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Shetty. Plast Aesthet Res 2022;9:47 Plastic and
DOI: 10.20517/2347-9264.2022.41
Aesthetic Research

Perspective Open Access

Practical considerations in starting a peripheral
lymphedema magnetic resonance imaging program

Anup S. Shetty

Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO 63110, USA.
Correspondence to: Dr. Anup S. Shetty, Mallinckrodt Institute of Radiology, Washington University School of Medicine, 501 S.
Kingshighway Blvd, Campus Box 8131, St. Louis, MO 63110, USA. E-mail: anup.shetty@wustl.edu

How to cite this article: Shetty AS. Practical considerations in starting a peripheral lymphedema magnetic resonance imaging
program. Plast Aesthet Res 2022;9:47. https://dx.doi.org/10.20517/2347-9264.2022.41
Received: 25 Apr 2022 First Decision: 23 Jun 2022 Revised: 23 Jun 2022 Accepted: 27 Jul 2022 Published: 3 Aug 2022

Academic Editors: Matthew L. Iorio, Joani M. Christensen Copy Editor: Peng-Juan Wen Production Editor: Peng-Juan Wen

Abstract
The management of chronic peripheral lymphedema benefits from a multidisciplinary approach in which magnetic
resonance imaging (MRI) can play a key role. The imaging has been well described in the literature (including this
journal), but the process for starting a novel imaging service line is complex. Participants in this process, including
radiologists, imaging technical staff, information technologists, and revenue cycle managers, must be engaged and
work in harmony to achieve success. The purpose of this article is to detail the building blocks and steps in starting
a peripheral lymphedema MRI program, how our process evolved, and lessons learned along the way.
Keywords: Magnetic resonance lymphangiography, magnetic resonance lymphography, lymphedema, radiology
service line

INTRODUCTION
Limb lymphedema is a chronic condition characterized by accumulation of protein-rich fluid in the
interstitium, adipose deposition, and inflammation leading to fibrosis and sclerosis . For the plastic
[1-3]
surgeon to most effectively manage the chronic lymphedema patient with modern microsurgical
approaches such as lymphovenous bypass or vascularized lymph node transfer, peripheral MR
lymphangiography (MRL) is a highly useful tool to noninvasively assess the anatomy and function of the
[4-8]
lymphatic system, but is not widely available at most centers .

© The Author(s) 2022. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, sharing,
adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as
long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and
indicate if changes were made.

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