Your Donations in Action: Geunwon Kim, MD, PhD

Using MRI to Aid in Lymphedema Diagnosis and Care

Guenwon Kim-Sun MD

Lymphedema is a chronic, debilitating disease prevalent in over three million people in the U.S. Limited treatment options, like manual and wrap compression, interfere with quality of life.

Although new, potentially curative surgical techniques are being developed, diagnostic tools for lymphedema detection and grading are limited in their ability to identify candidates for these novel treatments.

MRI is ideally suited to quantify both fluid and tissue distribution in extremities affected by lymphedema, without using ionizing radiation or intravenous contrast agents. Yet this modality is only in the early stages of adoption as protocol standardization and clinically relevant data supporting its diagnostic potential are lacking.

In her 2018 RSNA Research Resident Grant project, Geunwon Kim, MD, PhD, now a staff radiologist at Atrius Health, and colleagues at Beth Israel Deaconess Medical Center in Boston, studied the use of non-contrast MRI to detect, grade and monitor therapeutic response in lymphedema patients.

The team assessed MRI as a potential diagnostic tool and as an aid in the management algorithm for surgical approaches to lymphedema.

Dr. Kim and her team developed an MRI-based grading system that uses no exogenous contrast material and uses commercially available sequences (short tau inversion recovery, STIR sequence) that are shown to correlate with other imaging findings like backflow and clinical grading for lymphedema.

The system will help standardize staging, follow up and surgical management and assist with identifying lymphedema in patients. Additionally, identification of lymphedema patterns will aid in establishing a surgical approach for improved outcomes.

Dr. Kim’s mentor Leo Tsai, MD, a prior recipient of two RSNA grants, helped her secure the RSNA Research Resident Grant, which allowed her the time and initial funding needed to start research.

“Obtaining a grant in areas like lymphedema that need seed funding for discovery and innovation is difficult. The grant was instrumental in laying the groundwork for foundational research, like establishing imaging criteria for disease identification and staging,” Dr. Kim said. “This single grant supported research that culminated in multiple manuscripts, both in high impact imaging journals and in surgical literature. In addition, equipment purchased from the grant is now being used for new areas of lymphedema research.”

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