NTTS 2017

The first images of living human lymphatics required the naked eye to visualize intradermally-injected colored dyes. However, imaging the lymphatics with light is typically limited by poor penetration and depth resolution. On the other hand, ultrasound lymphatic imaging suffers from low contrast in soft tissue. This presentation will discuss several advanced, hybrid ultrasound modalities that have the potential to overcome these failings. Photoacoustic imaging (PAI), for example, combines pulses of light with optically-absorbing agents to generate ultrasonic waves that are detected to form an image. At a spatial resolution similar to ultrasound, PAI can detect lymphatic vessels and nodes 1 - 2 cm below the skin surface. In addition, shear wave imaging, now available on cutting-edge clinical ultrasound scanners, provides a quantitative assessment of tissue elasticity, which may be altered in subjects with lymphatic disease. These imaging technologies, along with complementary contrast agents, not only hold promise for better preclinical imaging of the lymphatics, but also for improving the diagnosis, staging, and treatment-decision making in patients with lymphatic disease or advanced cancer.