Enhancing Diagnostic Precision and Treatment Effectiveness Using Indocyanine Green Lymphography in Lymphedema

Hiroo Suami1, Jin A Yoon2

  • 1Australian Lymphoedema Education Research and Treatment Centre (ALERT), School of Health Sciences and Nursing, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia.

Indocyanine green (ICG) lymphography has rapidly emerged as a key imaging modality for improving the diagnosis and management of lymphedema. ICG lymphography offers superior sensitivity and detailed assessment of dermal backflow patterns, functional lymphatic channels, and collateral drainage routes. Evidence also supports its role in guiding targeted rehabilitation, including ICG-guided lymphedema treatment. Clinicians can enhance diagnostic precision and potentially improve therapeutic effectiveness by integrating ICG lymphography into clinical practice. This review summarizes current evidence on its clinical utility, highlighting how real-time visualization of superficial lymphatic pathways and lymph nodes allows for detection of dysfunction, and improved treatment planning. Future work should focus on standardizing protocols and developing quantitative metrics to expand its values in comprehensive lymphedema care.

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