Evidence map›Paper›PMID 40767571›Full record

ArticleAnnals of surgery2026

Bringing to Light the Invisible Lymphatic Anatomy of the Upper Extremity: Report From the 2024 Harvard Radcliffe Institute Accelerator Workshop.

James E Fanning, Leo L Tsai, Miguel A Amore, Rachelle Crescenzi, Katja N De Paepe, Kevin J Donohoe, Jeffrey H Maki, Timothy P Padera, Claus C Pieper, Hayley M Reynolds and 2 more

Abstract read
In one paragraph

Article in Annals of surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

James E FanningDepartment of Surgery, Division of Plastic and Reconstructive Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.
Leo L TsaiDepartment of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.
Miguel A AmoreVascular Anatomy Lab, III Chair of Anatomy, Faculty of Medicine, Buenos Aires University, Buenos Aires, Argentina.
Rachelle CrescenziDepartment of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN.
Katja N De PaepeDepartment of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.
Kevin J DonohoeDepartment of Radiology, Division of Nuclear Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.
Jeffrey H MakiDepartment of Radiology, University of Colorado Anschutz Medical Center, Aurora, CO.
Timothy P PaderaDepartment of Radiation Oncology, Edwin L. Steele Laboratories for Tumor Biology, Massachusetts General Hospital, Harvard Medical School, Boston, MA.
Claus C PieperDepartment of Diagnostic and Interventional Radiology, Division for Minimally-Invasive Lymph Vessel Therapy, University Hospital Bonn, Bonn, Germany.
Hayley M ReynoldsAuckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand.
Hiroo SuamiDepartment of Health Sciences, Faculty of Medicine, Health and Human Sciences, Australian Lymphoedema Education Research and Treatment Center (ALERT), Macquarie University, Sydney, NSW, Australia.
Dhruv SinghalDepartment of Surgery, Division of Plastic and Reconstructive Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.

Funding

Organ Specific ProjectU54HL165440 · NHLBI · BETH ISRAEL DEACONESS MEDICAL CENTER · PI HONG, YOUNG-KWON, SINGHAL, DHRUV · 2022 to 2025
$5.8M
Structural and Functional Remodeling of the Lymphatic System After Axillary Lymph Node DissectionR01HL157991 · NHLBI · BETH ISRAEL DEACONESS MEDICAL CENTER · PI Dhruv Singhal · 2021 to 2026
$3.1M
Imaging sodium and lymphatics in lymphedemaR01HL155523 · NHLBI · VANDERBILT UNIVERSITY MEDICAL CENTER · PI CRESCENZI, RACHELLE L · 2021 to 2025
$2.4M
Targeting lymph node metastases to block cancer progressionR01CA284372 · NCI · MASSACHUSETTS GENERAL HOSPITAL · PI TIMOTHY P PADERA · 2023 to 2026
$2.0M
High-Resolution Lymphatic Mapping of the Upper Extremities with MRIR21EB032932 · NIBIB · MASSACHUSETTS GENERAL HOSPITAL · PI TSAI, LEO LEE · 2023 to 2025
$550k
JOBST 2024 JOBST Lymphatic Research GrantNCI NIH HHS R01 CA284372NHLBI NIH HHS R01 HL155523NHLBI NIH HHS R01 HL157991NHLBI NIH HHS U54 HL165440NIBIB NIH HHS R21 EB032932
6 · The paper itself

Abstract

objectiveTo identify vulnerable upper extremity regions in native lymphatic anatomy that predispose women to the development of breast cancer-related lymphedema. In addition, to identify currently available imaging technologies that could be repurposed for in-vivo lymphatic imaging of these anatomic regions and pathways.

backgroundBreast cancer-related lymphedema remains an incurable complication of breast cancer treatment, but improvements to knowledge of upper extremity lymphatic anatomy and imaging can unlock new techniques for prevention and treatment.

methods"Bringing to Light the Invisible Lymphatic Anatomy of the Human Body" was a 2-day accelerator workshop held in May 2024 at the Harvard Radcliffe Institute attended by sixteen experts in lymphatic anatomy and imaging, including 4 lymphatic anatomists, 5 imaging clinicians, 3 lymphatic scientists, and 3 program officers from the National Heart, Lung, and Blood Institute (NHLBI) and Advanced Research Projects Agency for Health (ARPA-H).

resultsCollateral pathways of the superficial lymphatic system, perforating lymphatic vessels, and the deep lymphatic system were implicated in preventing or reducing the severity of BCRL. Several strategies were proposed for repurposing existing imaging technology and developing new imaging technology that can improve understanding of the anatomy, function, and connectivity of lymphatic vessels in these 3 regions of the arm.

conclusionAdvancements in lymphatic imaging are central to refining our knowledge of lymphatic anatomy. Key challenges to lymphatic imaging are visualization of the deep lymphatic system and perforating lymphatic vessels.

Indexed as

Breast NeoplasmsLymphatic SystemLymphatic VesselsLymphedemaUpper ExtremityFemaleHumanslymphaticlymphatic imaginglymphedemalymph nodeupper extremity

Identifiers

PMID40767571
PMCPMC12724531

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.