{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T11:38:48Z","timestamp":1788349128403,"version":"build-2803163510"},"reference-count":33,"publisher":"Oxford University Press (OUP)","issue":"1179","license":[{"start":{"date-parts":[[2026,1,11]],"date-time":"2026-01-11T00:00:00Z","timestamp":1768089600000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100018645","name":"MRC","doi-asserted-by":"publisher","award":["MR\/P011543\/1"],"award-info":[{"award-number":["MR\/P011543\/1"]}],"id":[{"id":"10.13039\/100018645","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100018645","name":"MRC","doi-asserted-by":"publisher","award":["MR\/Y013786\/1"],"award-info":[{"award-number":["MR\/Y013786\/1"]}],"id":[{"id":"10.13039\/100018645","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000274","name":"BHF","doi-asserted-by":"publisher","award":["RG\/17\/7\/33217"],"award-info":[{"award-number":["RG\/17\/7\/33217"]}],"id":[{"id":"10.13039\/501100000274","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000274","name":"BHF","doi-asserted-by":"publisher","award":["SP\/J\/24\/285005"],"award-info":[{"award-number":["SP\/J\/24\/285005"]}],"id":[{"id":"10.13039\/501100000274","id-type":"DOI","asserted-by":"publisher"}]},{"name":"BHF Research Training","award":["FS\/RTF\/24\/30083"],"award-info":[{"award-number":["FS\/RTF\/24\/30083"]}]},{"name":"St George\u2019s Hospital Charity","award":["SPF24119"],"award-info":[{"award-number":["SPF24119"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,3,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Indocyanine green lymphography (ICGL) has emerged as a potentially powerful tool for the study of the superficial lymphatic system and to support the diagnosis of lymphoedema. However, detailed descriptions of ICGL findings in healthy individuals are limited. In this study, we imaged a series of healthy participants using ICGL, attempting to establish quantitative and qualitative ICGL parameters of the lower limb.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Sixteen healthy individuals aged 20-55\u2009years were recruited to undergo lower limb ICGL after 0.1\u2009mL injections of 1\u2009g\/L ICG were administered intradermally to 5 locations around the foot. Outcome measures included: (1) the drainage routes of contractile lymphatic collectors observed, (2) the number of lymphatic vessels crossing the anterior ankle, and (3) the pumping frequency of lymphatic vessels. Abnormal features, such as highly tortuous or vessels with retrograde lymph flow, were noted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Propulsion of ICG containing lymph could be seen in all individuals, with drainage via the anteromedial and anterolateral drainage pathways predominating (observed in 31\/32 and 25\/32 limbs, respectively). The number of lymphatic vessels crossing the anterior ankle was 3.4\u2009\u00b1\u20091.1 with an average rate of 1 propulsion every 66\u2009seconds in the vessels investigated. Isolated cases of highly tortuous and refluxing vessels were observed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Although limited by absorption and scatter of infrared light, ICGL facilitated the characterization of normal lower limb lymphatic vessels through a rigorous set of objective measures. This in turn will allow better identification of pathological changes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Advances in knowledge<\/jats:title>\n                    <jats:p>Establishment of normal lower limb lymphatic anatomy and function.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/bjr\/tqag008","type":"journal-article","created":{"date-parts":[[2026,1,11]],"date-time":"2026-01-11T04:44:13Z","timestamp":1768106653000},"page":"577-582","source":"Crossref","is-referenced-by-count":1,"title":["Indocyanine green lymphography imaging of normal lymphatic drainage in the lower limbs"],"prefix":"10.1093","volume":"99","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6316-4561","authenticated-orcid":false,"given":"Mike","family":"Mills","sequence":"first","affiliation":[{"name":"School of Health and Medical Sciences, City St George\u2019s, University of London , London, SW17 0RE,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malou","family":"van Zanten","sequence":"additional","affiliation":[{"name":"School of Health and Medical Sciences, City St George\u2019s, University of London , London, SW17 0RE,","place":["United Kingdom"]},{"name":"Department of Dermatology and Lymphovascular Medicine, Nij Smellinghe Hospital , Drachten, 9202 NN,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Greta","family":"Brezgyte","sequence":"additional","affiliation":[{"name":"School of Health and Medical Sciences, City St George\u2019s, University of London , London, SW17 