Visualizing Sodium in Lymphatic Disease: a Translational Path

The long-term goal of this research program is to reduce lymphatic disease burden through translational magnetic resonance imaging (MRI). We have developed a noninvasive multi-nuclear 23Na/1H MRI approach to visualize the lymphatic system together with sodium and adipose tissue storage in humans called Sodium, Adipose, and Lymphatics Translational (SALT) MRI. In prior studies by the research team, SALT MRI demonstrated tissue sodium accumulation in human lymphatic disease for the first time in leg lymphedema (R01HL155523) and lipedema (R01HL157378). These discoveries open new questions about the lymphatic physiology of tissue sodium clearance in humans, as well as methods to image this physiology which we will pursue during the R35 program. The translational research goals of our R35 research program are to: (T2, Translation in Patients with Leg Lymphedema) understand disease progression of leg lymphedema and sodium response to micro-surgical repair, (T1, Technology Development for Imaging Arm Lymphedema) build MRI technologies to observe sodium and lymphatic physiology in arm lymphedema, and (T0, Basic Science of Lipedema) discover disease mechanisms of sodium storage in lipedema. Research goals are expected to develop imaging biomarkers of leg lymphedema progression and treatment, open new avenues of investigation in arm lymphedema, and could reveal new diagnostic strategies for lipedema which are desperately needed to reduce the time to diagnosis. Overall, these studies will prepare imaging outcome measures for emerging clinical trials in lymphatic disease. We are committed to developing translational imaging to meet clinical unmet needs for patients with lymphatic disease. Project Number: 1R35HL184172-01 | Fiscal Year: 2026 | NIH Institute/Center: National Heart Lung and Blood Institute (NHLBI) | Principal Investigator: Rachelle Crescenzi | Institution: UNIVERSITY OF VIRGINIA, CHARLOTTESVILLE, VA | Award Amount: $950,550 | Activity Code: R35 | Study Section: Special Emphasis Panel[ZRG1 RCCS-B (93)] View on NIH RePORTER: https://reporter.nih.gov/project-details/1R35HL18417201