Fluoroscopy Guided Manual Lymphatic drainage (FG-MLD)

The Lymphoedema Training Academy (LTA) is committed to carrying out the best and most evidenced based Manual Lymphatic Drainage (MLD) training. This will ensure that students will be providing the most evidenced based care with aims of improving MLD outcomes, reducing treatment time and proving efficacy of MLD. This is a really exciting development for MLD and is being rolled out throughout the world.

What is Fluoroscopy Guided MLD?

Though the use of Near Infrared imaging, the superficial lymphatics can be visualised. This allows to observe for the mapping of functional lymphatic collectors, the observation of dermal rerouting areas, dermal backflow areas and functional substitution pathways.  This allows for the mapping and the identification of the lymphatic system and ensures that the therapist knows the best drainage pathways to be used for the patient. Never before have we been able to identify functional lymphatic’s in real time. This development means that the therapist can ensure that they carry out a MLD technique to which they know the lymphatics are responsive.


Prof JP Belgrado has been working with NIR fluoroscopy for the last 5 years and has presented globally regarding its technique, applications and outcomes for clinical practice in lymphoedema and other related conditions. Some of the research carried out by Prof. JP Belgrado has examined over 371 pathological lymphatic patients. This has allowed for the identification of common lymphatic pathways of differing pathologies, leading to a better understanding of lymphatic pathways and subsequent drainage. It has also demonstrated what hand contacts, movement and pressure is necessary for effective drainage of the lymphatic system.

Do I need a NIR camera?

No, you do not need to have access to an NIR camera but should you choose to have patients mapped appropriately you will understand the mapping picture you receive and the drainage for that individual patient.

Can you carry out FG-MLD without mapping?

Yes you can carry out FG-MLD without a camera. We will show you on the course how to map patients without fluoroscopy and how to apply this to each individual patient according to their pathology and its application to our understanding of these new pathological and existing anatomical pathways.  FG-MLD is also the term that best describes a technique that Fluoroscopy has identified as working better through unique hand movements.