Classification of the lymphatic pathways in each lymphosome based on multi-lymphosome indocyanine green lymphography: Saphenous, Calf, and Thigh (SCaT) classification

AimsAutomatic identification of pachychoroid maybe used as an adjunctive method to confirm the condition and be of help in treatment for macular diseases. This study investigated the feasibility of classifying pachychoroid disease on ultra-widefield indocyanine green angiography (UWF ICGA) images using an automated machine-learning platform.MethodsTwo models were trained with a set including 783 UWF ICGA images of patients with pachychoroid (n=376) and non-pachychoroid (n=349) diseases using the AutoML Vision (Google). Pachychoroid was confirmed using quantitative and qualitative choroidal morphology on multimodal imaging by two retina specialists. Model 1 used the original and Model 2 used images of the left eye horizontally flipped to the orientation of the right eye to increase accuracy by equalising the mirror image of the right eye and left eye. The performances were compared with those of human experts.ResultsIn total, 284, 279 and 220 images of central serous chorioretinopathy, polypoidal choroidal vasculopathy and neovascular age-related maculopathy were included. The precision and recall were 87.84% and 87.84% for Model 1 and 89.19% and 89.19% for Model 2, which were comparable to the results of the retinal specialists (90.91% and 95.24%) and superior to those of ophthalmic residents (68.18% and 92.50%).ConclusionsAuto machine-learning platform can be used in the classification of pachychoroid on UWF ICGA images after careful consideration for pachychoroid definition and limitation of the platform including unstable performance on the medical image.

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High-accuracy Diagnosis and Regional Classification of Lymphedema Using Indocyanine Green Fluorescent Lymphography After Gynecologic Cancer Treatment

Annals of Plastic Surgery ◽

10.1097/sap.0b013e3182586b79 ◽

2014 ◽

Vol 72 (2) ◽

pp. 204-208 ◽

Cited By ~ 21

Author(s):

Makoto Mihara ◽

Yohei Hayashi ◽

Hisako Hara ◽

Takuya Iida ◽

Mitsunaga Narushima ◽

...

Keyword(s):

Indocyanine Green ◽

Cancer Treatment ◽

Gynecologic Cancer ◽

High Accuracy ◽

Green Fluorescent

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Classification of Non-Infectious and/or Immune Mediated Cho-Roiditis: A Brief Overview of the Essentials

Diagnostics ◽

10.3390/diagnostics11060939 ◽

2021 ◽

Vol 11 (6) ◽

pp. 939

Author(s):

Carl P. Herbort ◽

Alessandro Mantovani ◽

Ilknur Tugal-Tutkun ◽

Ioannis Papasavvas

Keyword(s):

Optical Coherence Tomography ◽

Indocyanine Green ◽

Indocyanine Green Angiography ◽

Sympathetic Ophthalmia ◽

Serpiginous Choroiditis ◽

White Dot Syndrome ◽

Immune Mediated ◽

Angiographic Findings ◽

Stromal Choroiditis

The choroid was poorly accessible to imaging investigation until the last decade of the last century. With the availability of more precise imaging methods such as indocyanine green angiography (ICGA) and, later, optical coherence tomography (OCT), enhanced depth OCT (EDI-OCT), and OCT angiography (OCTA), appraisal of choroidal inflammation has substantially gained in accuracy. This allowed to precisely determine which structures were touched in the different non-infectious choroiditis entities and made it possible to classify this group of diseases, ICGA signs, mainly hypofluorescent lesions, were identified and described. Previous publications have divided angiographic findings into two main sets of signs: (1) irregular “geographic” hypofluorescent areas corresponding to choriocapillaris non-perfusion and (2) round more regular, hypofluorescent dark dots more evenly distributed in the fundus corresponding to more deep choroidal stromal foci. These distinct findings allowed to subdivide and classify choroiditis into choriocapillaritis and stromal choroiditis. Additional signs were identified from EDI-OCT and OCTA examination supporting the classification of choroiditis into choriocapillaritis and stromal choroiditis. Results: Diseases involving principally the choriocapillaris included Multiple Evanescent White Dot Syndrome (MEWDS), Acute Posterior Multifocal Placoid Pigment Epitheliopathy (APMPPE), Idiopathic Multifocal Choroiditis (MFC), and Serpiginous Choroiditis (SC) as well as mixed forms. Diseases primarily involving the choroidal stroma included HLA-A29 Birdshot Retinochoroiditis (BRC), Vogt-Koyanagi-Harada disease (VKH), Sympathetic Ophthalmia (SO), and Sarcoidosis chorioretinitis (SARC). Thanks to new imaging investigations of the choroid, it is now possible to classify and understand the diverse clinicopathological mechanisms in the group of non-infectious choroiditis entities.

