Magnetic resonance imaging in lymphedema: Opportunities, challenges, and future perspectives

Magnetic resonance imaging (MRI) has become a pivotal non-invasive tool in the evaluation and management of lymphedema. This review systematically summarizes its current applications, highlighting imaging techniques, comparative advantages over other modalities, MRI-based staging systems, and emerging clinical roles. A comprehensive literature review was conducted, covering comparisons with lymphoscintigraphy, ultrasound, and computed tomography (CT), as well as studies on the feasibility of multiparametric MRI sequences. Compared to conventional imaging, MRI offers superior soft tissue contrast and enables detailed assessment of lymphatic anatomy, tissue composition, and fluid distribution through sequences such as T2-weighted imaging, diffusion-weighted imaging (DWI), and magnetic resonance lymphangiography (MRL). Standardized grading systems have been proposed to support clinical staging. MRI is increasingly applied in preoperative planning and postoperative surveillance.These findings underscore MRI's diagnostic precision and clinical utility. Future research should focus on protocol standardization, incorporation of quantitative biomarkers, and development of AI-driven tools to enable personalized, scalable lymphedema care.