Cross-Sectional Areas of Calf Soft Tissue Measured with MRI as a New Method for Staging Gynecologic Oncology-Related Extremity Lymphedema

Suqin Li, Hui Tang, Shiteng Suo, Lianming Wu, Qing Lu*, Jianrong Xu**

Department of Radiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, 160 Pujian Rd, Shanghai, China 200127.

*Corresponding author: Qing Lu, MD, PhD, Department of Radiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, China, 200127. E-mail: ; Tel: +86-21-68383259; Fax: +86-21-67052375; ^**Corresponding author: Jianrong Xu, E-mail: ; Tel: 86-21-68383864; fax: 86-21-63736075.

Citation: Suqin Li, et al. Cross-Sectional Areas of Calf Soft Tissue Measured with MRI as a New Method for Staging Gynecologic Oncology-Related Extremity Lymphedema. Cancer Research Frontiers. 2017; 3(1): 112-125. doi: 10.17980/2017.112

Copyright: @ 2017 Suqin Li, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Competing Interests: The authors declare no competing financial interests.

Received Mar 22, 2017; Revised June 12, 2017; Accepted Sept 18, 2017. Published Oct 17, 2017

Abstract

Objectives: To determine whether the cross-sectional area (CSA) of the soft tissue of the calf measured with magnetic resonance imaging (MRI) could stage unilateral lower extremity lymphedema (LEL) secondary to gynecological cancer treatments.

Materials and Methods: One hundred and twenty females with unilateral LEL and Thirty-two without LEL after gynecological cancer treatments underwent calf MRI and water displacement. Total soft tissue CSA (T), muscle CSA (M) and subcutaneous tissue CSA (S) of affected calf, and difference of T (DT), M (DM) and S (DS) between calves were obtained on MRI at mid-calf level. Volume of affected calf and difference of volume (DV) between calves were obtained by water displacement. Statistical analysis was performed to determine feasibility of MRI measurements for accessing LEL.

Results: There were close correlations between volume and T or S of affected calf, and between DV and DT or DS of calves. The correlations of stages of LEL with T and S of affected calf as well as DT and DS were stronger than with the volume of affected calf and DV (all p < 0.01). Multivariate analysis showed more significant differences between LEL stages in T and S than in volume of affected calf, and in DS than in DV (all p < 0.05). No difference was found between stage 0 and 1 in volume of affected calf and in DV. For staging LEL, DS showed the most profound discrimination ability among all measurable parameters.

Conclusions: DS of calves could be the most reliable parameter recommended for staging unilateral LEL.

Key words: Magnetic resonance imaging; water displacement; lymphedema; Gynecologic Oncology.

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