary gland images at each anatomical site are explained in the accompanying video. The echogenicity and echotexture at the thyroid gland are taken as a reference. The homogeneity, the presence and distribution of hypoechoic areas within the glands, and the border of the salivary glands are examined. The sizes and features of intra-/peri-glandular lymph nodes are recorded. The most distinctive sonographic feature in SS is glandular heterogeneity with the presence of hypoechoic/hyperechoic areas within the glands. 
In summary, while SGUS cannot diagnose SS on its own, it can supplement the current classification criteria of SS and guide the clinical decision for salivary gland biopsy to support the diagnosis of SS in patients with sicca syndrome or suspicious systemic features, combined with autoantibody testing.

Autore in primo piano: Un focus sul protocollo ecografico standardizzato delle ghiandole salivari nella ricerca sulle malattie del tessuto connettivo

Salivary gland ultrasonography is a promising tool for the diagnosis and evaluation of disease activity and complications in Sjogren's syndrome (SS). The scanning technique for salivary gland ultrasound examination relevant to SS is described in the article.

Valutazione ecografica delle ghiandole salivari per la sindrome di Sjogren: approfondimenti diagnostici e di monitoraggio

Sjogren's syndrome (SS) is a chronic autoimmune condition commonly affecting the exocrine glands, causing oral or ocular dryness and extraglandular ...

Ecografica Valutazione del seno Linfedema correlati al cancro

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Capitoli in questo video

Non invasiva di imaging ottico del sistema vascolare linfatico di un mouse

Analisi del volume dei linfonodi mediante imaging ecografico ad altissima frequenza nel modello murino geneticamente modificato braf/Pten del melanoma

Monitoraggio delle mammarie caratteristiche architettoniche e Rilevamento cancro al seno con risonanza magnetica del tensore di diffusione Imaging

Ad alta frequenza di Ecografia del mouse cervicali Linfonodi

Integrazione degli strumenti di realtà aumentata nella linfostica e diagnosi legate al cancro al seno

Un metodo rivisto per indurre il linfomal secondario nell'Hindlimb dei topi

Un modello di linfedema della coda murina

Valutazione ecografica delle ghiandole salivari per la sindrome di Sjogren: approfondimenti diagnostici e di monitoraggio

Valutazione ecografica delle ghiandole salivari per la sindrome di Sjogren: approfondimenti diagnostici e di monitoraggio

Valutazione ecografica delle ghiandole salivari per la sindrome di Sjogren: approfondimenti diagnostici e di monitoraggio