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Visualization of Accessory Lymphatic Pathways in Secondary Upper Extremity Lymphedema Using Indocyanine Green Lymphography

Annals of Plastic Surgery ◽

10.1097/sap.0000000000001120 ◽

2017 ◽

Vol 79 (4) ◽

pp. 393-396 ◽

Cited By ~ 9

Author(s):

Kensuke Tashiro ◽

Shuji Yamashita ◽

Isao Koshima ◽

Shimpei Miyamoto

Keyword(s):

Indocyanine Green ◽

Upper Extremity ◽

Lymphatic Pathways

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Indocyanine green plasma disappearance rate: a new tool for the classification of paediatric patients with acute liver failure

Liver International ◽

10.1111/liv.12298 ◽

2013 ◽

Vol 34 (5) ◽

pp. 689-694 ◽

Cited By ~ 11

Author(s):

Jesús Quintero ◽

Mar Miserachs ◽

Juan Ortega ◽

Javier Bueno ◽

Cristina Dopazo ◽

...

Keyword(s):

Liver Failure ◽

Indocyanine Green ◽

Acute Liver Failure ◽

Disappearance Rate ◽

Plasma Disappearance Rate ◽

Paediatric Patients

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Visualization of Accessory Lymphatic Pathways, before and after Manual Drainage, in Secondary Upper Limb Lymphedema Using Indocyanine Green Lymphography

Journal of Clinical Medicine ◽

10.3390/jcm8111917 ◽

2019 ◽

Vol 8 (11) ◽

pp. 1917

Author(s):

María Elena Medina-Rodríguez ◽

María de-la-Casa-Almeida ◽

Efrén Martel-Almeida ◽

Arminda Ojeda-Cárdenes ◽

Esther M. Medrano-Sánchez

Keyword(s):

Indocyanine Green ◽

Upper Limb ◽

Statistical Significance ◽

Infrared Camera ◽

Lymphatic Drainage ◽

Secondary Lymphedema ◽

Before And After ◽

Post Test ◽

After Cancer ◽

Lymphatic Pathways

Manual Lymphatic Drainage (MLD) appears to stimulate lymphatic contraction, aid in the development of secondary derivation pathways, and stimulate the appearance of collateral pathways that could function as the main drainage routes of the limb in case of lymphedema. Through stretching, call up maneuvers are used to stimulate lymphangion reflex contraction and, therefore, lymphatic function. The aim was to describe the presence of areas and pathways of collateral lymphatic drainage under basal conditions and to determine, using Indocyanine Green (ICG) lymphography, whether an increase in these pathways occurs after 30 min of manual lymphatic stimulation with only call up maneuvers according to the Leduc Method®®. In this prospective analytical study (pretest–posttest), the frequency of presentation of areas and collateral lymphatic pathways was analyzed in 19 patients with secondary lymphedema of the upper limb after breast cancer using an infrared camera. Analyses were completed at three time points: after ICG injection, at baseline (pretest), and after the application of MLD (post-test). The Leduc Method maneuvers were applied to the supraclavicular and axillary nodes, chest, back, Mascagni, and Caplan pathways. The areas visualized in the pretest continued to be visible in the posttest. Additional pathways and fluorescent areas were observed after the maneuvers. The McNemar test showed statistical significance (p = 0.008), the odds ratio was infinite, and the Cohen’s g value was equal to 0.5. Manual stimulation by call up maneuvers increased the observation frequency of areas and collateral lymphatic pathways. Therefore, ICG lymphography appears to be a useful tool for bringing out the routes of collateral bypass in secondary lymphoedema after cancer treatment.

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