Lymphedema is tissue swelling caused by dysfunction of the lymphatic drainage system and is a common side effect after surgery and radiotherapy for malignant tumors. Preoperative lymphatic mapping is desired for lymphedema surgery. To date, several groups have applied photoacoustic (PA) imaging (PAI) using indocyanine green (ICG) to lymphedema patients for this purpose. PAI of lymphatic vessels is also useful for basic research using small animals, such as evaluating therapeutic techniques and analyzing tissue degeneration. To this end, we developed a PAI with a high-frequency linear array sensor that can visualize small lymph vessels in small animals. Furthermore, we have developed a PA microscopy (PAM) that can obtain cell-resolution images of surface tissues. PAI and PAM were tested by imaging lymphatic vessels in rabbit ears with lymphedema. PAI clearly visualized lymphatic vessels parallel to blood vessels. PAM was able to visualize ICG flowing back into the superficial lymph capillaries and dermis due to dermal backflow that occurs in lymphedema.
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