Mapping & quantifying lymphatic drainage of the arm's alternate pathway

测绘

基本信息

批准号：
10334449
负责人：
Dhruv Singhal
金额：
$ 43.4万
依托单位：
BETH ISRAEL DEACONESS MEDICAL CENTER
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-01-26 至 2025-12-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10334449
关键词：
Affect Anatomy Area Attention Axilla Axillary Lymph Node Dissection Axillary lymph node group Back Bilateral Blood Circulation Breast Cancer Patient Breast Cancer Treatment Breast Cancer survivor Cadaver Cancer Survivorship Clinical Data Development Disease Dissection Dyes Event Fatigue Female Goals Gold Hand High-Risk Cancer Imaging Techniques Indocyanine Green Infection Injury Life Lymph Lymphatic Lymphatic System Lymphatic function Lymphedema Lymphography Malignant Female Reproductive System Neoplasm Malignant Neoplasms Measures Medical Methods Modeling Modernization Operating Rooms Operative Surgical Procedures Pain Pathway interactions Patient risk Patients Physical therapy Population Positive Lymph Node Prevention Procedures Prospective Studies Quality of life Radiation Risk Risk Factors Scanning Secondary to Skin Cancer Symptoms Testing Time Tissues United States Upper Extremity Upper arm Urologic Cancer Variant Woman arm arm function cost fluorophore high risk individual variation innovation intraoperative optical imaging lymphatic drainage lymphoscintigraphy malignant breast neoplasm novel nuclear imaging operation prevent preventive intervention sarcoma standard care temporal measurement treatment strategy volunteer

项目摘要

Project Summary/Abstract Breast Cancer Related Lymphedema affects 1.2 million patients in the United States and has no cure. The symptoms of lymphedema include fatigue, tightness, pain, and life-threatening infections. However, two-thirds of women undergoing breast cancer treatment with the highest risk factors for developing lymphedema do not develop the disease. While there is no explanation for this finding, one hypothesis is that normal anatomic variations of the lymphatic system pre-dispose certain women to developing lymphedema after breast cancer treatment. Specifically, the main back-up lymphatic pathway of the arm, the Mascagni-Sappey (MS) pathway, is variably present in cadaver studies and avoids areas that are usually damaged with breast cancer treatment. Moreover, when present in these cadaver studies, the MS pathway has variable anatomic connections which can impact its ability to drain the arm effectively. We hypothesize that, utilizing modern imaging techniques, we can define the anatomy of the MS pathway and its variations in normal women and in breast cancer survivors who have undergone high risk breast cancer treatment and did not develop lymphedema. Utilizing this information, we will be able to predict which variations predispose women to develop lymphedema. Finally, we will develop a novel method of non-invasive intra- operative optical imaging to assess the function of this pathway during breast cancer operations to predict the patient's risk of developing lymphedema. The ability to evaluate real-time lymphatic function would allow cancer teams to implement preventive interventions in high risk patients. As the most common cause of lymphedema in the United States is secondary to cancer procedures, this model of lymphedema prevention could be widely applied to the treatment of other high risk cancer populations including gynecologic cancers, urologic cancers, skin cancers, and sarcomas.

项目摘要/摘要与乳腺癌相关的淋巴水肿影响美国120万患者并且无法治愈。淋巴水肿的症状包括疲劳，紧绷，疼痛和威胁生命的感染。但是，三分之二的妇女正在乳腺癌患有最高危险因素的淋巴水肿的治疗不会发展疾病。虽然对这一发现没有解释，但一个假设是正常淋巴系统的解剖学变异预先分解某些女性乳腺癌治疗后的淋巴水肿。具体而言，主要的备用淋巴处理手臂的途径，Mascagni-Sappey（MS）途径，在尸体中可变。研究并避免通常受到乳腺癌治疗受损的区域。此外，当在这些尸体研究中存在时，MS途径具有可变解剖连接可能会影响其有效排干手臂的能力。我们假设，利用现代成像技术，我们可以定义 MS途径及其在正常女性和乳腺癌幸存者中的变化经历了高风险的乳腺癌治疗，并且没有出现淋巴水肿。利用这些信息，我们将能够预测哪些变化使女性易于发展淋巴水肿。最后，我们将开发一种新型的非侵入性内部方法手术光学成像以评估乳腺癌期间该途径的功能预测患者患淋巴水肿的风险的手术。能力评估实时淋巴功能将使癌症小组实施预防高风险患者的干预措施。作为淋巴水肿的最常见原因美国是癌症程序的继发性，这种预防淋巴水肿模型可以广泛应用于其他高风险癌症种群的治疗妇科癌症，泌尿科癌症，皮肤癌和肉瘤。