Indocyanine Green Lymphography in Conservative Lymphedema Therapy: A Scoping Review

Abstract

Background: There is great potential but seemingly limited use of indocyanine green (ICG) lymphography to influence conservative lymphedema therapy clinical practice. This scoping review aimed to map existing evidence for ICG lymphography relating to conservative lymphedema therapy. Methods: A 6-staged scoping review framework of Arksey and O'Malley was used to guide the study. Protocol development included key stakeholder consultation. Searches were conducted in 5 databases with specialist librarian support. A 2-phase selection process undertaken by 2 researchers identified studies for inclusion. Conflicts were resolved by consensus. A subsequent 3-phase data extraction and quality appraisal process occurred. Key findings were presented in a descriptive numerical summary. Results: A total of 6316 records were identified, yielding 162 articles for inclusion. Categorization was made according to article type and purpose of ICG lymphography including lymphedema assessment (diagnosis and staging) and/or conservative therapy. Seventy-six empirical research articles with detailed reference to ICG lymphography were explored further. Conclusion: Current published research about ICG lymphography in conservative lymphedema therapy describes support for its use in lymphedema diagnosis, and proposes staging systems for lymphedema severity. Despite existing work, further exploration of effect on conservative therapy planning, clinical, and patient outcomes is necessary to consider future translation to clinical practice.