Review
BibTex RIS Cite

LYMPHEDEMA AND PERIPHERAL LYMPHOSCINTIGRAPHY

Year 2024, Volume: 87 Issue: 3, 253 - 260, 19.07.2024
https://doi.org/10.26650/IUITFD.1452389

Abstract

Peripheral lymphedema occurs because of mechanical or func tional obstruction of the lymphatic system. Accurate diagnosis is important for the appropriate management of patients with lymphedema. Lymphoscintigraphy is a useful technique among the first-choice methods to detect lymphedema. Factors affect ing the outcome of the test and different test protocols can make it difficult to interpret. The aim of this review is to provide a literature-based overview of the aetiology and diagnostic meth ods of extremity lymphedema and to summarise the current knowledge on lymphoscintigraphy protocols and interpretation.

References

  • 1. Walker LA. Localization of radioactive colloids in lymph nodes. The J Lab Clin Med 1950;36(3):440-9. google scholar
  • 2. Sherman AI, Ter - Pogossian M. Lymph-node concentration of radioactive colloidal gold following interstitial injection. Cancer 1953;6(6):1238-40. [CrossRef] google scholar
  • 3. Threefoot S, Kent W, Hatchett B. Lymphaticovenous and lymphaticolymphatic communications demonstrated by plastic corrosion models of rats and by postmortem lymphangiography in man. The J Lab Clin Med 1963;61:9-22. google scholar
  • 4. Szuba A, Shin WS, Strauss HW, Rockson S. The third circulation: radionuclide lymphoscintigraphy in the evaluation of lymphedema. J Nucl Med 2003;44(1):43-57. google scholar
  • 5. Jensen MR, Simonsen L, Karlsmark T, Bülow J. Lymphoedema of the lower extremities-background, pathophysiology and diagnostic considerations. Clin Phisiol Funct I 2010;30(6):389-98. [CrossRef] google scholar
  • 6. O’Donnell Jr TF, Rasmussen JC, Sevick-Muraca EM. New diagnostic modalities in the evaluation of lymphedema. J Vasc Surg-Venous L 2017;5(2):261-73. [CrossRef] google scholar
  • 7. Barrett T, Choyke PL, Kobayashi H. Imaging of the lymphatic system: new horizons. Contrast Media Mol I 2006;1(6):230-45. [CrossRef] google scholar
  • 8. Maclellan RA, Greene AK. Lymphedema. Semin Pediatr Surg 2014;23(4):191-7. [CrossRef] google scholar
  • 9. Tiwari A, Cheng KS, Button M, Myint F, Hamilton G. Differential diagnosis, investigation, and current treatment of lower limb lymphedema. Arch Surg 2003;138(2):152-61. [CrossRef] google scholar
  • 10. Erickson VS, Pearson ML, Ganz PA, Adams J, Kahn KL. Arm edema in breast cancer patients. J Natl Cancer I 2001;93(2):96-111. [CrossRef] google scholar
  • 11. Suami H, Koelmeyer L, Mackie H, Boyages J. Patterns of lymphatic drainage after axillary node dissection impact arm lymphoedema severity: A review of animal and clinical imaging studies. Surg Oncol 2018;27(4):743-50. [CrossRef] google scholar
  • 12. Warren AG, Brorson H, Borud LJ, Slavin SA. Lymphedema: a comprehensive review. Ann Plas Surg 2007;59(4):464-72. [CrossRef] google scholar
  • 13. Du X, Liu C. Application of imaging in lymphedema surgical therapies. Gland Surg 2020;9(2):582. [CrossRef] google scholar
  • 14. Kinmonth JB. Lymphangiography in man; a method of outlining lymphatic trunks at operation. Clin Sci 1952;11(1):13-20. google scholar
  • 15. Weissleder H, Weissleder R. Interstitial lymphangiography: initial clinical experience with a dimeric nonionic contrast agent. Radiology 1989;170(2):371-4. [CrossRef] google scholar
  • 16. Yoshida RY, Kariya S, Ha-Kawa S, Tanigawa N. Lymphoscintigraphy for imaging of the lymphatic flow disorders. Tech Vasc Interv Radiol 2016;19(4):273-6. [CrossRef] google scholar
  • 17. Suehiro K, Morikage N, Murakami M, Yamashita O, Samura M, Hamano K. Significance of ultrasound examination of skin and subcutaneous tissue in secondary lower extremity lymphedema. Ann Vasc Dis 2013;6(2):180-8. [CrossRef] google scholar
  • 18. Shin SU, Lee W, Park E-A, Shin C-I, Chung JW, Park JH. Comparison of characteristic CT findings of lymphedema, cellulitis, and generalized edema in lower leg swelling. Int J Cardiovasc Imaging 2013;29:135-43. [CrossRef] google scholar
  • 19. Carroll BJ, Singhal D. Advances in lymphedema: An underrecognized disease with a hopeful future for patients. Vasc Med 2024;29(1):70-84. [CrossRef] google scholar
  • 20. White R, Weir-McCall J, Budak M, Waugh S, Munnoch D, Sudarshan T. Contrast-enhanced magnetic resonance lymphography in the assessment of lower limb lymphoedema. Clin Radiol 2014;69(11):e435-e44. [CrossRef] google scholar
  • 21. Unno Na, Nishiyama M, Suzuki M, Yamamoto N, Inuzuka K, Sagara D, et al. Quantitative lymph imaging for assessment of lymph function using indocyanine green fluorescence lymphography. Eur J Vasc Endovasc Surg 2008;36(2):230-6. [CrossRef] google scholar
