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Lymphatic Imaging and Interventions Lab (LIIL)

Lymphatic Imaging and Interventions Lab

The group employs novel imaging techniques, especially Magnetic-Resonance-Lymphangiography (MRL) for the investigation of the lymphatic vascular system and its pathologies. We especially investigate pathological alterations in peripheral and central lymph flow as observed in lymphedema, lipedema, chylous effusions (e.g. chylothrox) and plastic bronchitis (in patients with congenital heart disease) as well as lymphatic malformations. The group also specializes in innovative minimally-invasive treatment techniques for lymphatic diseases and their implementation in clinical routine.

Lymph vessel injury

Lymph vessel injuries with lymphatic or chylous leakage (chylothorax, chylous ascites, chylopericardium, cutaneous lymphatic fistula, lymphceles) are traumatic, especially iatrogenic diseases that can be difficult to treat. They are associated with considerable morbidity and mortality.

The research group works on the technical development and clinical implementation of innovative imaging and interventional techniques for minimally-invasive treatment of lymphatic leakages. Research topics are for example:

  • Value of MR-lymphangiography (transpedal or transnodal) for pre-treatment planning in patients with lymphatic leakages
  • Clinical value and individual indications for minimally-invasive lymphatic therapies (e.g. catheter-based selective lymph vessel embolisation)
  • Long-term effects of lymph vessel interventions
  • Polymerisation properties of liquid embolics in the lymphatic system

Lymphatic flow pathologies

Apart from direct lymph vessel injury, lymphatic leakage or lymphedema may also be caused by abnormal lymph flow (e.g. chylolymphatic reflux) without evident external causes. This phenomenon can be observed especially in children (e.g. in patients with congenital heart disease; plastic bronchitis), but also in adults. Diagnosis and treatment of these diseases are often more complex than that of localized lymphatic leakage.

We aim at elucidating the currently poorly understood pathophysiology of these diseases by evaluating lymphatic flow dynamically. This may lead to targeted and minimally-invasive treatment options. Research topics are:

  • Evaluation of lymphatic flow pathologies by MR-lymphangiography and determination of the value of different MR techniques
  • Impact of physiological changes on central lymphatic flow
  • Clinical impact of and indications for embolisation techniques in patients with pathological lymph flow
  • MR-lymphangiography for differential indications of different treatment options in lymphedema

Lymphatic malformations

Lymph vessel anomalies and malformations can be localised or generalised and can occur isolated or in combination with other anomalies. Our group works on optimization of imaging techniques for these lymph vessel alterations and associated lymph flow changes. Furthermore, imaging findings are correlated with the underlying (genetic) cause.

Quantitative imaging in lymphedema and lipedema

Lymphedema and lipedema are often diagnosed diseases that are associated with often long treatment periods which can be unsatisfactory for the patients. Research topics of our group are the evaluation of quantitative imaging techniques in an effort to aid objective diagnosis of lipedema and to objectively assess treatment success in lymphedema.

Group Leader:

Priv.-Doz. Dr.med. Claus C. Pieper
Tel.: +49 228 287 - 19763
E-Mail: Enable JavaScript to view protected content.

 

Team Members:

Priv.-Doz. Dr. Daniel L. Kütting
Dr. Patrick A. Kupczyk
Dr. Alois Martin Sprinkart (Core Facility)
Dr. Julia Wagenpfeil
Dr. Katharina Hoß
Dr. Andreas Feißt (Department of Radiation Therapy and Radiooncology)
Dr. Katharina Laumen
Marius Vach
Sergej Geiger
Andreas Henkel (Postgraduate Student)
Lea Kaminski (Postgraduate Student)

 

  • C.C. Pieper, Posterpreis Interventionell Radiologisches Olbert Symposium (IROS) 2018: “Interstitielle transpedale MR-Lymphangiographie zur Planung lymphatischer Interventionen bei Patienten mit chylösen Leckagen”
  • C.C. Pieper, Young Investigator Award der Deutschen Röntgengesellschaft (DRG) 2017: “Transpedale MR-Lymphangiographie des zentralen Lymphsystems – Eine neue Technik zur Planung lymphatischer Interventionen bei Patienten mit chylösen Leckagen”
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