{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T19:16:28Z","timestamp":1777922188430,"version":"3.51.4"},"reference-count":31,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2023,4,1]],"date-time":"2023-04-01T00:00:00Z","timestamp":1680307200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Lymphatic Research and Biology"],"published-print":{"date-parts":[[2023,4,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Secondary upper extremity lymphedema occurs after an insult such as surgery. One theory suggests underlying lymphatic dysfunction predisposing certain patients into developing secondary lymphedema. We aim to determine the rate of incidental edema in the contralateral upper extremity of patients with secondary unilateral lymphedema.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and Results:<\/jats:title>\n                    <jats:p>\n                      MRI of the upper extremities were obtained in patients with lymphedema who were referred by a lymphedema clinic from 2017 to 2019. Axial short-tau inversion recovery MR images of the symptomatic and contralateral arms were retrospectively reviewed and edema severity was graded. Interobserver agreement was calculated. Indocyanine green (ICG) lymphography was compared against MRI stage in symptomatic and contralateral. Age, symptom duration, body mass index (BMI), and history of chemotherapy were compared between patients with and without contralateral limb lymphedema. ICG severity was compared against MRI stage. Seventy-eight patients were analyzed. The MRI stages of symptomatic versus contralateral arms were 1.7\u2009\u00b1\u20091.1 versus 0.1\u2009\u00b1\u20090.4 (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.00001). Interobserver agreement was 0.86 (0.79\u20130.94). Of the patients with MRI Stage 1 or above in the symptomatic arm (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u200964), 55 (82.1%) patients demonstrated no abnormality in the contralateral arm. Nine patients (14.1%) demonstrated asymptomatic edema (MRI Stage 1). The mean ICG lymphography stage of symptomatic versus contralateral arms was 1.83\u2009\u00b1\u20090.96 versus 0.04\u2009\u00b1\u20090.25 (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.00001). There was no difference in the age, symptom duration, BMI, or history of chemotherapy between patients with or without edema in the contralateral arm.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Asymptomatic contralateral edema was detected in 14.1% of patients with unilateral secondary upper extremity lymphedema using MRI modality.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/lrb.2021.0022","type":"journal-article","created":{"date-parts":[[2022,8,1]],"date-time":"2022-08-01T14:22:32Z","timestamp":1659363752000},"page":"111-117","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Rate of Incidental Edema in the Contralateral Arm of Patients with Unilateral Postsurgical Secondary Upper Extremity Lymphedema"],"prefix":"10.1177","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3477-9986","authenticated-orcid":false,"given":"Geunwon","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Radiology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA."},{"name":"Department of Radiology, Atrius Health, Boston, Massachusetts, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Adondakis","sequence":"additional","affiliation":[{"name":"Department of Radiology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin P.","family":"Smith","sequence":"additional","affiliation":[{"name":"Department of Radiology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dhruv","family":"Singhal","sequence":"additional","affiliation":[{"name":"Department of Surgery, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leo L.","family":"Tsai","sequence":"additional","affiliation":[{"name":"Department of Radiology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2023,4,20]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(13)70076-7"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.1800730723"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(20010915)92:6<1368::AID-CNCR1459>3.0.CO;2-9"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2008.16.3725"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0142(19981215)83:12B <2814::AID-CNCR31>3.0.CO;2-E"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/93.2.96"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1113\/JP272088"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.sap.0000257149.42922.7e"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-017-5960-x"},{"issue":"1","key":"e_1_3_4_11_2","first-page":"E2","article-title":"Causes and consequences of lymphatic disease","volume":"1207","author":"Rockson SG","year":"2010","unstructured":"Rockson SG. Causes and consequences of lymphatic disease. Ann N Y Acad Sci, 2010; 1207 Suppl 1:E2\u2013E6doi: 10.1111\/j.1749-6632.2010.05804.x.","journal-title":"Ann N Y Acad Sci"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000002337"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejso.2004.02.008"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1364\/BOE.3.001256"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinimag.2018.10.006"},{"key":"e_1_3_4_16_2","doi-asserted-by":"publisher","DOI":"10.1097\/SAP.0000000000002055"},{"key":"e_1_3_4_17_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-020-06790-0"},{"key":"e_1_3_4_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2004.11.013"},{"key":"e_1_3_4_19_2","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e3182268da8"},{"key":"e_1_3_4_20_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0035-1564608"},{"issue":"8","key":"e_1_3_4_21_2","first-page":"905","article-title":"Radionuclide \u201cdermal backflow\u201d in lymphatic obstruction","volume":"20","author":"Sty JR","year":"1979","unstructured":"Sty JR, , Boedecker RA, , Scanlon GT, et al. Radionuclide \u201cdermal backflow\u201d in lymphatic obstruction. J Nucl Med Off Publ Soc Nucl Med, 1979; 20(8):905\u2013906.","journal-title":"J Nucl Med Off Publ Soc Nucl Med"},{"key":"e_1_3_4_22_2","doi-asserted-by":"publisher","DOI":"10.2307\/2529310"},{"key":"e_1_3_4_23_2","doi-asserted-by":"publisher","DOI":"10.1097\/RLU.0b013e31823931f5"},{"key":"e_1_3_4_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvsv.2016.11.008"},{"key":"e_1_3_4_25_2","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.137.11.1253"},{"issue":"2","key":"e_1_3_4_26_2","first-page":"85","article-title":"L-dex ratio in detecting breast cancer-related lymphedema: Reliability, sensitivity, and specificity","volume":"46","author":"Fu MR","year":"2013","unstructured":"Fu MR, , Cleland CM, , Guth AA, et al. L-dex ratio in detecting breast cancer-related lymphedema: Reliability, sensitivity, and specificity. Lymphology, 2013; 46(2):85\u201396.","journal-title":"Lymphology"},{"key":"e_1_3_4_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinimag.2021.08.018"},{"key":"e_1_3_4_28_2","doi-asserted-by":"publisher","DOI":"10.1089\/lrb.2014.0030"},{"key":"e_1_3_4_29_2","doi-asserted-by":"publisher","DOI":"10.1097\/CAD.0000000000000468"},{"key":"e_1_3_4_30_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.breast.2017.09.006"},{"key":"e_1_3_4_31_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1524-4741.2009.00855.x"},{"key":"e_1_3_4_32_2","article-title":"Physical activity level and age contribute to functioning problems in patients with breast cancer-related lymphedema: A multicentre cross-sectional study","author":"De Vrieze T","year":"2020","unstructured":"De Vrieze T, , Gebruers N, , Nevelsteen I, et al. Physical activity level and age contribute to functioning problems in patients with breast cancer-related lymphedema: A multicentre cross-sectional study. Support Care Cancer, 2020; In Press; doi: 10.1007\/s00520-020-05375-3.","journal-title":"Support Care Cancer"}],"container-title":["Lymphatic Research and Biology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1089\/lrb.2021.0022","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/lrb.2021.0022","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/lrb.2021.0022","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T20:13:59Z","timestamp":1777666439000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1089\/lrb.2021.0022"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,4,1]]},"references-count":31,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2023,4,1]]}},"alternative-id":["10.1089\/lrb.2021.0022"],"URL":"https:\/\/doi.org\/10.1089\/lrb.2021.0022","relation":{},"ISSN":["1539-6851","1557-8585"],"issn-type":[{"value":"1539-6851","type":"print"},{"value":"1557-8585","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,4,1]]}}}