1251 - Beyond the Surface: Linking MRI of Tissue Sodium Content to Patient-Reported Experience in Lymphedema

Friday, February 20, 2026

5:00 PM - 6:30 PM AST

Presenting Author(s)

SM

Surbhi Mathur, BA

4th Year Medical Student
University of Virginia School of Medicine
Ashburn, Virginia, United States

Co-Author(s)

ST

Shannon L. Taylor, PhD

Graduate Researcher
Vanderbilt University
Boston, Massachusetts, United States
VC

Vanessa Crain, BS

Clinical Research Coordinator
University of Virginia
Charlottesville, Virginia, United States
AS

Allison Scott, MSc

Research Scientist
University of Virginia
Charlottesville, Virginia, United States
SC

Sheau-Chiann Chen, PhD

Biostatistician
Vanderbilt University Medical Center
Nashville, Tennessee, United States
AB

Alaina Brown, MD

Associate Professor
Vanderbilt University Medical Center
Nashville, Tennessee, United States
MP

Michael Pridmore, PhD

Assistant Professor
Vanderbilt University Medical Center
Nashville, Tennessee, United States
AM

Alyssa Mixon, DO, MBA

Assistant Professor & Associate Program Director
University of Virginia
Charlottesville, Virginia, United States
RC

Rachelle Crescenzi, PhD

Associate Professor
University of Virginia
Charlottesville, Virginia, United States

Submitter(s)

SM

Surbhi Mathur, BA

University of Virginia
Ashburn, Virginia, United States

Objectives: Lymphedema is an under-recognized condition that impairs function, alters appearance, and can challenge emotional well-being. Patient-reported outcome measures (PROMs) capture quality of life and have become increasingly important in lymphedema management. Magnetic resonance imaging (MRI), including novel sodium mapping, provides physiologic tissue-level assessment with potential value for diagnosis and staging. Yet the relationship between objective disease measures and patients’ lived experience remains poorly defined. This study evaluated whether MRI-derived measures correspond with PROMs in patients with lower extremity lymphedema (LEL).

Design: Adults with LEL were prospectively enrolled in an ongoing observational clinical trial to develop relevant MRI metrics of LEL (NCT05242900). Patients who completed both MRI and PROM assessments were analyzed. MRI data included affected-leg calf skin sodium content (mmol/L) and subcutaneous adipose tissue (SAT) area (mm²). PROMs were collected using the Lymphedema Quality of Life Questionnaire (LYMQOL-Leg), a validated instrument that evaluates four domains: function, appearance, symptoms, and mood. Spearman’s correlations were used to measure the strength and direction of monotonic association between MRI measures and PROM domains in RStudio.

Results: Thirty-two patients with LEL were included (age=60.5±11.4; number with ISL-stage I/II/III = 9/19/5). Skin sodium demonstrated correlation with the domains of function (r_s = 0.41, p = 0.027) and appearance (r_s = 0.52, p = 0.003). Calf SAT area was similarly correlated with the domains of function (r_s = 0.42, p = 0.022) and appearance (r_s = 0.54, p = 0.002). There was no significant correlation with the domains of symptoms or mood for either MRI measurement.

Conclusions: MRI-derived measures, particularly skin sodium content and SAT area, demonstrated low-to-moderate correlations with PROMs, with perception of appearance showing the strongest associations. These results suggest that MRI has potential as an objective complement to PROMs, offering a tool that could aid in staging LEL while also reflecting aspects of patients’ lived experience.