ARPA-H commits up to $135.7m to overhaul lymphatic diagnostics, a long-neglected area of medicine with outsized impact on women
A common complication for breast cancer survivors
The Advanced Research Projects Agency for Health (ARPA-H), part of the U.S. Department of Health and Human Services (HHS), has awarded up to $135.7m over five years to a new research programme designed to bring the body’s lymphatic system into routine clinical care.
The initiative, known as Lymphatic Imaging, Genomics, and pHenotyping Technologies (LIGHT), aims to create the first comprehensive diagnostic toolkit for assessing lymphatic health during standard physical exams. ARPA-H said the investment represents the largest coordinated federal effort to modernise lymphatic diagnostics, an area that has lagged decades behind imaging and genetic tools used for other organ systems.
Women disproportionately affected
The lymphatic system plays a central role in immune defence, fluid balance, and waste removal. Yet dysfunction is frequently missed or misdiagnosed. An estimated 10 million Americans live with lymphedema, a chronic condition marked by severe swelling around lymph nodes, often following cancer treatment. Women are disproportionately affected, particularly breast and gynecologic cancer survivors, for whom lymphatic damage is a common and long-term complication.
ARPA-H said millions more people with lymphatic dysfunction remain undiagnosed, leading to delayed or inappropriate care, preventable hospitalisations, disability, lost productivity, and, in some cases, death.
“Lymphatic dysfunction quietly harms millions of Americans every year. Often, solutions are identified too late, if at all,” said HHS Deputy Secretary Jim O’Neill. “This investment will help spur innovation to create efficient diagnostics that millions will benefit from.”
Despite its importance, the lymphatic system remains one of medicine’s most significant blind spots. Unlike the heart or brain, there are few standardised tools to visualise lymphatic flow, measure function, or detect early disease. In clinical practice, providers often rely on crude measures such as limb circumference, offering limited insight into underlying biology.
“The lymphatic system touches every major organ in your body, yet we’ve had no good way to see it, measure it, or understand when it’s failing,” said Alicia Jackson, PhD, director of ARPA-H. She added that the lack of visibility has obscured the lymphatic system’s role in cancer spread, heart failure, chronic inflammation, and neurodegenerative disease.
Beyond rare disorders, lymphatic dysfunction is increasingly implicated in common chronic conditions including obesity, diabetes, autoimmune disease, kidney and liver disease, and infectious illnesses such as Long COVID and Lyme disease. ARPA-H said earlier, routine assessment of lymphatic health could change how these conditions are detected, monitored, and treated.
The LIGHT programme is structured around milestone-based “performer” awards, rather than traditional grants or procurement contracts. Funding levels vary by team and are contingent on meeting aggressive technical goals.
Selected teams include both academic and industry-led efforts:
3DT Holdings, LLC (San Diego) will develop an interventional device to measure lymphatic flow and obstruction in real time, with a focus on earlier detection of thoracic duct disease.
Columbia University will apply cell-based and cell-free DNA panels to improve diagnosis of paediatric lymphatic anomalies.
Hospital for Special Surgery plans to create a “GeneLoad” score to predict lymphedema risk, including in patients with autoimmune disease.
Stanford University will work to make magnetic resonance lymphangiography safer, faster, and more accessible.
University of Alberta aims to build an ultrasound and photoacoustic imaging system suitable for rural and resource-limited settings.
University of Arizona will develop phase-change ultrasound lymphography using novel microbubble contrast agents.
University of California, Irvine plans to optimise dual-energy CT lymphangiography for broader clinical use.
University of Pennsylvania will apply AI-driven multi-omics to identify biomarkers and imaging agents for liver and gut lymphatics.
University of South Florida intends to build an AI-powered “clinical copilot” for lymphatic disease management.
Weill Cornell Medicine will integrate imaging, biomarkers, and genetic predictors into a unified diagnostic platform.
Rice University aims to develop non-invasive photoacoustic imaging for rare and complex lymphatic diseases.
In a departure from conventional research programmes, each LIGHT team must include a “Discovery Duo”: an early-career investigator paired with a patient or caregiver ambassador. ARPA-H said this structure is intended to embed patient experience into technology development from the outset and accelerate translation into real-world care.
“Most healthcare providers simply aren’t equipped—or trained—to recognise lymphatic dysfunction, and the tools they need are virtually nonexistent,” said Kimberley Steele, MD, PhD, LIGHT programme manager. “Patients are often diagnosed only after irreversible damage has occurred.”
If successful, ARPA-H said LIGHT could make lymphatic assessment a standard part of medicine, expanding access to earlier diagnosis and personalised care for conditions that have historically fallen through the cracks—particularly for women living with the long-term consequences of cancer and chronic disease.