  • 22. Ohtake E, Matsui K. Lymphoscintigraphy in patients with lymphedema. A new approach using intradermal injections of technetium-99m human serum albumin. Clin Nucl Med 1986;11(7):474-8. [CrossRef] google scholar
  • 23. Henze E, Schelbert H, Collins J, Najafi A, Barrio J, Bennett L. Lymphoscintigraphy with Tc-99m-labeled dextran. J Nucl Med 1982;23(10):923-9. google scholar
  • 24. Svensson W, Glass D, Bradley D, Peters A. Measurement of lymphatic function with technetium-99m-labelled polyclonal immunoglobulin. Eur J Nucl Med Mol Imaging 1999;26:504-10. [CrossRef] google scholar
  • 25. Partsch H. Assessment of abnormal lymph drainage for the diagnosis of lymphedema by isotopic lymphangiography and by indirect lymphography. Clin Dermatol 1995;13(5):445-50. [CrossRef] google scholar
  • 26. Pappalardo M, Cheng MH. Lymphoscintigraphy for the diagnosis of extremity lymphedema: Current controversies regarding protocol, interpretation, and clinical application. J Surg Oncol 2020;121(1):37-47. [CrossRef] google scholar
  • 27. Baulieu F, Bourgeois P, Maruani A, Belgrado J, Tauveron V, Lorette G, et al. Contributions of SPECT/CT imaging to the lymphoscintigraphic investigations of the lower limb lymphedema. Lymphology 2013;46(3):106-19. google scholar
  • 28. Villa G, Campisi C, Ryan M, Boccardo F, Di Summa P, Frascio M, et al. Procedural recommendations for lymphoscintigraphy in the diagnosis of peripheral lymphedema: the Genoa protocol. Nucl Med Mol Imaging 2019;53:47-56. [CrossRef] google scholar
  • 29. Nagy BI, Mohos B, Tzou C-HJ. Imaging Modalities for Evaluating Lymphedema. Medicina 2023;59(11):2016. [CrossRef] google scholar
  • 30. Yoon H-J, Woo K-J, Kim J-Y, Kang SY, Moon BS, Kim BS. The added value of SPECT/CT lymphoscintigraphy in the initial assessment of secondary extremity lymphedema patients. Sci Rep 2023;13(1):19494. [CrossRef] google scholar
  • 31. Scarsbrook AF, Ganeshan A, Bradley KM. Pearls and pitfalls of radionuclide imaging of the lymphatic system. Part 2: evaluation of extremity lymphoedema. Brit J Radiol 2007;80(951):219-26. [CrossRef] google scholar
  • 32. Kleinhans E, Baumeister RG, Hahn D, Siuda S, Büll U, Moser E. Evaluation of transport kinetics in lymphoscintigraphy: follow-up study in patients with transplanted lymphatic vessels. Eur J Nucl Med Mol Imaging 1985;10:349-52. [CrossRef] google scholar
  • 33. Cambria RA, Gloviczki P, Naessens JM, Wahner HW. Noninvasive evaluation of the lymphatic system with lymphoscintigraphy: a prospective, semiquantitative analysis in 386 extremities. J Vasc Surg 1993;18(5):773-82. [CrossRef] google scholar
  • 34. Partsch H. Practical aspects of indirect lymphography and lymphoscintigraphy. Lymphat Res Biol 2003;1(1):71-4. [CrossRef] google scholar
  • 35. Weissleder H, Weissleder R. Lymphedema: evaluation of qualitative and quantitative lymphoscintigraphy in 238 patients. Radiology 1988;167(3):729-35. [CrossRef] google scholar
  • 36. Ter S-E, Alavi A, Kim CK, Merli G. Lymphoscintigraphy A reliable test for the diagnosis of lymphedema. Clin Nucl Med 1993;18(8):646-54. [CrossRef] google scholar
  • 37. Hassanein AH, Maclellan RA, Grant FD, Greene AK. Diagnostic accuracy of lymphoscintigraphy for lymphedema and analysis of false-negative tests. Plast Reconstr Surg Glob Open 2017;5(7):e1396. [CrossRef] google scholar
  • 38. Donohoe KJ, Carroll BJ, Chung DK, Dibble EH, Diego E, Giammarile F, et al. Summary: Appropriate Use Criteria for Lymphoscintigraphy in Sentinel Node Mapping and Lymphedema/Lipedema. J Nucl Med 2023;64(4):525-8. [CrossRef] google scholar
  • 39. Bourgeois P, Frühling J, Henry J. Postoperative axillary lymphoscintigraphy in the management of breast cancer. Int J Radiat Oncol Biol Phys 1983;9(1):29-32. [CrossRef] google scholar
  • 40. Szuba A, Chachaj A, Koba-Wszedybylb M, Hawro R, Jasinski R, Tarkowski R, et al. Axillary lymph nodes and arm lymphatic drainage pathways are spared during routine complete axillary clearance in majority of women undergoing breast cancer surgery. Lymphology 2011;44(3):103-12. google scholar
  • 41. Forte AJ, Boczar D, Huayllani MT, Lu X. Lymphoscintigraphy for evaluation of lymphedema treatment: A systematic review. Cureus 2019;11(12):e6363. [CrossRef] google scholar
  • 42. Moon T, O’Donnell TF, Weycker D, Iafrati M. Lymphoscintigraphy is frequently recommended but seldom used in a “real world setting”. J Vasc Surg-Venous L 2023;12(2):101738. [CrossRef] google scholar
  • 43. Lurie F, Malgor RD, Carman T, Dean SM, Iafrati MD, Khilnani NM, et al. The American Venous Forum, American Vein and Lymphatic Society and the Society for Vascular Medicine expert opinion consensus on lymphedema diagnosis and treatment. Phlebology 2022;37(4):252-66. [CrossRef] google scholar

