68Ga-NOTA-Evans Blue TOF PET/MR lymphoscintigraphy evaluate the severity of lower-limb lymphedema: a primary clinical application

Purpose: This study was designed to evaluate the severity of lower-limb lymphedema, using 68Ga-NOTA-Evans Blue TOF PET/MR. Methods: Thirteen patients with lower-limb lymphedema were subjected to TOF PET/MRI acquisitions at 20 and 40 min after subcutaneous injection into the first interdigital spaces of both feet (0.5ml,37MBq/foot). Diagnosis of lymphedema was determined by history, physical examination, and lymphoscintigraphy. Clinical severity of lymphedema was determined by physical examination, based on the International Society of Lymphology classification of increased limb volume. All patients were classified into 4 mild, 5 moderate, and 4 severe. Regions-of-interest (ROI) was used when measuring SUV of bilateral superficial lymphatic vessels(SLV) and deep lymphatic vessels(DLV). SUVslv/SUVdlv was designed to assess the level of lymphedema. The correlation between lymphedema severity and lymphoscintigraphy findings was determined using one-way analysis of variance (ANOVA). Results: There was significant difference among all subjects of the SUVslv of affected side and normal side (P0.1). SUVslv/SUVdlv of affected limb showed statistical differences among each stage (P1.1; stage II: 0.7