Lymphedema research conducted at Vanderbilt University Medical Center (VUMC) to better understand patient risk for this chronic condition and treatment responses received recognition at an international conference.
Paula Donahue, DPT, assistant professor of Physical Medicine and Rehabilitation, recently received Best Research Award in the new investigator category at the 2016 National Lymphedema Network Conference, which attracts an international audience.
Lymphedema is a condition that may develop after cancer treatment and is characterized by arm and chest swelling in breast cancer survivors. The Vanderbilt research, funded by a $1.6 million, four-year grant from the National Institutes of Health, uses customized noninvasive MRI methods to identify internal biomarkers related to lymphedema and to quantify the effects of therapies, such as manual lymphatic drainage.
“This is the first clinical trial involving functional MRI in patients with lymphedema to more sensitively characterize internal mechanisms of lymphatic dysfunction,” said Donahue, a certified lymphedema therapist.
Donahue presented one component of that research at the conference, an evaluation of the immediate impact of manual lymphatic therapy as an intervention on patients with and at risk for developing lymphedema. The MRI measures are sensitive to subtle changes in tissue composition, including interstitial protein accumulation, a hallmark of lymphedema.
“Before patients received manual lymphatic drainage they had a high interstitial protein accumulation versus after the manual lymphatic drainage, so we showed directly how the therapy impacted lymphatic functioning and tissue health,” Donahue said.
Donahue and colleagues, including Department of Radiology principal investigator Manus Donahue, Ph.D., and post-doctoral fellow Rachelle Crescenzi, Ph.D., have just begun the third year of the four-year grant award. The research group is composed of a multidisciplinary team from Radiology, nursing, Physical Medicine and Rehabilitation, breast surgical oncology and Pharmacology. One of the primary goals is to identify biomarkers that indicate which patients are most at risk for developing lymphedema so they can receive earlier treatments.
“There is a lot of uncertainty on how to inform a person about prevention and management, as each person’s body will have its individual response,” Donahue said. “If we had better ways of monitoring a patient’s internal lymphatic system, we could probably better guide them on what they could do and even show them how their system is directly responding to their self-management attempts. Seeing is believing.”
