journal article·2023-08-30Open access

Quantitative Assessment of Upper-Limb Volume: Implications for Lymphedema Rehabilitation?

Lorenzo Lippi, Alessio Turco, Stefano Moalli, Mauro Nascimben, Claudio Curci, Alessandro de Sire, Lia Rimondini, Marco Invernizzi

Applied Sciences· Volume 13· Issue 17

Abstract

Upper-limb lymphedema is a chronic condition characterized by the accumulation of lymphatic fluid in the arm or hand, resulting in swelling and functional impairment. The accurate and reliable volumetric assessment of limb volume is crucial for the correct management of lymphedema. This narrative review provides an overview of the different methods proposed in the literature for the volumetric assessment of upper-limb lymphedema. In more detail, several methods of volumetric assessment have been proposed in recent years, including water displacement, the centimetric method, perometry, bioimpedance spectroscopy, dual-energy X-ray absorptiometry, magnetic resonance imaging, computed tomography, and three-dimensional laser scanning techniques. On the other hand, each method is characterized by specific strengths and limitations in terms of accuracy, reliability, practicality, and cost-effectiveness. Moreover, factors including operator experience, equipment availability, and patient population characteristics might have several implications in the optimal assessment of upper-limb volume. In this context, a precise volumetric assessment is crucial to improving the rehabilitation framework, patient education, and research outcomes. As a result, the integration of emerging technologies is needed to improve the tailored management of patients with upper-limb lymphedema. In conclusion, volumetric assessment methods provide valuable insights in the management of upper-limb lymphedema, improving patient care, treatment outcomes, and research advancements. Future research should focus on testing these innovative solutions on larger samples of patients to enhance the reproducibility, accuracy, accessibility, and clinical utility of volumetric assessment methods in the complex treatment framework of upper-limb lymphedema.
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Research context

OpenAlex topics: Lymphatic System and Diseases · Diagnosis and Treatment of Venous Diseases

SciVX discovery tags are terminology-based. OpenAlex topics are source-provided classifications.

Affiliations

Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, 28100 Novara, Italy

Translational Medicine, Dipartimento Attività Integrate Ricerca e Innovazione (DAIRI), Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, 15121 Alessandria, Italy

Enginsoft SpA, 35129 Padua, Italy

Physical Medicine and Rehabilitation Unit, Department of Neurosciences, ASST Carlo Poma, 46100 Mantova, Italy

Department of Medical and Surgical Sciences, University of Catanzaro “Magna Graecia”, 88100 Catanzaro, Italy

Research Center on Musculoskeletal Health, MusculoSkeletalHealth@UMG, University of Catanzaro “Magna Graecia”, 88100 Catanzaro, Italy

Center for Translational Research on Autoimmune and Allergic Diseases-CAAD, Università del Piemonte Orientale, 28100 Novara, Italy

Funding

European Union’s Horizon 2020 research and innovation

References (97)

