Spatial Atlas of Dermal Backflow in Breast Cancer Lymphedema and ML Staging

ICG lymphography spatial atlas in 289 limbs with breast cancer-related lymphedema showed dermal backflow most prevalent in wrist, forearm, olecranon. Adding backflow percentage improved ML prediction of MDACC stage (best: logistic regression, random forest).

• The atlas co-registered and segmented 289 clinician-annotated ICG lymphography studies from the ALERT Centre Databank.
• Subgroup-specific heat maps stratified by MDACC stage, L-Dex ratio, and limb volume difference demonstrated distinct spatial variations.
• Adding dermal backflow percentage to ML models improved disease severity prediction over clinical features alone.

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