0RE,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernard","family":"Ho","sequence":"additional","affiliation":[{"name":"School of Health and Medical Sciences, City St George\u2019s, University of London , London, SW17 0RE,","place":["United Kingdom"]},{"name":"Lymphovascular Medicine, Dermatology Department, St George\u2019s University Hospitals NHS Foundation Trust , London, SW17 0QT,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julian","family":"Pearce","sequence":"additional","affiliation":[{"name":"School of Health and Medical Sciences, City St George\u2019s, University of London , London, SW17 0RE,","place":["United Kingdom"]},{"name":"Lymphovascular Medicine, Dermatology Department, St George\u2019s University Hospitals NHS Foundation Trust , London, SW17 0QT,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie","family":"Wilken-Smith","sequence":"additional","affiliation":[{"name":"School of Health and Medical Sciences, City St George\u2019s, University of London , London, SW17 0RE,","place":["United Kingdom"]},{"name":"Lymphovascular Medicine, Dermatology Department, St George\u2019s University Hospitals NHS Foundation Trust , London, SW17 0QT,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manan","family":"Shelton","sequence":"additional","affiliation":[{"name":"School of Health and Medical Sciences, City St George\u2019s, University of London , London, SW17 0RE,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Mortimer","sequence":"additional","affiliation":[{"name":"School of Health and Medical Sciences, City St George\u2019s, University of London , London, SW17 0RE,","place":["United Kingdom"]},{"name":"Lymphovascular Medicine, Dermatology Department, St George\u2019s University Hospitals NHS Foundation Trust , London, SW17 0QT,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroo","family":"Suami","sequence":"additional","affiliation":[{"name":"Australian Lymphoedema Education, Research & Treatment (ALERT) Centre, Faculty of Medicine, Health and Human Sciences, Macquarie University , Sydney, New South Wales, NSW 2109,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7840-5644","authenticated-orcid":false,"given":"Kristiana","family":"Gordon","sequence":"additional","affiliation":[{"name":"School of Health and Medical Sciences, City St George\u2019s, University of London , London, SW17 0RE,","place":["United Kingdom"]},{"name":"Lymphovascular Medicine, Dermatology Department, St George\u2019s University Hospitals NHS Foundation Trust , London, SW17 0QT,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2190-1356","authenticated-orcid":false,"given":"Pia","family":"Ostergaard","sequence":"additional","affiliation":[{"name":"School of Health and Medical Sciences, City St George\u2019s, University of London , London, SW17 0RE,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,1,10]]},"reference":[{"key":"2026032003514166600_tqag008-B1","first-page":"1203","volume-title":"Br Med J","author":"Jackson","year":"1966"},{"key":"2026032003514166600_tqag008-B2","doi-asserted-by":"crossref","DOI":"10.1007\/978-3-319-52423-8","volume-title":"Lymphedema: A Concise Compendium of Theory and Practice","author":"Lee","year":"2018","edition":"nd edn"},{"key":"2026032003514166600_tqag008-B3","doi-asserted-by":"crossref","first-page":"25","DOI":"10.3390\/lymphatics1010004","article-title":"Lymphoscintigraphy versus indocyanine green lymphography\u2014which should be the gold standard for lymphedema imaging?","volume":"1","author":"Figueroa","year":"2023","journal-title":"Lymphatics"},{"key":"2026032003514166600_tqag008-B4","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1097\/01.sap.0000253341.70866.54","article-title":"Intraoperative lymphography using indocyanine green dye for near-infrared fluorescence labeling in lymphedema","volume":"59","author":"Ogata","year":"2007","journal-title":"Ann Plast Surg"},{"key":"2026032003514166600_tqag008-B5","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1089\/lrb.2020.0090","article-title":"Personalizing conservative lymphedema management using indocyanine green-guided manual lymphatic drainage","volume":"19","author":"Koelmeyer","year":"2021","journal-title":"Lymphat Res Biol"},{"key":"2026032003514166600_tqag008-B6","doi-asserted-by":"crossref","first-page":"814","DOI":"10.1016\/j.bjps.2017.01.020","article-title":"Indocyanine green applications in plastic surgery: a review of the literature","volume":"70","author":"Burnier","year":"2017","journal-title":"J Plast Reconstr Aesthet Surg"},{"key":"2026032003514166600_tqag008-B7","doi-asserted-by":"crossref","first-page":"558E","DOI":"10.1097\/PRS.0000000000005362","article-title":"Flow pattern classification in lymphatic malformations by indocyanine green lymphography","volume":"143","author":"Kato","year":"2019","journal-title":"Plast Reconstr Surg"},{"key":"2026032003514166600_tqag008-B8","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1080\/17434440.2021.1900725","article-title":"The