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Related Experiment Video

Updated: May 5, 2026

Non-invasive Optical Imaging of the Lymphatic Vasculature of a Mouse

Non-invasive Optical Imaging of the Lymphatic Vasculature of a Mouse

Published on: March 8, 2013

Reverse Lymphatic Flow in Lower Extremity Lymphedema Visualized on Single-Photon Emission Computed Tomography-A

Jun Won Lee¹, Han-Sang Song^2,3, Chulhan Kim^4,5

¹Department of Plastic and Reconstructive Surgery, Kangnam Sacred Heart Hospital, College of Medicine, Hallym University, Seoul 07441, Republic of Korea.

Journal of Clinical Medicine

|February 13, 2026

Summary

Pelvic lymphadenectomy for cancer can cause lower extremity lymphedema. New imaging shows that in many cases, lymphatic fluid flows backward toward the swollen limb, indicating retrograde lymphatic flow.

Keywords:

lymphatic system lymphedema lymphography

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Last Updated: May 5, 2026

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Published on: April 10, 2026

Area of Science:

Oncology
Radiology
Lymphology

Background:

Pelvic lymphadenectomy for gynecologic and genitourinary cancers increases lymphedema risk.
Bilateral lower extremity lymphedema is uncommon despite total lymphadenectomy.
Understanding lymph flow dynamics is crucial for managing post-surgical lymphedema.

Purpose of the Study:

To investigate lymph flow physiology in patients with lower extremity lymphedema post-pelvic lymphadenectomy.
To identify the presence and patterns of retrograde lymphatic flow using advanced imaging.
To correlate radiologic findings with clinical presentation in lymphedema patients.

Main Methods:

Retrospective analysis of patients treated for lower extremity lymphedema from January 2017 to December 2018.
Evaluation of 10 patients with a history of pelvic lymphadenectomy using single-photon emission computed tomography (SPECT).
Subdermal radioisotope injection into the healthy foot, followed by SPECT imaging after 4 hours to assess lymph transport and identify retrograde flow.

Main Results:

The majority of patients had undergone surgery for gynecological malignancies.
Pelvic and hip lymphatic retention was observed in 70% of patients.
Retrograde lymphatic flow towards the affected limb was detected in 60% of the evaluated patients.

Conclusions:

SPECT-CT imaging effectively visualizes lymphatic abnormalities after pelvic lymphadenectomy.
Retrograde lymphatic flow is a significant finding in a substantial proportion of patients with unilateral lower extremity lymphedema.
These findings enhance the understanding of lymphedema pathophysiology and may inform future treatment strategies.