LENFÖDEM VE PERİFERİK LENFOSİNTİGRAFİ

Year 2024, Volume: 87 Issue: 3, 253 - 260, 19.07.2024
https://doi.org/10.26650/IUITFD.1452389

Abstract

Periferik ekstremite lenfödemi lenfatik sistemin mekanik veya fonksiyonel obstrüksiyonu sonucunda oluşur. Lenfödemli has taların uygun şekilde yönetilebilmesi için doğru tanı konulması önemlidir. Lenödemin saptanması için ilk tercih edilecek yön temler arasında lenfosintigrafi önemli bir yer tutar. Testin sonucu nu etkileyen faktörler, farklı test protokollerinin yorumlanmasını zorlaştırabilir. Bu derlemenin amacı, alt ekstremite lenfödeminin etiyolojisi ve tanı yöntemleri hakkında literatüre dayalı bir bakış sağlamak ve lenfosintigrafi protokolleri ve yorumlaması hakkın daki güncel bilgileri özetlemektir.

References

  • 1. Walker LA. Localization of radioactive colloids in lymph nodes. The J Lab Clin Med 1950;36(3):440-9. google scholar
  • 2. Sherman AI, Ter - Pogossian M. Lymph-node concentration of radioactive colloidal gold following interstitial injection. Cancer 1953;6(6):1238-40. [CrossRef] google scholar
  • 3. Threefoot S, Kent W, Hatchett B. Lymphaticovenous and lymphaticolymphatic communications demonstrated by plastic corrosion models of rats and by postmortem lymphangiography in man. The J Lab Clin Med 1963;61:9-22. google scholar
  • 4. Szuba A, Shin WS, Strauss HW, Rockson S. The third circulation: radionuclide lymphoscintigraphy in the evaluation of lymphedema. J Nucl Med 2003;44(1):43-57. google scholar
  • 5. Jensen MR, Simonsen L, Karlsmark T, Bülow J. Lymphoedema of the lower extremities-background, pathophysiology and diagnostic considerations. Clin Phisiol Funct I 2010;30(6):389-98. [CrossRef] google scholar
  • 6. O’Donnell Jr TF, Rasmussen JC, Sevick-Muraca EM. New diagnostic modalities in the evaluation of lymphedema. J Vasc Surg-Venous L 2017;5(2):261-73. [CrossRef] google scholar
  • 7. Barrett T, Choyke PL, Kobayashi H. Imaging of the lymphatic system: new horizons. Contrast Media Mol I 2006;1(6):230-45. [CrossRef] google scholar
  • 8. Maclellan RA, Greene AK. Lymphedema. Semin Pediatr Surg 2014;23(4):191-7. [CrossRef] google scholar
  • 9. Tiwari A, Cheng KS, Button M, Myint F, Hamilton G. Differential diagnosis, investigation, and current treatment of lower limb lymphedema. Arch Surg 2003;138(2):152-61. [CrossRef] google scholar
  • 10. Erickson VS, Pearson ML, Ganz PA, Adams J, Kahn KL. Arm edema in breast cancer patients. J Natl Cancer I 2001;93(2):96-111. [CrossRef] google scholar
  • 11. Suami H, Koelmeyer L, Mackie H, Boyages J. Patterns of lymphatic drainage after axillary node dissection impact arm lymphoedema severity: A review of animal and clinical imaging studies. Surg Oncol 2018;27(4):743-50. [CrossRef] google scholar
  • 12. Warren AG, Brorson H, Borud LJ, Slavin SA. Lymphedema: a comprehensive review. Ann Plas Surg 2007;59(4):464-72. [CrossRef] google scholar
  • 13. Du X, Liu C. Application of imaging in lymphedema surgical therapies. Gland Surg 2020;9(2):582. [CrossRef] google scholar
  • 14. Kinmonth JB. Lymphangiography in man; a method of outlining lymphatic trunks at operation. Clin Sci 1952;11(1):13-20. google scholar