application of indocyanine green (ICG) and near-infrared (NIR) fluorescence imaging for assessment of the lymphatic system in reconstructive lymphaticovenular anastomosis surgery","volume":"18","author":"Chao","year":"2021","journal-title":"Expert Rev Med Devices"},{"key":"2026032003514166600_tqag008-B9","doi-asserted-by":"publisher","first-page":"3946","DOI":"10.1016\/j.bjps.2022.08.017","article-title":"A new indocyanine green fluorescence lymphography protocol for diagnostic assessment of lower limb lymphoedema","volume":"75","author":"Suami","year":"2022","journal-title":"J Plast Reconstr Aesthet Surg"},{"key":"2026032003514166600_tqag008-B10","doi-asserted-by":"crossref","first-page":"517","DOI":"10.1093\/bjr\/tqaf006","article-title":"A systematic review of indocyanine green lymphography imaging for the diagnosis of primary lymphoedema","volume":"98","author":"Brezgyte","year":"2025","journal-title":"Br J Radiol"},{"key":"2026032003514166600_tqag008-B11","doi-asserted-by":"crossref","first-page":"1161","DOI":"10.1097\/PRS.0000000000004315","article-title":"A fresh cadaver study on indocyanine green fluorescence lymphography: a new whole-body imaging technique for investigating the superficial lymphatics","volume":"141","author":"Shinaoka","year":"2018","journal-title":"Plast Reconstr Surg"},{"key":"2026032003514166600_tqag008-B12","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1016\/j.jvsv.2016.11.008","article-title":"Lymphoscintigraphic abnormalities in the contralateral lower limbs of patients with unilateral lymphedema","volume":"5","author":"de Almeida","year":"2017","journal-title":"J Vasc Surg Venous Lymphat Disord"},{"key":"2026032003514166600_tqag008-B13","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1097\/RLU.0b013e31823931f5","article-title":"Lymphatic dysfunction in the apparently clinically normal contralateral limbs of patients with unilateral lower limb swelling","volume":"37","author":"Burnand","year":"2012","journal-title":"Clin Nucl Med"},{"key":"2026032003514166600_tqag008-B14","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1148\/radiol.2019191169","article-title":"Lower-limb lymphatic drainage pathways and lymph nodes: a CT lymphangiography cadaver study","volume":"294","author":"Shinaoka","year":"2020","journal-title":"Radiology"},{"key":"2026032003514166600_tqag008-B15","doi-asserted-by":"crossref","first-page":"634","DOI":"10.1097\/PRS.0000000000005982","article-title":"Correlations between tracer injection sites and lymphatic pathways in the leg: a near-infrared fluorescence lymphography study","volume":"144","author":"Shinaoka","year":"2019","journal-title":"Plast Reconstr Surg"},{"key":"2026032003514166600_tqag008-B16","doi-asserted-by":"crossref","first-page":"e2938","DOI":"10.1097\/GOX.0000000000002938","article-title":"Lymphovenous bypass using indocyanine green mapping for successful treatment of penile and scrotal lymphedema","volume":"8","author":"Frojo","year":"2020","journal-title":"Plast Reconstr Surg Glob Open"},{"key":"2026032003514166600_tqag008-B17","doi-asserted-by":"crossref","first-page":"665","DOI":"10.1097\/PRS.0000000000011027","article-title":"Lymphatic pathways on indocyanine green lymphography in patients with labia minora hypertrophy","volume":"154","author":"Yuan","year":"2024","journal-title":"Plast Reconstr Surg"},{"key":"2026032003514166600_tqag008-B18","doi-asserted-by":"crossref","first-page":"356","DOI":"10.1089\/lrb.2017.0025","article-title":"Indocyanine green lymphographic and lymphoscintigraphic findings in genital lymphedema-genital pathway score","volume":"15","author":"Hara","year":"2017","journal-title":"Lymphat Res Biol"},{"key":"2026032003514166600_tqag008-B19","doi-asserted-by":"crossref","first-page":"21103","DOI":"10.1038\/s41598-021-00396-2","article-title":"Indocyanine green lymphangiography is superior to clinical staging in breast cancer-related lymphedema","volume":"11","author":"J\u00f8rgensen","year":"2021","journal-title":"Sci Rep"},{"key":"2026032003514166600_tqag008-B20","doi-asserted-by":"crossref","first-page":"151792","DOI":"10.1016\/j.soncn.2024.151792","article-title":"Indocyanine green lymphography in conservative lymphedema management: an exploration of the impact on lymphedema therapy plans","volume":"41","author":"Trevethan","year":"2025","journal-title":"Semin Oncol Nurs"},{"key":"2026032003514166600_tqag008-B21","first-page":"153","volume-title":"A New Lymphography Protocol and Interpretation Principles Based on Functional Lymphatic Anatomy in Lower Limb Lymphedema","author":"Shinaoka","year":"2024"},{"key":"2026032003514166600_tqag008-B22","doi-asserted-by":"crossref","first-page":"985","DOI":"10.1186\/s12885-019-6192-1","article-title":"A new indocyanine green fluorescence lymphography protocol for