Show source-provided references
1. de Sire, A., Losco, L., Lippi, L., Spadoni, D., Kaciulyte, J., Sert, G., Ciamarra, P., Marcasciano, M., Cuomo, R., and Bolletta, A. (2022). Surgical treatment and rehabilitation strategies for upper and lower extremity lymphedema: A comprehensive review. Medicina, 58.10.3390/medicina58070954 ↗
2. Nascimben, M., Lippi, L., de Sire, A., Invernizzi, M., and Rimondini, L. (2023). Algorithm-Based Risk Identification in Patients with Breast Cancer-Related Lymphedema: A Cross-Sectional Study. Cancers, 15.10.3390/cancers15020336 ↗
3. Lymphedema: A comprehensive review10.1097/01.sap.0000257149.42922.7e ↗
4. Axillary web syndrome in women after breast cancer surgery referred to an Oncological Rehabilitation Unit: Which are the main risk factors? A retrospective case-control study
5. Early detection and treatment of subclinical lymphedema in patients with breast cancer10.1089/lrb.2018.0033 ↗
6. Measurement of upper extremity volume in women after axillary dissection for breast cancer10.1053/apmr.2001.26822 ↗
7. Reliability and limits of agreement of circumferential, water displacement, and optoelectronic volumetry in the measurement of upper limb lymphedema
8. Upper-extremity volume measurements in women with lymphedema: A comparison of measurements obtained via water displacement with geometrically determined volume10.1093/ptj/82.12.1201 ↗
9. Invernizzi, M., Runza, L., de Sire, A., Lippi, L., Blundo, C., Gambini, D., Boldorini, R., Ferrero, S., and Fusco, N. (2020). Integrating augmented reality tools in breast cancer related lymphedema prognostication and diagnosis. JoVE (J. Vis. Exp.), e60093.10.3791/60093 ↗
10. Three-dimensional laser scanning as a reliable and reproducible diagnostic tool in breast cancer related lymphedema rehabilitation: A proof-of-principle study
11. Tánori-Tapia, J.M., Romero-Pérez, E.M., Camberos, N.A., Horta-Gim, M.A., Núñez-Othón, G., Medina-Pérez, C., and de Paz, J.A. (2020). Determination of the minimum detectable change in the total and segmental volumes of the upper limb, evaluated by perimeter measurements. Healthcare, 8.10.3390/healthcare8030285 ↗
12. Early diagnosis of lymphedema using multiple frequency bioimpedance
13. The comparison of two different physiotherapy methods in treatment of lymphedema after breast surgery10.1007/s10549-005-3781-2 ↗
14. The upper-limb volumetric changes in breast cancer survivors with axillary web syndrome10.1111/ecc.12637 ↗
15. Limb volume measurements: Comparison of accuracy and decisive parameters of the most used present methods10.1186/s40064-015-1468-7 ↗
16. SANRA—A scale for the quality assessment of narrative review articles10.1186/s41073-019-0064-8 ↗
17. Beyond PICO: The SPIDER tool for qualitative evidence synthesis10.1177/1049732312452938 ↗
18. The lymphatic territories of the upper limb: Anatomical study and clinical implications10.1097/01.prs.0000246516.64780.61 ↗
19. The lymphatic vascular system: Much more than just a sewer10.1186/s13578-022-00898-0 ↗
20. Prevalence and prognostic significance of secondary lymphedema following breast cancer10.1089/lrb.2011.0007 ↗
21. Advances in the prevention and treatment of breast cancer-related lymphedema10.1007/s10549-023-06947-7 ↗
22. Regulation of inflammation and fibrosis by macrophages in lymphedema10.1152/ajpheart.00598.2014 ↗
23. Ly, C.L., Kataru, R.P., and Mehrara, B.J. (2017). Inflammatory manifestations of lymphedema. Int. J. Mol. Sci., 18.10.3390/ijms18010171 ↗
24. Paolucci, T., Saggino, A., Agostini, F., Paoloni, M., Bernetti, A., Mangone, M., Santilli, V., Saggini, R., and Tommasi, M. (2021). The influence of rehabilitation on quality of life in breast cancer survivors: A clinical study. Int. J. Environ. Res. Public Health, 18.10.3390/ijerph18168585 ↗
25. Lymphatic function and immune regulation in health and disease10.1089/lrb.2013.0012 ↗
26. Psychosocial impact of living with cancer-related lymphedema10.1016/j.soncn.2012.11.007 ↗
27. Integrating molecular biomarkers in breast cancer rehabilitation. What is the current evidence? A systematic review of randomized controlled trials10.3389/fmolb.2022.930361 ↗
28. de Sire, A., Fusco, N., Sajjadi, E., Lippi, L., Cisari, C., and Invernizzi, M. (2021). Lymphedema Rehabilitation Using Self-Adaptive Inelastic Compression in Breast Cancer: A Proof-of-Principle Study. Appl. Sci., 11.10.3390/app11041901 ↗
29. Pappalardo, M., Starnoni, M., Franceschini, G., Baccarani, A., and De Santis, G. (2021). Breast cancer-related lymphedema: Recent updates on diagnosis, severity and available treatments. J. Pers. Med., 11.10.3390/jpm11050402 ↗
30. Lymphedema diagnosis, treatment, and follow-up from the view point of physical medicine and rehabilitation specialists10.5606/tftrd.2018.3539 ↗
