LymphedemaV1, Pmc, Checkpoint, bibRecord, 000F36

Quantitative Contrast-Enhanced Magnetic Resonance Lymphangiography of the Upper Limbs in Breast Cancer Related Lymphedema: An Exploratory Study

Identifieur interne : 000F36 ( Pmc/Checkpoint ); précédent : 000F35; suivant : 000F37

Quantitative Contrast-Enhanced Magnetic Resonance Lymphangiography of the Upper Limbs in Breast Cancer Related Lymphedema: An Exploratory Study

Auteurs : Marco Borri ; Maria A. Schmidt ; Kristiana D. Gordon ; Toni A. Wallace ; Julie C. Hughes ; Erica D. Scurr ; Dow-Mu Koh ; Martin O. Leach ; Peter S. Mortimer

Source :

Lymphatic Research and Biology [ 1539-6851 ] ; 2015.

RBID : PMC:4492592

Abstract

Background: Contrast-Enhanced Magnetic Resonance Lymphangiography (CE-MRL) presents some limitations: (i) it does not quantify lymphatic functionality; and (ii) enhancement of vascular structures may confound image interpretation. Furthermore, although CE-MRL is well described in the published literature for the lower limbs, there is a paucity of data with regards to its use in the upper limbs. In this proof-of-principle study, we propose a new protocol to perform CE-MRL in the upper limbs of patients with breast cancer-related lymphedema (BCRL) which addresses these limitations.

Methods and Results: CE-MRL was performed using a previously published (morphological) protocol and the proposed protocol (quantitative) on both the ipsilateral (abnormal) and contralateral (normal) arms of patients with BCRL. The quantitative protocol employs contrast agent (CA) intradermal injections at a lower concentration to prevent T2*-related signal decay. Both protocols provided high-resolution three-dimensional images of upper limb lymphatic vessels. CA uptake curves were utilized to distinguish between lymphatic vessels and vascular structures. The quantitative protocol minimized venous enhancement and avoided spurious delays in lymphatic enhancement due to short T2* values, enabling correct CA uptake characterization. The quantitative protocol was therefore employed to measure the lymphatic fluid velocity, which demonstrated functional differences between abnormal and normal arms. The velocity values were in agreement with previously reported lymphoscintigraphy and near infra-red lymphangiography measurements.

Conclusions: This work demonstrated the feasibility of CE-MRL of the upper limbs in patients with BRCL, introducing an advanced imaging and analysis protocol suitable for anatomical and functional study of the lymphatic system.

Url:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4492592

DOI: 10.1089/lrb.2014.0039
PubMed: 25774851
PubMed Central: 4492592

Affiliations:

