This retrospective cross-sectional study assessed different methods for staging lymphedema on Dual Agent Relaxivity Contrast MR Lymphangiography (DARC-MRL). Images from 20 patients (40 limbs) with clinically diagnosed and staged lower extremity lymphedema who had undergone DARC-MRL were assessed for dermal backflow, lymphatic vessel enhancement, and subcutaneous edema, in six regions of the lower limbs. These assessments were translated into a dermal backflow score and an edema score of our own design, as well as a recently published MRL Stage (Soga et al. 2021). All three scores demonstrated strong to excellent correlation with International Society of Lymphology (ISL) clinical stages.
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