31. Volume measurement in lymphoedema treatment: Examination of formulae10.1111/j.1365-2354.1995.tb00047.x ↗
32. Non-invasive assessment of the lymphedematous limb
33. Mayrovitz, H.N. (2022). Breast Cancer, Exon Publications.10.36255/exon-publications-breast-cancer ↗
34. The effect of prospective monitoring and early physiotherapy intervention on arm morbidity following surgery for breast cancer: A pilot study10.3138/ptc.2012-23O ↗
35. Mathieu, J., Daneau, C., Lemeunier, N., Doyon, A., Marchand, A.A., and Descarreaux, M. (2022). Conservative interventions and clinical outcome measures used in the perioperative rehabilitation of breast cancer patients undergoing mastectomy: A scoping review. BMC Womens Health, 22.10.1186/s12905-022-01927-3 ↗
36. Assessment of volume measurement of breast cancer-related lymphedema by three methods: Circumference measurement, water displacement, and dual energy X-ray absorptiometry10.1089/lrb.2009.0016 ↗
37. Validity for the simplified water displacement instrument to measure arm lymphedema as a result of breast cancer surgery10.1016/j.apmr.2008.11.016 ↗
38. A Software Suite for Limb Volume Analysis Applicable in Clinical Settings: Upper Limb Quantification10.3389/fbioe.2022.863689 ↗
39. Comparative study between mobile infrared optoelectronic volumetry with a perometer® and two commonly used methods for the evaluation of arm volume in patients with breast cancer related lymphedema of the arm
40. Three-dimensional camera system for measuring arm volume in women with lymphedema following breast cancer treatment10.1089/lrb.2014.0026 ↗
41. A Comparison of Bioimpedance Spectroscopy or Tape Measure Triggered Compression Intervention in Chronic Breast Cancer Lymphedema Prevention10.1089/lrb.2021.0084 ↗
42. Assessment of Arm Volume Using a Tape Measure Versus a 3D Optical Scanner in Survivors with Breast Cancer-Related Lymphedema10.1089/lrb.2020.0119 ↗
43. Measurement properties of instruments for measuring of lymphedema: Systematic review10.2522/ptj.20150412 ↗
44. Measuring Limb Volume: Accuracy and Reliability of Tape Measurement Versus Perometer Measurement10.1089/lrb.2017.0039 ↗
45. Lymphedema following treatment for breast cancer: A new approach to an old problem10.1016/j.critrevonc.2013.05.001 ↗
46. Reliability and concurrent validity of the perometer for measuring hand volume in women with and without lymphedema10.1089/lrb.2010.0021 ↗
47. Breast cancer-related lymphedema: A literature review for clinical practice
48. Three decades of bioelectrical impedance spectroscopy in lymphedema assessment: An historical perspective10.1089/lrb.2020.0085 ↗
49. Quantitative bioimpedance spectroscopy for the assessment of lymphoedema10.1007/s10549-008-0258-0 ↗
50. Bioimpedance spectroscopy for breast cancer-related lymphedema assessment: Clinical practice guidelines10.1007/s10549-022-06850-7 ↗
51. Is bioimpedance spectroscopy a useful tool for objectively assessing lymphovenous bypass surgical outcomes in breast cancer-related lymphedema?10.1007/s10549-020-06059-6 ↗
52. Segmental measurement of breast cancer-related arm lymphoedema using perometry and bioimpedance spectroscopy10.1007/s00520-010-0896-8 ↗
53. Assessment of breast cancer-related arm lymphedema—Comparison of physical measurement methods and self-report10.3109/07357900902918494 ↗
54. Correlation between bioelectrical spectroscopy and perometry in assessment of upper extremity swelling
55. Measurement of breast cancer-related lymphoedema10.1016/j.jphys.2022.09.008 ↗
56. Use of Dual-Energy X-ray Absorptiometry to Assess Soft Tissue Composition in Breast Cancer Survivors with and without Lymphedema10.1089/lrb.2021.0030 ↗
57. Heavy-load resistance exercise during chemotherapy in physically inactive breast cancer survivors at risk for lymphedema: A randomized trial10.1080/0284186X.2019.1643916 ↗
58. Body composition with dual energy X-ray absorptiometry: From basics to new tools10.21037/qims.2020.03.02 ↗
59. Non-contrast magnetic resonance lymphography (NCMRL) in cancer-related secondary lymphedema: Acquisition technique and imaging findings10.1007/s11547-021-01410-3 ↗
60. Use of magnetic resonance imaging lymphangiography for preoperative planning in lymphedema surgery: A systematic review10.1002/micr.30731 ↗
61. Magnetic resonance imaging: Principles and techniques: Lessons for clinicians10.1016/j.jceh.2015.08.001 ↗
62. Lymphedema leads to fat deposition in muscle and decreased muscle/water volume after liposuction: A magnetic resonance imaging study10.1089/lrb.2017.0042 ↗
63. Non-contrast Magnetic Resonance Lymphangiography: An emerging technique for the study of lymphedema10.1016/j.clinimag.2018.10.006 ↗
64. Lymphedema: Surgical and medical therapy10.1097/PRS.0000000000002683 ↗
