title: Validity of soft-tissue thickness of calf measured using MRI for assessing unilateral lower extremity lymphoedema secondary to cervical and endometrial cancer treatments.
abstract: OBJECTIVE
  To determine whether soft-tissue thickness of the calf measured using MRI could be valid for assessing unilateral lower extremity lymphoedema (LEL) secondary to cervical and endometrial cancer treatments.
  
  
  METHODS
  Seventy women with unilateral LEL and 25 without LEL after cervical or endometrial cancer treatments underwent MRI examinations of their calves. Total thickness of soft-tissue (TT), muscle thickness (MT), and subcutaneous tissue thickness (STT) of the calf, and the difference between the affected and contralateral unaffected calf regarding TT (DTT), MT (DMT), and STT (DSTT) were obtained using fat-suppressed T2-weighted imaging in the middle of the calves. The volume of the calf and difference in volume (DV) between calves were obtained by the method of water displacement. Statistical analysis was performed to determine the validity of MRI measurements by volume measurements in staging LEL.
  
  
  RESULTS
  There was a close correlation between volume and TT for the affected (r = 0.927) or unaffected calves (r = 0.896). STT of the affected calf, and DTT or DSTT of the calves were closely correlated with volume of the affected calf or DV of the calves (all p < 0.05). Multivariate analysis showed significant differences in TT, STT, volume of the affected calf, DTT, DSTT, and DV between stages except in volume of the affected calf or in DV between stage 0 and 1. For staging LEL, DSTT showed the best discrimination ability among all the parameters.
  
  
  CONCLUSIONS
  Soft-tissue thickness of the calf measured at MRI could be valid for quantitatively staging unilateral LEL, and DSTT of the calves could be the best classifying factor.
authors.affiliation: Department of Radiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, 1630 Dongfang Rd, Shanghai, China.
authors.forename: Qing
authors.initials: Q
authors.lastname: Lu
authors.affiliation: Department of Radiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, 1630 Dongfang Rd, Shanghai, China.
authors.forename: Yulai
authors.initials: Y
authors.lastname: Li
authors.affiliation: Sichuan Key Laboratory of Medical Imaging, and Department of Radiology, Affiliated Hospital of North Sichuan Medical College, 63 Wenhua Road, Shunqing District, Nanchong, Sichuan, China.
authors.forename: Tian-Wu
authors.initials: TW
authors.lastname: Chen
authors.affiliation: Department of Radiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, 1630 Dongfang Rd, Shanghai, China.
authors.forename: Yuan
authors.initials: Y
authors.lastname: Yao
authors.affiliation: Department of Radiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, 1630 Dongfang Rd, Shanghai, China.
authors.forename: Zizhou
authors.initials: Z
authors.lastname: Zhao
authors.affiliation: Department of Radiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, 1630 Dongfang Rd, Shanghai, China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Li
authors.affiliation: Department of Radiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, 1630 Dongfang Rd, Shanghai, China. Electronic address: xujianrong1634@163.com.
authors.forename: Jianrong
authors.initials: J
authors.lastname: Xu
authors.affiliation: Department of Plastic & Reconstructive Surgery, Shanghai 9th People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhi Zao Ju Rd, Shanghai 200011, China.
authors.forename: Zhaohua
authors.initials: Z
authors.lastname: Jiang
authors.affiliation: Department of Radiology, Wayne State University, 3990 John R Detroit, MI 48201, USA.
authors.forename: Jiani
authors.initials: J
authors.lastname: Hu
mesh_terms: D001837:Body Weights and Measures / Q000379:methods / Q000592:standards*; D016889:Endometrial Neoplasms / Q000150:complications* / Q000601:surgery; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D007866:Leg / Q000473:pathology*; D008209:Lymphedema / Q000150:complications* / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008875:Middle Aged; D015588:Observer Variation; D011446:Prospective Studies; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D002583:Uterine Cervical Neoplasms / Q000150:complications* / Q000601:surgery