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Le document en format XML

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<front><div type="abstract" xml:lang="en"><title>Abstract</title>
<p><bold><italic>Background:</italic>
</bold>
 Contrast-Enhanced Magnetic Resonance Lymphangiography (CE-MRL) presents some limitations: (i) it does not quantify lymphatic functionality; and (ii) enhancement of vascular structures may confound image interpretation. Furthermore, although CE-MRL is well described in the published literature for the lower limbs, there is a paucity of data with regards to its use in the upper limbs. In this proof-of-principle study, we propose a new protocol to perform CE-MRL in the upper limbs of patients with breast cancer-related lymphedema (BCRL) which addresses these limitations.</p>
<p><bold><italic>Methods and Results:</italic>
</bold>
 CE-MRL was performed using a previously published (<italic>morphological</italic>
) protocol and the proposed protocol (<italic>quantitative</italic>
) on both the ipsilateral (abnormal) and contralateral (normal) arms of patients with BCRL. The quantitative protocol employs contrast agent (CA) intradermal injections at a lower concentration to prevent T2*-related signal decay. Both protocols provided high-resolution three-dimensional images of upper limb lymphatic vessels. CA uptake curves were utilized to distinguish between lymphatic vessels and vascular structures. The quantitative protocol minimized venous enhancement and avoided spurious delays in lymphatic enhancement due to short T2* values, enabling correct CA uptake characterization. The quantitative protocol was therefore employed to measure the lymphatic fluid velocity, which demonstrated functional differences between abnormal and normal arms. The velocity values were in agreement with previously reported lymphoscintigraphy and near infra-red lymphangiography measurements.</p>
<p><bold><italic>Conclusions:</italic>
</bold>
 This work demonstrated the feasibility of CE-MRL of the upper limbs in patients with BRCL, introducing an advanced imaging and analysis protocol suitable for anatomical and functional study of the lymphatic system.</p>
</div>
</front>
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<biblStruct><analytic><author><name sortKey="Moate, Pj" uniqKey="Moate P">PJ Moate</name>
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<biblStruct><analytic><author><name sortKey="Brorson, H" uniqKey="Brorson H">H Brorson</name>
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<biblStruct><analytic><author><name sortKey="Chang, Dw" uniqKey="Chang D">DW Chang</name>
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  <front><journal-meta><journal-id journal-id-type="nlm-ta">Lymphat Res Biol</journal-id>
<journal-id journal-id-type="iso-abbrev">Lymphat Res Biol</journal-id>
<journal-id journal-id-type="publisher-id">lrb</journal-id>
<journal-title-group><journal-title>Lymphatic Research and Biology</journal-title>
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<issn pub-type="ppub">1539-6851</issn>
<issn pub-type="epub">1557-8585</issn>
<publisher><publisher-name>Mary Ann Liebert, Inc.</publisher-name>
<publisher-loc>140 Huguenot Street, 3rd FloorNew Rochelle, NY 10801USA</publisher-loc>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">25774851</article-id>
<article-id pub-id-type="pmc">4492592</article-id>
<article-id pub-id-type="publisher-id">10.1089/lrb.2014.0039</article-id>
<article-id pub-id-type="doi">10.1089/lrb.2014.0039</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Original Articles</subject>
</subj-group>
</article-categories>
<title-group><article-title>Quantitative Contrast-Enhanced Magnetic Resonance Lymphangiography of the Upper Limbs in Breast Cancer Related Lymphedema: An Exploratory Study</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Borri</surname>
<given-names>Marco</given-names>
</name>
<degrees>MPhys</degrees>
<xref ref-type="aff" rid="aff1"><sup>1</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Schmidt</surname>
<given-names>Maria A.</given-names>
</name>
<degrees>PhD</degrees>
<xref ref-type="aff" rid="aff1"><sup>1</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Gordon</surname>
<given-names>Kristiana D.</given-names>
</name>
<degrees>MBBS</degrees>
<xref ref-type="aff" rid="aff2"><sup>2,</sup>
</xref>
<xref ref-type="aff" rid="aff3"><sup>3</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Wallace</surname>
<given-names>Toni A.</given-names>
</name>
<degrees>MSc</degrees>
<xref ref-type="aff" rid="aff1"><sup>1</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Hughes</surname>
<given-names>Julie C.</given-names>
</name>
<degrees>BSc</degrees>
<xref ref-type="aff" rid="aff1"><sup>1</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Scurr</surname>
<given-names>Erica D.</given-names>
</name>
<degrees>BSc</degrees>
<xref ref-type="aff" rid="aff1"><sup>1</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Koh</surname>
<given-names>Dow-Mu</given-names>
</name>
<degrees>MD</degrees>
<xref ref-type="aff" rid="aff1"><sup>1</sup>
</xref>
</contrib>
<contrib contrib-type="author" corresp="yes"><name><surname>Leach</surname>
<given-names>Martin O.</given-names>
</name>
<degrees>PhD</degrees>
<xref ref-type="aff" rid="aff1"><sup>1</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Mortimer</surname>
<given-names>Peter S.</given-names>
</name>
<degrees>MD</degrees>
<xref ref-type="aff" rid="aff2"><sup>2,</sup>
</xref>
<xref ref-type="aff" rid="aff3"><sup>3</sup>
</xref>
</contrib>
<aff id="aff1"><label><sup>1</sup>
</label>
CR-UK Cancer Imaging Centre, Institute of Cancer Research and Royal Marsden NHS Foundation Trust, Sutton,<country>United Kingdom</country>
.</aff>
<aff id="aff2"><label><sup>2</sup>
</label>
Skin Unit, Royal Marsden NHS Foundation Trust. Sutton,<country>United Kingdom</country>
.</aff>