65. A systematic review of magnetic resonance lymphography for the evaluation of peripheral lymphedema10.1016/j.jvsv.2020.03.007 ↗
66. Lopes, B., Azevedo, K., Abrantes, A., Rodrigues, S., Ribeiro, L., Vicente, B., and Almeida, R. (2022, January 2–6). Claustrophobia and Anxiety in Magnetic Resonance Imaging. Proceedings of the European Congress of Radiology, Online.
67. Application of imaging in lymphedema surgical therapies10.21037/gs.2020.03.24 ↗
68. Computed Tomography: A Technical Review
69. Clinical and diagnostic aspects of lymphedema10.1024/0301-1526/a000622 ↗
70. Lee, S., Lee, D.G., and Kim, K.T. (2022). Temporal Changes in Subcutaneous Fibrosis in Patients with Lower Extremity Lymphedema Following Surgery for Gynecologic Cancer: A Computed Tomography-Based Quantitative Analysis. Diagnostics, 12.10.3390/diagnostics12081949 ↗
71. A systematic review of guidelines for lymphedema and the need for contemporary intersocietal guidelines for the management of lymphedema10.1016/j.jvsv.2020.03.006 ↗
72. An Analysis of Out-of-Pocket Expenditure Due to Non-Availability of Computed Tomography Scan in Public Sector: A Case Study of Hira Medical Center Sukkur Pakistan10.32413/pjph.v11i2.664 ↗
73. Investigation of Shape with Patients Suffering from Unilateral Lymphoedema10.1007/s10439-017-1929-y ↗
74. An infrared 3D scanning device as a novel limb volume measurement tool in breast cancer patients10.1186/s12957-020-02043-y ↗
75. Reliability and Measurement Error of Breast Volume Calculation Using Three-Dimensional Surface Imaging
76. Reliability and validity of arm volume measurements for assessment of lymphedema10.1093/ptj/86.2.205 ↗
77. Rabe, E., Stücker, M., and Ottillinger, B. (2010). Water displacement leg volumetry in clinical studies—A discussion of error sources. BMC Med. Res. Methodol., 10.10.1186/1471-2288-10-5 ↗
78. Experimental and analytical comparisons of tissue dielectric constant (TDC) and bioimpedance spectroscopy (BIS) in assessment of early arm lymphedema in breast cancer patients after axillary surgery and radiotherapy10.1089/lrb.2015.0019 ↗
79. Lymphedema: Classification, diagnosis and therapy10.1177/1358836X9800300209 ↗
80. Lymphatic mapping and lymphedema surgery in the breast cancer patient
81. The use of bioimpedance analysis to evaluate lymphedema10.1097/01.sap.0000244977.84130.cf ↗
82. A new technique for the quantification of peripheral edema with application in both unilateral and bilateral cases10.1177/000331970205300106 ↗
83. Magnetic Resonance Lymphography of Lymphatic Vessels in Upper Extremity With Breast Cancer-Related Lymphedema10.1097/SAP.0000000000001994 ↗
84. Accuracy of a single measurement site for self-monitoring of patients with breast cancer at risk for lymphedema10.1080/09593985.2018.1474404 ↗
85. The effectiveness of lymphedema self-management in the prevention of breast cancer-related lymphedema and quality of life: A randomized controlled trial10.1016/j.ejon.2019.02.006 ↗
86. Combined complete decongestive therapy reduces volume and improves quality of life and functional status in patients with breast cancer-related lymphedema10.1016/j.clbc.2021.08.005 ↗
87. Evolution of the 2020 international society of lymphology consensus document parallels advances in lymphology: An historical perspective
88. Machine learning for detection of lymphedema among breast cancer survivors10.21037/mhealth.2018.04.02 ↗
89. Development of a Mobile-Based Self-care Application for Patients with Breast Cancer-Related Lymphedema in Iran10.1055/s-0042-1757295 ↗
90. Anik, A.R., Hasan, K., Islam, M.M., Hasan, M.M., Ali, M.F., and Das, S.K. (2023). Non-Invasive Portable Technologies for Monitoring Breast Cancer Related Lymphedema to Facilitate Telehealth: A Scoping Review. IEEE J. Biomed. Health Inform.10.1109/JBHI.2023.3280196 ↗
91. Healthcare Practitioners’ Knowledge of Lymphedema
92. Lymphedema: A primer on the identification and management of a chronic condition in oncologic treatment10.3322/caac.20001 ↗
93. Breast Cancer-Related Lymphedema: Risk Factors, Screening, Management, and the Impact of Locoregional Treatment10.1200/JCO.19.02896 ↗
94. The standard of care for lymphedema: Current concepts and physiological considerations10.1089/lrb.2009.0006 ↗
95. Lymphedema following breast cancer treatment and impact on quality of life: A review10.1016/j.critrevonc.2014.06.004 ↗
96. Godman, B., Finlayson, A.E., Cheema, P.K., Zebedin-Brandl, E., Gutiérrez-Ibarluzea, I., Jones, J., Malmström, R.E., Asola, E., Baumgärtel, C., and Bennie, M. (2013). Personalizing health care: Feasibility and future implications. BMC Med., 11.10.1186/1741-7015-11-179 ↗
97. Updated guidance for trusted systematic reviews: A new edition of the Cochrane Handbook for Systematic Reviews of Interventions