identification of the lymphatic drainage pathway for patients with breast cancer-related lymphoedema","volume":"19","author":"Suami","year":"2019","journal-title":"BMC Cancer"},{"key":"2026032003514166600_tqag008-B23","doi-asserted-by":"crossref","first-page":"1265","DOI":"10.1364\/BOE.3.001256","article-title":"Lymphatic abnormalities in the normal contralateral arms of subjects with breast cancer-related lymphedema as assessed by near-infrared fluorescent imaging","volume":"3","author":"Aldrich","year":"2012","journal-title":"Biomed Opt Express"},{"key":"2026032003514166600_tqag008-B24","doi-asserted-by":"crossref","first-page":"1097","DOI":"10.1177\/0284185117744226","article-title":"Lymphatic drainage efficiency: a new parameter of lymphatic function","volume":"59","author":"Keramida","year":"2018","journal-title":"Acta Radiol"},{"key":"2026032003514166600_tqag008-B25","doi-asserted-by":"crossref","first-page":"610","DOI":"10.1089\/lrb.2019.0016","article-title":"Lymphoscintigraphic abnormalities associated with milroy disease and lymphedema-distichiasis syndrome","volume":"17","author":"Sarica","year":"2019","journal-title":"Lymphat Res Biol"},{"key":"2026032003514166600_tqag008-B26","doi-asserted-by":"crossref","first-page":"1443","DOI":"10.2214\/AJR.11.6631","article-title":"Popliteal node visualization during standard pedal lymphoscintigraphy for a swollen limb indicates impaired lymph drainage","volume":"197","author":"Burnand","year":"2011","journal-title":"AJR Am J Roentgenol"},{"key":"2026032003514166600_tqag008-B27","doi-asserted-by":"crossref","first-page":"134","DOI":"10.4103\/0972-3919.119540","article-title":"Significance of popliteal lymph nodes visualization during radionuclide lymphoscintigraphy for lower limb lymphedema","volume":"28","author":"Kandeel","year":"2013","journal-title":"Indian J Nucl Med"},{"key":"2026032003514166600_tqag008-B28","first-page":"26","article-title":"Optimized lymphoscintigraphy and diagnostics of lymphatic oedema of the lower extremities","volume":"11","author":"Dabrowski","year":"2008","journal-title":"Nucl Med Rev Cent East Eur"},{"key":"2026032003514166600_tqag008-B29","doi-asserted-by":"crossref","first-page":"895","DOI":"10.1016\/j.medengphy.2016.04.020","article-title":"Monitoring contractile dermal lymphatic activity following uniaxial mechanical loading","volume":"38","author":"Gray","year":"2016","journal-title":"Med Eng Phys"},{"key":"2026032003514166600_tqag008-B30","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1089\/lrb.2017.0001","article-title":"Investigating the short-term effects of manual lymphatic drainage and compression garment therapies on lymphatic function using near-infrared imaging","volume":"15","author":"Lopera","year":"2017","journal-title":"Lymphat Res Biol"},{"key":"2026032003514166600_tqag008-B31","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1016\/j.jvsv.2019.03.021","article-title":"Indocyanine green lymphography findings in older patients with lower limb lymphedema","volume":"8","author":"Yoshida","year":"2020","journal-title":"J Vasc Surg Venous Lymphat Disord [Internet]"},{"key":"2026032003514166600_tqag008-B32","doi-asserted-by":"crossref","first-page":"1197","DOI":"10.1097\/PRS.0000000000006176","article-title":"A novel approach to quantifying lymphatic contractility during indocyanine green lymphangiography","volume":"144","author":"Granoff","year":"2019","journal-title":"Plast Reconstr Surg"},{"key":"2026032003514166600_tqag008-B33","doi-asserted-by":"crossref","first-page":"e261787","DOI":"10.1136\/bcr-2024-261787","article-title":"Indocyanine green lymphography identifies lymphatic structures in patients with Milroy\u2019s disease who demonstrate functional aplasia on lymphoscintigraphy","volume":"17","author":"Brezgyte","year":"2024","journal-title":"BMJ Case Rep"}],"container-title":["British Journal of Radiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/bjr\/advance-article-pdf\/doi\/10.1093\/bjr\/tqag008\/66341702\/tqag008.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/bjr\/article-pdf\/99\/1179\/577\/66341702\/tqag008.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/bjr\/article-pdf\/99\/1179\/577\/66341702\/tqag008.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T07:51:50Z","timestamp":1773993110000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/bjr\/article\/99\/1179\/577\/8419869"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,10]]},"references-count":33,"journal-issue":{"issue":"1179","published-online":{"date-parts":[[2026,1,10]]},"published-print":{"date-parts":[[2026,3,1]]}},"URL":"https:\/\/doi.org\/10.1093\/bjr\/tqag008","relation":{},"ISSN":["0007-1285","1748-880X"],"issn-type":[{"value":"0007-1285","type":"print"},{"value":"1748-880X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,3]]},"published":{"date-parts":[[2026,1,10]]}}}