Indocyanine green (ICG) lymphangiography

What is it?

ICG imaging is performed by injecting indocyanine green into the interdigital web spaces; fluorescence images of lymphatic vessels can be obtained with a near- infrared camera device; the fluorescence images are digitalised for real- time display. It allows real time visualization of lymphatic flow without exposure to radiation.

When is this exam indicated?

ICG is considered remakably useful in planning surgical options for lymphedema and especially useful for intraoperative planning during various physiological procedures.

How is it performed?

ICG lymphangiography involves the injection of a contrast agent into the interdigital web spaces and then monitoring flow of protein bound dye in the superficial lymphatic channels below the dermis. This uses near infrared cameras to detect the fluorescence from protein bound,with no exposure to radiation.


Indocyanine green contains sodium iodide and is contraindicated in patients with iodine hypersensitivity. Anaphylaxis or other allergic reactions may occur. Indocyanine green should be used with caution in patients with renal failure or uremia, and those who are on dialysis.

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