Indocyanine Green (ICG) Lymphography Is Superior to Lymphoscintigraphy for Diagnostic Imaging of Early Lymphedema of the Upper Limbs

BACKGROUND: Secondary lymphedema causes swelling in limbs due to lymph retention following lymph node dissection in cancer therapy. Initiation of treatment soon after appearance of edema is very important, but there is no method for early diagnosis of lymphedema. In this study, we compared the utility of four diagnostic imaging methods: magnetic resonance imaging (MRI), computed tomography (CT), lymphoscintigraphy, and Indocyanine Green (ICG) lymphography. PATIENTS AND METHODS: Between April 2010 and November 2011, we examined 21 female patients (42 arms) with unilateral mild upper limb lymphedema using the four methods. The mean age of the patients was 60.4 years old (35-81 years old). Biopsies of skin and collecting lymphatic vessels were performed in 7 patients who underwent lymphaticovenous anastomosis. RESULTS: The specificity was 1 for all four methods. The sensitivity was 1 in ICG lymphography and MRI, 0.62 in lymphoscintigraphy, and 0.33 in CT. These results show that MRI and ICG lymphography are superior to lymphoscintigraphy or CT for diagnosis of lymphedema. In some cases, biopsy findings suggested abnormalities in skin and lymphatic vessels for which lymphoscintigraphy showed no abnormal findings. ICG lymphography showed a dermal backflow pattern in these cases. CONCLUSIONS: Our findings suggest the importance of dual diagnosis by examination of the lymphatic system using ICG lymphography and evaluation of edema in subcutaneous fat tissue using MRI

Sharing the archive: Using web technologies for accessing, storing and re-using historical data

Historical data pose a variety of problems to those who seek statistically based understandings of the past. Quantitative historical analysis has been limited by researcher’s reliance on rigid statistics collected by individuals or agencies, or else by researcher access to small samples of raw data. Even digital technologies by themselves have not been enough to overcome the challenges of working with manuscript sources and aligning dis-aggregated data. However, by coupling the facilities enabled by the web with the enthusiasm of the public for explorations of the past, history has started to make the same strides towards big data evident in other fields. While the use of citizens to crowdsource research data was first pioneered within the sciences, a number of projects have similarly begun to draw on the help of citizen historians. This article explores the particular example of the Prosecution Project, which since 2014 has been using crowdsourced volunteers on a research collaboration to build a large-scale relational database of criminal prosecutions throughout Australia from the early 1800s to 1960s. The article outlines the opportunities and challenges faced by projects seeking to use web technologies to access, store and re-use historical data in an environment that increasingly enables creative collaborations between researchers and other users of social and historical data