Pictured from left: Rachelle Crescenzi, PhD, Vanessa Crain, Zola Bzdek, PhD, and Allison Scott, MSc of UVA’s SALT Lab (photo credit Karen Barden)
Patients with chronic lymphatic diseases like lymphedema and lipedema suffer from misdiagnoses and delayed treatment because lymphatic function is difficult to monitor by current medical technologies. Imaging the lymphatic system is a critical challenge to effectively caring for these patients and improving health outcomes.
To address this challenge, Rachelle Crescenzi, PhD, will lead a seven-year program backed by a new $6.5 million grant from the NIH National, Heart, Lung, and Blood Institute (NHLBI) to develop magnetic resonance imaging (MRI) to research lymphedema and lipedema. The goal is to translate new technologies to clinical care and reduce disease burden.
Dr. Crescenzi’s research program centers on the abilities to image sodium, adipose tissue, and lymphatics by translational magnetic resonance imaging (SALT MRI). SALT MRI is a noninvasive strategy to visualize sodium in the body’s tissues and measure how it relates to lymphatic function.
In prior work, Dr. Crescenzi’s team discovered that patients with lymphatic disease store more sodium in affected areas of their body, including the skin and adipose tissue in extremities. These effects can be measured on SALT MRI.
“This was a significant finding because it showed that lymphatic clearance function is necessary to maintain levels of tissue sodium in humans. It’s interesting physiology but more importantly, highlights the translational value of noninvasive sodium MRI,” said Dr. Crescenzi.
The new research, funded by the NHLBI R35 grant mechanism for emerging investigators, will focus on developing and applying SALT MRI across three translational projects. The program will study the progression of leg lymphedema, develop the SALT MRI exam for the upper body to address breast cancer-related lymphedema, and explore biological features of lipedema that may improve objective diagnosis.
“This award puts a timeline on the goal of reducing lymphatic disease burden. Imaging technologies are advancing, and ready to help us,” stated Dr. Crescenzi.
Dr. Crescenzi’s research team includes clinical research coordinator Vanessa Crain and research scientist Allison Scott, MSc, who bring over 14 years of combined experience in translational research and clinical trials for lymphedema and lipedema. The program creates a unique training environment for graduate students at UVA, where Zola Bzdek is a PhD candidate in UVA Physics.
The program also brings together experts from UVA Departments of Radiology and Medical Imaging and Plastic Surgery, Maxillofacial, and Oral Health.
Radiologist Klaus Hagspiel, MD, will work together with trainees to develop clinically-relevant imaging strategies for lymphatic physiology. Plastic surgeons Scott Hollenbeck, MD, and Amanda Silva, MD, will have opportunity to see SALT MRI applied to patients receiving microsurgical repair of lymphatics to treat lymphedema.
Together, these advances aim to give clinicians new imaging tools to guide personalized treatment decisions and monitor response to emerging lymphatic therapies. By shortening time to diagnosis and improving care, the work has the potential to improve quality of life for patients with chronic lymphatic disease.