The authors have nothing to acknowledge.

手順のすべてを見直し、忠南国立大学病院の治験審査委員会によって承認されました。 超音波検査1.測定<ol><li>患者の姿勢を設定します。 <ol><li>ベッドの上で両腕で、仰臥位で患者の腕を置きます。 </li></ol></li><li>患者の上肢の測定部位を決定。 <ol><li>手首のしわの中間点でマーク、内側および外側上顆肘のレベルで、ペンによって二頭筋溝の間の中間点。 </li><li>ペンを使用して直接定規ことにより、これらの3点を結びます。マーク上腕と前腕の2つの対象領域（ 図1）。 <ol><li>肘と二頭筋溝の間の線に沿ってエルボ点に近位部、10cmの近位をマークします。 </li><li>肘と手首の間の線に沿ってエルボ点に遠位部、10cmの先端をマークします。 </li></ol></li></ol></li><li>上肢の皮下組織および筋肉の厚さを測定します。手順は、熟練した検査技師が行ってください。 <ol><li>超音波システムのスイッチをオンにします。キーボードを介して、軟組織の2Dモードを入力します。 5センチメートルに深さを設定します。 <ol><li> 14L5リニアアレイトランスデューサを選択してください。 </li><li>超音波トランスデューサに十分なゲルを適用します。皮下組織に焦点を当てています。 </li></ol></li><li>上肢腹軸に対して垂直に超音波振動子を配置します。短軸ビューを使用します。ゲルの厚さが少なくとも1cmであると軟部組織の輪郭が歪んでいない画像をキャプチャします。 </li><li>筋肉や皮下組織の厚さを測定します。 <ol><li>超音波システムのキーボードを介しソフトウェアにキャリブレータを選択して線を描画します</li><li>最高点に骨の境界上の最高点からの距離として定義され、筋肉の厚さを測定筋膜の境界部分に（ 図2）。 </li><li>筋膜への皮膚からの距離として定義され、皮下組織の厚さを測定します。 </li></ol></li></ol></li></ol> BCRLへの超音波検査の2臨床応用<ol><li>ベースラインでの上肢の皮下組織および筋肉の厚さを測定します。 <ol><li>ステップ1に示すために、ベースライン測定を行います。 </li></ol></li><li> 0.5キロのダンベル14を使用してのPREのシリーズを実行するために患者に指示します。 <ol><li>着用する患者に圧迫ストッキングや多層包帯を与えます。 0.5キロのダンベルを選択してください。 </li><li>次の順序でのPREを実行するために患者に指示：（1）ダンベル、（2）三頭筋の拡張、（3）一方のアームベント・オーバー・ローイング、（4）上腕二頭筋カール、（5）ダンベルサイドレイズ、及びフライ（6 ）前方に腕を持ち上げる（ 図3）。 <ol><li> 6を完了するために患者に指示第1週の間に5回ずつ、2 回目の週の間に10回ずつ、3 回目の週の間に15回ずつ、4 週目の間に20回ずつ、25回：以下のスケジュールに従って演習一日二回、 5 番目の -8 番目の週（ 図4）中の各。 </li></ol></li></ol></li><li>従来の治療法に比べてPREの治療効果を識別するために超音波検査を使用してください。 <ol><li> 4および8週目に皮下組織と上肢の筋肉の厚さを測定します。ステップ1に示す順序で測定を行います。 </li></ol></li><li>ベースライン、4週目、および8週目の皮下組織および筋肉の厚さを計算します。 </li><li>データを分析します。 <ol><li>ペアリングトンの検定を用いて、両腕の間の差を比較してください。反復測定ANOVAを用いて、皮下組織や筋肉の厚さの変化を比較してください。 </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.

BCRLの評価は、腕周テープ測定、水の変位測定、生体インピーダンス分光法、perometry（光電子容積）、リンパシンチグラフィ、臨床医の診断、または患者による自己報告膨潤を含む様々な技術によって行うことができます。しかし、BCRLの測定のための基準はありません。治療の診断および持続時間は、診療所に応じて、いくつかの方法で経験的に決定することができます。 <p class="jove_conte...

