Head and neck cancers (HNCs) are the 7th most prevalence cancer worldwide, and despite the declining use of tobacco products associated with its incidence, the prevalence of human papillomavirus (HPV) may be the reason why HNC is rising world-wide and in the US. Treatment of HPV positive HNC is largely effective, but can involve lymph node dissection and radiation therapy, both of which cause head and neck lymphedema (HNL) in an estimated 75% of all HNC survivors. Akin to the well-known condition of breast cancer related lymphedema (BRCL) that causes irreversible swelling of arms, HNL can involve edema that manifests as external and internal swelling that can impair movement, speech, breathi...

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Head and neck cancers (HNCs) are the 7th most prevalence cancer worldwide, and despite the declining use of tobacco products associated with its incidence, the prevalence of human papillomavirus (HPV) may be the reason why HNC is rising world-wide and in the US. Treatment of HPV positive HNC is largely effective, but can involve lymph node dissection and radiation therapy, both of which cause head and neck lymphedema (HNL) in an estimated 75% of all HNC survivors. Akin to the well-known condition of breast cancer related lymphedema (BRCL) that causes irreversible swelling of arms, HNL can involve edema that manifests as external and internal swelling that can impair movement, speech, breathing, and swallowing and cause profound disability. There are no objective diagnostic criteria for HNL, frequently resulting in the development of disabling and/or life threatening fibrosis prior to diagnosis. HNL requires a life-long, time-consuming, and often expensive regimen of manual therapies that are not typically available to HNC survivors outside urban medical centers.

Under prior CPRIT funding (RP120941), we used near-infrared fluorescence lymphatic imaging (NIRFLI) in longitudinal studies of HNC patients to show persistent and progressive lymphatic dysfunction over months and years. In a subsequent pilot study, early treatment in HNL patients 4 weeks after RT caused reductions and even amelioration of lymphatic dysfunction, suggesting that early treatment could potentially prevent progression to HNL. However, current methods quantify lymphatic dysfunction are time-consuming and inaccurate for point-of-care, diagnostic use or evaluation of treatment efficacy.

In this translational project we seek to integrate and validate the use of computer vision technology into the NIRFLI system to scan and quantify areas of lymphatic dysfunction to guide and monitor response to physiotherapy.

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