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Updated: Jun 20, 2025

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Randomized Feasibility Study Evaluating Multiple FDA-approved Microbubbles for CEUS Lymphography.

Samuel Jang1, Jess D Rames2, Gina K Hesley1

  • 1From the Department of Radiology, Mayo Clinic, Rochester, Minn.

Plastic and Reconstructive Surgery. Global Open
|July 18, 2024
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Summary
This summary is machine-generated.

This study explored using Definity and Optison microbubble agents for contrast-enhanced ultrasound (CEUS) lymphography in lymphedema patients. These agents show feasibility for preoperative lymphatic mapping, potentially improving procedure accessibility.

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Area of Science:

  • Medical Imaging
  • Vascular Surgery
  • Lymphedema Research

Background:

  • Contrast-enhanced ultrasound (CEUS) lymphography is crucial for preoperative mapping before lymphaticovenous anastomosis (LVA) surgery in extremity lymphedema patients.
  • Previous CEUS lymphography studies were limited to Lumason and Sonazoid microbubble contrast agents.
  • A broader range of agents could enhance accessibility and safety.

Purpose of the Study:

  • To assess the feasibility of using Food & Drug Administration-approved microbubble agents, Optison and Definity, for CEUS lymphography.
  • To evaluate lymphatic vessel imaging in the upper extremities of patients with lymphedema.
  • To compare the efficacy of Optison and Definity against Lumason in this context.

Main Methods:

  • Nine female adults with unilateral upper extremity lymphedema underwent CEUS lymphography.
  • The unaffected upper extremity was randomized to receive Lumason, Definity, or Optison microbubble agents.
  • Lymphatic vessels were imaged following intradermal microbubble injections.

Main Results:

  • Lymphatic vessels were visualized in most cases, with successful imaging in 57% of injections across all agents.
  • Definity and Optison demonstrated successful lymphatic vessel visualization, marking the first reported use of these agents for CEUS lymphography.
  • Effective dilution protocols for each agent were determined.

Conclusions:

  • Definity and Optison are feasible microbubble agents for CEUS lymphography in upper extremity lymphedema.
  • Expanding the available agents for CEUS lymphography can improve patient access and offer safer alternatives.
  • This study successfully demonstrated lymphatic vessel imaging using Definity and Optison.