{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T19:16:39Z","timestamp":1777922199382,"version":"3.51.4"},"reference-count":33,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2023,2,1]],"date-time":"2023-02-01T00:00:00Z","timestamp":1675209600000},"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":[[2023,2,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>A standardized lymphedema grading system is a prerequisite for accurately and objectively evaluating its severity, both preoperatively and postoperatively. The purpose of this study was to establish a clinically feasible noncontrast magnetic resonance lymphangiography (NMRL) protocol and a standardized scoring system for the evaluation of lymphedema.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and Results:<\/jats:title>\n                    <jats:p>\n                      From January 2020 to February 2021, 39 patients who had been clinically diagnosed with lymphedema and had undergone NMRL were included. The severity and circumferential extent of lymphedema were assessed using magnetic resonance imaging, and a combined index was devised as the sum of the product of the severity and extent scores determined at four different levels. A magnetic resonance imaging (MRI) stage was allocated based on the combined index score, its correlation with clinical indices was analyzed. The MR and clinical staging showed a percentage agreement of 85.9% and a kappa coefficient of 0.641, indicating moderate agreement (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Both the interlimb volume and interlimb impedance ratios differed significantly between groups (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001 for both). The correlation analysis revealed a significant correlation between the combined index score and the inter-limb volume ratio (\n                      <jats:italic toggle=\"yes\">r<\/jats:italic>\n                      \u2009=\u20090.70,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and inter-limb impedance ratio at both 1\u2009kHz (\n                      <jats:italic toggle=\"yes\">r<\/jats:italic>\n                      \u2009=\u20090.71,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and 5\u2009kHz (\n                      <jats:italic toggle=\"yes\">r<\/jats:italic>\n                      \u2009=\u20090.71,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001). The interobserver agreement was moderate for the severity score, extent score, and combined score.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>The proposed standardized scoring system for evaluating lymphedema based on NMRL can reproducibly determine the severity and extent of lymphedema in both the upper and lower extremities, and correlates strongly with established clinical measures.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/lrb.2021.0092","type":"journal-article","created":{"date-parts":[[2022,5,3]],"date-time":"2022-05-03T00:30:05Z","timestamp":1651537805000},"page":"70-77","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":6,"title":["Validation of a Lymphedema Index Score Based on Noncontrast Magnetic Resonance Lymphangiography: Correlation with Clinical Staging and Indocyanine Green Lymphangiography"],"prefix":"10.1177","volume":"21","author":[{"given":"Yujin","family":"Myung","sequence":"first","affiliation":[{"name":"Department of Plastic Surgery, Seoul National University Bundang Hospital, Seongnam-si, South Korea."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seokwon","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery, Seoul National University Bundang Hospital, Seongnam-si, South Korea."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bo Ram","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Radiology, and Seoul National University Bundang Hospital, Seongnam-si, South Korea."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eun Joo","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seongnam-si, South Korea."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0812-6228","authenticated-orcid":false,"given":"Joseph Kyu-hyung","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery, Seoul National University Bundang Hospital, Seongnam-si, South Korea."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1838-2564","authenticated-orcid":false,"given":"Yusuhn","family":"Kang","sequence":"additional","affiliation":[{"name":"Department of Radiology, and Seoul National University Bundang Hospital, Seongnam-si, South Korea."