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Assessment of lymphatic impairment and interstitial protein accumulation in patients with breast cancer treatment‐related lymphedema using CEST MRI
Author(s) -
Donahue Manus J.,
Donahue Paula C.M.,
Rane Swati,
Thompson Christopher R.,
Strother Megan K.,
Scott Allison O.,
Smith Seth A.
Publication year - 2016
Publication title -
magnetic resonance in medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.696
H-Index - 225
eISSN - 1522-2594
pISSN - 0740-3194
DOI - 10.1002/mrm.25649
Subject(s) - lymphedema , medicine , lymphatic system , breast cancer , radiology , cancer , magnetic resonance imaging , nuclear medicine , pathology
Purpose Lymphatic impairment is known to reduce quality of life in some of the most crippling diseases of the 21 st century, including obesity, lymphedema, and cancer. However, the lymphatics are not nearly as well‐understood as other bodily systems, largely owing to a lack of sensitive imaging technologies that can be applied using standard clinical equipment. Here, proton exchange‐weighted MRI is translated to the lymphatics in patients with breast cancer treatment‐related lymphedema (BCRL). Methods Healthy volunteers (N = 8) and BCRL patients (N = 7) were scanned at 3 Tesla using customized structural MRI and amide proton transfer (APT) chemical exchange saturation transfer (CEST) MRI in sequence with the hypothesis that APT effects would be elevated in lymphedematous tissue. APT contrast, lymphedema stage, symptomatology, and histology information were evaluated. Results No significant difference between proton‐weighted APT contrast in the right and left arms of healthy controls was observed. An increase in APT contrast in the affected arms of patients was found ( P = 0.025; Cohen's d = 2.4), and variability among patients was consistent with documented damage to lymphatics as quantified by lymphedema stage. Conclusion APT CEST MRI may have relevance for evaluating lymphatic impairment in patients with BCRL, and may extend to other pathologies where lymphatic compromise is evident. Magn Reson Med 75:345–355, 2016. © 2015 Wiley Periodicals, Inc.