  • 15. Weissleder H, Weissleder R. Interstitial lymphangiography: initial clinical experience with a dimeric nonionic contrast agent. Radiology 1989;170(2):371-4. [CrossRef] google scholar
  • 16. Yoshida RY, Kariya S, Ha-Kawa S, Tanigawa N. Lymphoscintigraphy for imaging of the lymphatic flow disorders. Tech Vasc Interv Radiol 2016;19(4):273-6. [CrossRef] google scholar
  • 17. Suehiro K, Morikage N, Murakami M, Yamashita O, Samura M, Hamano K. Significance of ultrasound examination of skin and subcutaneous tissue in secondary lower extremity lymphedema. Ann Vasc Dis 2013;6(2):180-8. [CrossRef] google scholar
  • 18. Shin SU, Lee W, Park E-A, Shin C-I, Chung JW, Park JH. Comparison of characteristic CT findings of lymphedema, cellulitis, and generalized edema in lower leg swelling. Int J Cardiovasc Imaging 2013;29:135-43. [CrossRef] google scholar
  • 19. Carroll BJ, Singhal D. Advances in lymphedema: An underrecognized disease with a hopeful future for patients. Vasc Med 2024;29(1):70-84. [CrossRef] google scholar
  • 20. White R, Weir-McCall J, Budak M, Waugh S, Munnoch D, Sudarshan T. Contrast-enhanced magnetic resonance lymphography in the assessment of lower limb lymphoedema. Clin Radiol 2014;69(11):e435-e44. [CrossRef] google scholar
  • 21. Unno Na, Nishiyama M, Suzuki M, Yamamoto N, Inuzuka K, Sagara D, et al. Quantitative lymph imaging for assessment of lymph function using indocyanine green fluorescence lymphography. Eur J Vasc Endovasc Surg 2008;36(2):230-6. [CrossRef] google scholar
  • 22. Ohtake E, Matsui K. Lymphoscintigraphy in patients with lymphedema. A new approach using intradermal injections of technetium-99m human serum albumin. Clin Nucl Med 1986;11(7):474-8. [CrossRef] google scholar
  • 23. Henze E, Schelbert H, Collins J, Najafi A, Barrio J, Bennett L. Lymphoscintigraphy with Tc-99m-labeled dextran. J Nucl Med 1982;23(10):923-9. google scholar
  • 24. Svensson W, Glass D, Bradley D, Peters A. Measurement of lymphatic function with technetium-99m-labelled polyclonal immunoglobulin. Eur J Nucl Med Mol Imaging 1999;26:504-10. [CrossRef] google scholar
  • 25. Partsch H. Assessment of abnormal lymph drainage for the diagnosis of lymphedema by isotopic lymphangiography and by indirect lymphography. Clin Dermatol 1995;13(5):445-50. [CrossRef] google scholar
  • 26. Pappalardo M, Cheng MH. Lymphoscintigraphy for the diagnosis of extremity lymphedema: Current controversies regarding protocol, interpretation, and clinical application. J Surg Oncol 2020;121(1):37-47. [CrossRef] google scholar
  • 27. Baulieu F, Bourgeois P, Maruani A, Belgrado J, Tauveron V, Lorette G, et al. Contributions of SPECT/CT imaging to the lymphoscintigraphic investigations of the lower limb lymphedema. Lymphology 2013;46(3):106-19. google scholar
  • 28. Villa G, Campisi C, Ryan M, Boccardo F, Di Summa P, Frascio M, et al. Procedural recommendations for lymphoscintigraphy in the diagnosis of peripheral lymphedema: the Genoa protocol. Nucl Med Mol Imaging 2019;53:47-56. [CrossRef] google scholar
  • 29. Nagy BI, Mohos B, Tzou C-HJ. Imaging Modalities for Evaluating Lymphedema. Medicina 2023;59(11):2016. [CrossRef] google scholar