<aff id="aff3"><label><sup>3</sup>
</label>
St. George's,<institution>University of London</institution>
, Cardiac and Vascular Sciences, London,<country>United Kingdom</country>
.</aff>
</contrib-group>
<author-notes><corresp><addr-line>Address correspondence to:</addr-line>
<addr-line><italic>Professor Martin O. Leach, PhD</italic>
</addr-line>
<addr-line><italic>Co-Director, CR-UK Cancer Imaging Centre</italic>
</addr-line>
<addr-line><italic>Director, NIHR Clinical Research Facility</italic>
</addr-line>
<institution><italic>Institute of Cancer Research and Royal Marsden NHS Foundation Trust</italic>
</institution>
<addr-line><italic>Downs Road</italic>
</addr-line>
<addr-line><italic>Sutton SM2 5PT</italic>
</addr-line>
<country>United Kingdom</country>
<break></break>
<italic>E-mail:</italic>
<email xlink:href="mailto:martin.leach@icr.ac.uk">martin.leach@icr.ac.uk</email>
</corresp>
</author-notes>
<pub-date pub-type="ppub"><day>01</day>
<month>6</month>
<year>2015</year>
<pmc-comment>string-date: June 2015</pmc-comment>
      </pub-date>
<pub-date pub-type="pmc-release"><day>01</day>
<month>6</month>
<year>2015</year>
<pmc-comment>string-date: June 2015</pmc-comment>
      </pub-date>
<pmc-comment> PMC Release delay is 0 months and 0 days and was based on the 
 							. </pmc-comment>
      <volume>13</volume>
<issue>2</issue>
<fpage>100</fpage>
<lpage>106</lpage>
<permissions><copyright-statement>© The Author(s) 2015; Published by Mary Ann Liebert, Inc.</copyright-statement>
<copyright-year>2015</copyright-year>
<license license-type="open-access"><license-p>This Open Access article is distributed under the terms of the Creative Commons License (<uri xlink:type="simple" xlink:href="http://creativecommons.org/licenses/by/4.0">http://creativecommons.org/licenses/by/4.0</uri>
), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited.</license-p>
</license>
</permissions>
<self-uri content-type="pdf" xlink:type="simple" xlink:href="lrb.2014.0039.pdf"></self-uri>
<abstract><title>Abstract</title>
<p><bold><italic>Background:</italic>
</bold>
 Contrast-Enhanced Magnetic Resonance Lymphangiography (CE-MRL) presents some limitations: (i) it does not quantify lymphatic functionality; and (ii) enhancement of vascular structures may confound image interpretation. Furthermore, although CE-MRL is well described in the published literature for the lower limbs, there is a paucity of data with regards to its use in the upper limbs. In this proof-of-principle study, we propose a new protocol to perform CE-MRL in the upper limbs of patients with breast cancer-related lymphedema (BCRL) which addresses these limitations.</p>
<p><bold><italic>Methods and Results:</italic>
</bold>
 CE-MRL was performed using a previously published (<italic>morphological</italic>
) protocol and the proposed protocol (<italic>quantitative</italic>
) on both the ipsilateral (abnormal) and contralateral (normal) arms of patients with BCRL. The quantitative protocol employs contrast agent (CA) intradermal injections at a lower concentration to prevent T2*-related signal decay. Both protocols provided high-resolution three-dimensional images of upper limb lymphatic vessels. CA uptake curves were utilized to distinguish between lymphatic vessels and vascular structures. The quantitative protocol minimized venous enhancement and avoided spurious delays in lymphatic enhancement due to short T2* values, enabling correct CA uptake characterization. The quantitative protocol was therefore employed to measure the lymphatic fluid velocity, which demonstrated functional differences between abnormal and normal arms. The velocity values were in agreement with previously reported lymphoscintigraphy and near infra-red lymphangiography measurements.</p>
<p><bold><italic>Conclusions:</italic>
</bold>
 This work demonstrated the feasibility of CE-MRL of the upper limbs in patients with BRCL, introducing an advanced imaging and analysis protocol suitable for anatomical and functional study of the lymphatic system.</p>
</abstract>
<counts><fig-count count="3"></fig-count>
<table-count count="1"></table-count>
<equation-count count="1"></equation-count>
<ref-count count="18"></ref-count>
<page-count count="7"></page-count>
</counts>
</article-meta>
</front>
</pmc>
<affiliations><list></list>
<tree><noCountry><name sortKey="Borri, Marco" sort="Borri, Marco" uniqKey="Borri M" first="Marco" last="Borri">Marco Borri</name>
<name sortKey="Gordon, Kristiana D" sort="Gordon, Kristiana D" uniqKey="Gordon K" first="Kristiana D." last="Gordon">Kristiana D. Gordon</name>
<name sortKey="Hughes, Julie C" sort="Hughes, Julie C" uniqKey="Hughes J" first="Julie C." last="Hughes">Julie C. Hughes</name>
<name sortKey="Koh, Dow Mu" sort="Koh, Dow Mu" uniqKey="Koh D" first="Dow-Mu" last="Koh">Dow-Mu Koh</name>
<name sortKey="Leach, Martin O" sort="Leach, Martin O" uniqKey="Leach M" first="Martin O." last="Leach">Martin O. Leach</name>
<name sortKey="Mortimer, Peter S" sort="Mortimer, Peter S" uniqKey="Mortimer P" first="Peter S." last="Mortimer">Peter S. Mortimer</name>
<name sortKey="Schmidt, Maria A" sort="Schmidt, Maria A" uniqKey="Schmidt M" first="Maria A." last="Schmidt">Maria A. Schmidt</name>
<name sortKey="Scurr, Erica D" sort="Scurr, Erica D" uniqKey="Scurr E" first="Erica D." last="Scurr">Erica D. Scurr</name>
<name sortKey="Wallace, Toni A" sort="Wallace, Toni A" uniqKey="Wallace T" first="Toni A." last="Wallace">Toni A. Wallace</name>
</noCountry>
</tree>
</affiliations>
</record>

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Quantitative Contrast-Enhanced Magnetic Resonance Lymphangiography of the Upper Limbs in Breast Cancer Related Lymphedema: An Exploratory Study

Quantitative Contrast-Enhanced Magnetic Resonance Lymphangiography of the Upper Limbs in Breast Cancer Related Lymphedema: An Exploratory Study

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