Imaging and Management of Lymphedema in the Era of Precision Oncology.

IF 1.8 4区 医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Pranjal Rai, Abhishek Mahajan, Shreya Shukla, Niyati Pokar
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Abstract

Lymphedema is a common complication of cancer treatment, leading to significant morbidity. Early and accurate diagnosis through the combined expertise of radiology and nuclear medicine is crucial for preventing lymphedema progression and improving patient outcomes. Imaging techniques such as lymphoscintigraphy, duplex ultrasound, MRI, and CT as well as newer modalities including near-infrared lymphangiography can diagnose and assess lymphedema severity. Bioimpedance spectroscopy (BIS) provides a non-invasive tool for early detection by measuring extracellular fluid changes, aiding in identifying lymphedema at its earliest stages. Pretreatment baseline measurements and prospective surveillance models (PSMs) are essential for tracking limb volume changes and mobility, enhancing early intervention outcomes. Recognizing the strengths and limitations of each imaging modality allows radiologists and nuclear medicine physicians to synergistically optimize lymphedema diagnosis and management. Effective management relies on multidisciplinary collaboration and includes conservative and surgical options tailored to disease severity. Advanced imaging modalities are pivotal for planning and monitoring interventional strategies. This review explores the development and management of secondary lymphedema in oncological patients, focusing chiefly on imaging and treatment strategies. It also briefly highlights the evolving role of artificial intelligence and machine learning in enhancing imaging precision and treatment outcomes.

精准肿瘤学时代的淋巴水肿成像与管理。
淋巴水肿是癌症治疗的常见并发症,导致显著的发病率。通过结合放射学和核医学的专业知识进行早期和准确的诊断对于预防淋巴水肿进展和改善患者预后至关重要。成像技术,如淋巴显像、双工超声、MRI和CT,以及包括近红外淋巴管造影在内的新方法,可以诊断和评估淋巴水肿的严重程度。生物阻抗谱(BIS)提供了一种非侵入性的工具,通过测量细胞外液的变化进行早期检测,有助于在早期阶段识别淋巴水肿。预处理基线测量和前瞻性监测模型(psm)对于跟踪肢体体积变化和活动,增强早期干预结果至关重要。认识到每种成像方式的优势和局限性,使放射科医生和核医学医生能够协同优化淋巴水肿的诊断和管理。有效的管理依赖于多学科合作,包括根据疾病严重程度量身定制的保守和手术选择。先进的成像模式对于规划和监测介入策略至关重要。本文综述了肿瘤患者继发性淋巴水肿的发展和处理,主要集中在影像学和治疗策略上。它还简要地强调了人工智能和机器学习在提高成像精度和治疗结果方面不断发展的作用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
British Journal of Radiology
British Journal of Radiology 医学-核医学
CiteScore
5.30
自引率
3.80%
发文量
330
审稿时长
2-4 weeks
期刊介绍: BJR is the international research journal of the British Institute of Radiology and is the oldest scientific journal in the field of radiology and related sciences. Dating back to 1896, BJR’s history is radiology’s history, and the journal has featured some landmark papers such as the first description of Computed Tomography "Computerized transverse axial tomography" by Godfrey Hounsfield in 1973. A valuable historical resource, the complete BJR archive has been digitized from 1896. Quick Facts: - 2015 Impact Factor – 1.840 - Receipt to first decision – average of 6 weeks - Acceptance to online publication – average of 3 weeks - ISSN: 0007-1285 - eISSN: 1748-880X Open Access option
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