  • 30. Yoon H-J, Woo K-J, Kim J-Y, Kang SY, Moon BS, Kim BS. The added value of SPECT/CT lymphoscintigraphy in the initial assessment of secondary extremity lymphedema patients. Sci Rep 2023;13(1):19494. [CrossRef] google scholar
  • 31. Scarsbrook AF, Ganeshan A, Bradley KM. Pearls and pitfalls of radionuclide imaging of the lymphatic system. Part 2: evaluation of extremity lymphoedema. Brit J Radiol 2007;80(951):219-26. [CrossRef] google scholar
  • 32. Kleinhans E, Baumeister RG, Hahn D, Siuda S, Büll U, Moser E. Evaluation of transport kinetics in lymphoscintigraphy: follow-up study in patients with transplanted lymphatic vessels. Eur J Nucl Med Mol Imaging 1985;10:349-52. [CrossRef] google scholar
  • 33. Cambria RA, Gloviczki P, Naessens JM, Wahner HW. Noninvasive evaluation of the lymphatic system with lymphoscintigraphy: a prospective, semiquantitative analysis in 386 extremities. J Vasc Surg 1993;18(5):773-82. [CrossRef] google scholar
  • 34. Partsch H. Practical aspects of indirect lymphography and lymphoscintigraphy. Lymphat Res Biol 2003;1(1):71-4. [CrossRef] google scholar
  • 35. Weissleder H, Weissleder R. Lymphedema: evaluation of qualitative and quantitative lymphoscintigraphy in 238 patients. Radiology 1988;167(3):729-35. [CrossRef] google scholar
  • 36. Ter S-E, Alavi A, Kim CK, Merli G. Lymphoscintigraphy A reliable test for the diagnosis of lymphedema. Clin Nucl Med 1993;18(8):646-54. [CrossRef] google scholar
  • 37. Hassanein AH, Maclellan RA, Grant FD, Greene AK. Diagnostic accuracy of lymphoscintigraphy for lymphedema and analysis of false-negative tests. Plast Reconstr Surg Glob Open 2017;5(7):e1396. [CrossRef] google scholar
  • 38. Donohoe KJ, Carroll BJ, Chung DK, Dibble EH, Diego E, Giammarile F, et al. Summary: Appropriate Use Criteria for Lymphoscintigraphy in Sentinel Node Mapping and Lymphedema/Lipedema. J Nucl Med 2023;64(4):525-8. [CrossRef] google scholar
  • 39. Bourgeois P, Frühling J, Henry J. Postoperative axillary lymphoscintigraphy in the management of breast cancer. Int J Radiat Oncol Biol Phys 1983;9(1):29-32. [CrossRef] google scholar
  • 40. Szuba A, Chachaj A, Koba-Wszedybylb M, Hawro R, Jasinski R, Tarkowski R, et al. Axillary lymph nodes and arm lymphatic drainage pathways are spared during routine complete axillary clearance in majority of women undergoing breast cancer surgery. Lymphology 2011;44(3):103-12. google scholar
  • 41. Forte AJ, Boczar D, Huayllani MT, Lu X. Lymphoscintigraphy for evaluation of lymphedema treatment: A systematic review. Cureus 2019;11(12):e6363. [CrossRef] google scholar
  • 42. Moon T, O’Donnell TF, Weycker D, Iafrati M. Lymphoscintigraphy is frequently recommended but seldom used in a “real world setting”. J Vasc Surg-Venous L 2023;12(2):101738. [CrossRef] google scholar
  • 43. Lurie F, Malgor RD, Carman T, Dean SM, Iafrati MD, Khilnani NM, et al. The American Venous Forum, American Vein and Lymphatic Society and the Society for Vascular Medicine expert opinion consensus on lymphedema diagnosis and treatment. Phlebology 2022;37(4):252-66. [CrossRef] google scholar
There are 43 citations in total.