リンパ浮腫は妥協リンパ系1,2による膨れ局在するタンパク質が豊富な体液貯留や組織の状態として定義されています。リンパ浮腫が進行するにつれて、線維細胞および/または脂肪細胞は、皮膚と皮下組織および細菌や真菌感染3,4に増加した脆弱性のテクスチャーの変化につながる、被災地で増殖します。四肢の様々な部分におけるこれらの変化の観察は、さらに重症度とリンパ浮腫の程度を解明することができます。筋膜下リンパ系は、筋膜上のリンパ系よりもリンパ浮腫の重症度に貢献しています。 最近の研究では、主にリンパ浮腫5,6の診断における超音波検査の使用に焦点を当てています。超音波検査は、軟部組織の特性を観察する比較的安価な方法です。以前の研究では、リンパ浮腫を確実Tを比較することにより、超音波を用いて診断することができることを報告し彼は、臨床設定7,8における皮下組織のコンプライアンスを評価することにより、皮膚と皮下組織の厚さと。また、超音波検査が広く、その簡単にアクセス、放射線被曝からの安全性、および安価5,6の診療所で使用されています。これらの利点にもかかわらず、リンパ浮腫のための超音波検査の研究だけではない治療的介入の評価に、診断に焦点が当てられてきました。 したがって、現在の研究では、BCRL上のPREの影響を解明における超音波検査の有用性だけでなく、を決定することを目的とした、だけでなく、超音波検査、治療の有効性を確認するには、フォローアップテストとして臨床的意義を持っているかどうか。この研究は、リンパ浮腫を調べるために行う超音波のためのプロトコルを確立するために行きました。

<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

リンパ浮腫は、乳癌手術後の最も一般的な合併症の1つです。そこリンパ浮腫のための多くの診断ツールがありますが、標準的な方法がまだ存在しません。プログレッシブレジスタンス運動（PRE）は、追加の腫脹なしでリンパ浮腫を改善することが期待されます。この研究は、筋肉及び皮下組織の厚さの変化を測定するために超音波を使用して、リンパ浮腫のPREの治療効果を示しました。皮下組織の厚さは、非PRE群よりもPRE群でより減少しました。超音波検査は、その簡単にアクセス、安全性、および安価で多くの診療所で広く使用されています。 超音波は、診断および乳癌関連リンパ浮腫（BCRL）の治療効果を判定するための最高のツールの一つです。

この研究は、BCRLと診断された32人の患者が含まれていました。筋肉や皮下組織と近位および遠位上肢の周囲の厚さは、ベースライン、4週、およびPRE後8週目に測定しました。審査官は、巻尺で上肢の円周を測定し、その後、筋肉や皮下組織の厚さは、超音波検査で測定しました。患者を無作為PRE基および非PRE群に分けました。参加者は、測定および評価セッションの?...

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

Ultrasonographic Evaluation of Breast Cancer-related Lymphedema

本研究では、診断用超音波を利用し、フォローアップ乳がん関連リンパ浮腫（BCRL）に漸増抵抗運動（PRE）の治療の有効性を確認するためのテストを。超音波検査は、リンパ浮腫の診断および治療を確実にするために効果的に適用することができます。

乳がん関連リンパ浮腫の超音波評価

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

9.5K ビュー.  Chungnam National University Hospital (CNUH). 本研究では、診断用超音波を利用し、フォローアップ乳がん関連リンパ浮腫（BCRL）に漸増抵抗運動（PRE）の治療の有効性を確認するためのテストを。超音波検査は、リンパ浮腫の診断および治療を確実にするために効果的に適用することができます。 

ビデオ: 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.

マウスのリンパ脈管構造の非侵襲的光イメージング

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

免疫・感染学

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.

メラノーマのBraf/Pten遺伝子操作マウスモデルにおける超高周波超音波イメージングによるリンパ節容積の解析

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 ...

がん研究

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.

乳腺アーキテクチャの特長を追跡し、磁気共鳴拡散テンソルイメージングと乳がんの検出

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 ...

医学

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.

マウス子宮頸部リンパ節の高周波超音波イメージング

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.

乳癌関連リンパ浮腫予後診断における拡張現実ツールの統合

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.

マウスの後肢における二次リンパ浮腫を誘導する改訂方法

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.

ネズミ尾リンパ浮腫モデル

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

シェーグレン症候群の唾液腺超音波検査の技術

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.

著者スポットライト:結合組織疾患研究における標準化された唾液腺超音波プロトコルへの注目

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.

シェーグレン症候群に対する唾液腺の超音波評価:診断とモニタリングの洞察

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

乳がん関連リンパ浮腫の超音波評価

要約

さらに動画を探す

この動画の章

マウスのリンパ脈管構造の非侵襲的光イメージング

メラノーマのBraf/Pten遺伝子操作マウスモデルにおける超高周波超音波イメージングによるリンパ節容積の解析

乳腺アーキテクチャの特長を追跡し、磁気共鳴拡散テンソルイメージングと乳がんの検出

マウス子宮頸部リンパ節の高周波超音波イメージング

乳癌関連リンパ浮腫予後診断における拡張現実ツールの統合

マウスの後肢における二次リンパ浮腫を誘導する改訂方法

ネズミ尾リンパ浮腫モデル

シェーグレン症候群に対する唾液腺の超音波評価:診断とモニタリングの洞察

シェーグレン症候群に対する唾液腺の超音波評価:診断とモニタリングの洞察

シェーグレン症候群に対する唾液腺の超音波評価:診断とモニタリングの洞察