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2023,2,16]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.critrevonc.2014.06.004"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9610(99)00008-2"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2012.41.8574"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0142(19981215)83:12B <2882::AID-CNCR45>3.0.CO;2-0"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1177\/1358836X9800300209"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1089\/lrb.2017.0039"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1089\/lrb.2017.0047"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e3182063639"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.prs.0000277995.25009.3e"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0038182"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.178.2.1780405"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.167.3.3363131"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1002\/jmri.27328"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1089\/lrb.2020.0034"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000004748"},{"key":"e_1_3_3_17_2","first-page":"6","volume-title":"Template for Practice Compression Hosiery in Upper Body Lymphoedema","author":"Cariati C","year":"2009","unstructured":"Cariati C, , Gannon B, , Piller N. Principles of anatomy and physiology in relation to compression of the upper limb and thorax. In: Rusling N, ed. Template for Practice Compression Hosiery in Upper Body Lymphoedema. Aberdeen: Health Comm UK Ltd.; 2009:6\u201315."},{"key":"e_1_3_3_18_2","first-page":"5","volume-title":"Template for Practice Compression Hosiery in Lymphoedema","author":"Partsch H","year":"2006","unstructured":"Partsch H, , J\u00fcnger M. Evidence for the use of compession hosiery in lymphoedema. In: Mac Gregor L, ed. Template for Practice Compression Hosiery in Lymphoedema. Aberdeen: Health Comm UK Ltd.; 2006:5\u20139."},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1177\/028418519403500314"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.184.1.1609085"},{"key":"e_1_3_3_21_2","first-page":"170","article-title":"The diagnosis and treatment of peripheral lymphedema: 2016 consensus document of the International Society of Lymphology","volume":"49","author":"Executive Committee","year":"2016","unstructured":"Executive Committee. The diagnosis and treatment of peripheral lymphedema: 2016 consensus document of the International Society of Lymphology. Lymphology, 2016; 49:170\u2013184.","journal-title":"Lymphology"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e31820cf5df"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e3182268cd9"},{"key":"e_1_3_3_24_2","first-page":"26","article-title":"Reliability and limits of agreement of circumferential, water displacement, and optoelectronic volumetry in the measurement of upper limb lymphedema","volume":"40","author":"Deltombe T","year":"2007","unstructured":"Deltombe T, , Jamart J, , Recloux S, et al. Reliability and limits of agreement of circumferential, water displacement, and optoelectronic volumetry in the measurement of upper limb lymphedema. Lymphology, 2007; 40:26\u201334.","journal-title":"Lymphology"},{"key":"e_1_3_3_25_2","first-page":"35","article-title":"Comparison of upper limb volume measurement techniques and arm symptoms between healthy volunteers and individuals with known lymphedema","volume":"40","author":"Ridner SH","year":"2007","unstructured":"Ridner SH, , Montgomery L, , Hepworth J, , Stewart B, , Armer J. Comparison of upper limb volume measurement techniques and arm symptoms between healthy volunteers and individuals with known lymphedema. Lymphology, 2007; 40:35\u201346.","journal-title":"Lymphology"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10549-016-3993-7"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.124.6.2136"},{"key":"e_1_3_3_28_2","first-page":"99","article-title":"Persistence of lymphedema reduction after noninvasive complex lymphedema therapy","volume":"11","author":"Boris M","year":"1997","unstructured":"Boris M, , Weindorf S, , Lasinkski S. Persistence of lymphedema reduction after noninvasive complex lymphedema therapy. Oncology (Williston Park), 1997; 11:99\u2013109; discussion 110, 113\u2013114.","journal-title":"Oncology (Williston Park)"},{"key":"e_1_3_3_29_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11547-019-01122-9"},{"key":"e_1_3_3_30_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.mri.2020.02.004"},{"key":"e_1_3_3_31_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-020-06790-0"},{"key":"e_1_3_3_32_2","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000012945"},{"key":"e_1_3_3_33_2","doi-asserted-by":"publisher","DOI":"10.1089\/lrb.2010.0014"},{"key":"e_1_3_3_34_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12885-019-5840-9"}],"container-title":["Lymphatic Research and Biology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1089\/lrb.2021.0092","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/lrb.2021.0092","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/lrb.2021.0092","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T20:14:19Z","timestamp":1777666459000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1089\/lrb.2021.0092"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,2,1]]},"references-count":33,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2023,2,1]]}},"alternative-id":["10.1089\/lrb.2021.0092"],"URL":"https:\/\/doi.org\/10.1089\/lrb.2021.0092","relation":{},"ISSN":["1539-6851","1557-8585"],"issn-type":[{"value":"1539-6851","type":"print"},{"value":"1557-8585","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,2,1]]}}}