Details

Primary Language English
Subjects Health Services and Systems (Other)
Journal Section Reviews
Authors

Ayşe Mudun 0000-0002-5533-0969

Publication Date July 19, 2024
Submission Date March 18, 2024
Acceptance Date June 4, 2024
Published in Issue Year 2024 Volume: 87 Issue: 3

Cite

APA Mudun, A. (2024). LYMPHEDEMA AND PERIPHERAL LYMPHOSCINTIGRAPHY. Journal of Istanbul Faculty of Medicine, 87(3), 253-260. https://doi.org/10.26650/IUITFD.1452389
AMA Mudun A. LYMPHEDEMA AND PERIPHERAL LYMPHOSCINTIGRAPHY. İst Tıp Fak Derg. July 2024;87(3):253-260. doi:10.26650/IUITFD.1452389
Chicago Mudun, Ayşe. “LYMPHEDEMA AND PERIPHERAL LYMPHOSCINTIGRAPHY”. Journal of Istanbul Faculty of Medicine 87, no. 3 (July 2024): 253-60. https://doi.org/10.26650/IUITFD.1452389.
EndNote Mudun A (July 1, 2024) LYMPHEDEMA AND PERIPHERAL LYMPHOSCINTIGRAPHY. Journal of Istanbul Faculty of Medicine 87 3 253–260.
IEEE A. Mudun, “LYMPHEDEMA AND PERIPHERAL LYMPHOSCINTIGRAPHY”, İst Tıp Fak Derg, vol. 87, no. 3, pp. 253–260, 2024, doi: 10.26650/IUITFD.1452389.
ISNAD Mudun, Ayşe. “LYMPHEDEMA AND PERIPHERAL LYMPHOSCINTIGRAPHY”. Journal of Istanbul Faculty of Medicine 87/3 (July 2024), 253-260. https://doi.org/10.26650/IUITFD.1452389.
JAMA Mudun A. LYMPHEDEMA AND PERIPHERAL LYMPHOSCINTIGRAPHY. İst Tıp Fak Derg. 2024;87:253–260.
MLA Mudun, Ayşe. “LYMPHEDEMA AND PERIPHERAL LYMPHOSCINTIGRAPHY”. Journal of Istanbul Faculty of Medicine, vol. 87, no. 3, 2024, pp. 253-60, doi:10.26650/IUITFD.1452389.
Vancouver Mudun A. LYMPHEDEMA AND PERIPHERAL LYMPHOSCINTIGRAPHY. İst Tıp Fak Derg. 2024;87(3):253-60.

Contact information and address

Addressi: İ.Ü. İstanbul Tıp Fakültesi Dekanlığı, Turgut Özal Cad. 34093 Çapa, Fatih, İstanbul, TÜRKİYE

Email: itfdergisi@istanbul.edu.tr

Phone: +90 212 414 21 61