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Pongpat W, Othong R. Utilization of 3-dimensional scanner technology to measure circumference and volume of limbs in patients bitten by venomous snakes. Clin Toxicol (Phila) 2024:1-9. [PMID: 39076146 DOI: 10.1080/15563650.2024.2377273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Revised: 07/01/2024] [Accepted: 07/02/2024] [Indexed: 07/31/2024]
Abstract
INTRODUCTION The objective of this study was to compare limb circumference measurements between a three-dimensional scanner and a measuring tape. METHODS Patients older than 18 years, who were bitten by a green pit viper and visited the emergency department between 1 October and 20 December, 2019 were included. Two physicians measured the circumference of a bitten limb and a contralateral unaffected limb twice using both a measuring tape and a three-dimensional scanner. Each patient was measured at the first emergency department visit and again at 24 h, 48 h, and 72 h post-snakebite. There were three points of measurement on both limbs. RESULTS There were 408 anatomical locations from 17 patients for measurement. The three-dimensional scanner and the measuring tape demonstrated a very high correlation (r-squared >0.940, P value <0.001) in measuring limb circumferences. Bland Altman plots also demonstrated the two methods measured limb circumferences with similar results with mean differences <1 cm. Intraclass correlation coefficient between the two methods was greater than 0.8 in every site for the lower limbs, but for the upper limbs, most sites had a poor agreement (ranges: 0.073-0.633). For limb volume measurement, the three-dimensional scanner provided excellent and moderate inter and intrarater reliabilities for the lower and upper limbs, respectively. DISCUSSION The three-dimensional scanner could be reliably used to assess limb circumference with a strong correlation and with a relatively small error compared with the conventional method. Pictures from the scan can also be constructed to calculate limb volume that could have potential for other clinical purposes such as in evaluating antivenom response for limb swelling. CONCLUSIONS Circumferences from the three-dimensional scanner were comparable to those from the measuring tape, especially for the lower limbs, and the three-dimensional scanner demonstrated an added value for calculating limb volume.
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Affiliation(s)
- Warangkana Pongpat
- Department of Emergency Medicine, Chiangrai Prachanukroh Hospital, Robwiang, Mueang, Thailand
| | - Rittirak Othong
- Department of Emergency Medicine, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Dusit, Thailand
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Heroes AK, Devoogdt N, Damstra RJ, Fourneau I, Gordon K, Keeley V, Thomis S, Van Calster C, Van Zanten M, De Vrieze T. Reliability, concurrent validity, and clinical feasibility of measurement methods determining volume in patients with lower limb lymphedema and healthy controls. Disabil Rehabil 2024:1-15. [PMID: 38975645 DOI: 10.1080/09638288.2024.2374482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 06/24/2024] [Indexed: 07/09/2024]
Abstract
PURPOSE To investigate reliability, concurrent validity, and clinical feasibility of measurements assessing volume in patients with lower limb lymphedema (LLL) and healthy controls. MATERIALS AND METHODS To investigate intra- and interrater reliability, 47 patients with LLL and 30 healthy controls were assessed three times by two assessors. To investigate between session reliability, 50 participants were reassessed two weeks later. Each assessment included measurements of the midline region (hip circumference; suprapubic volume), leg volume (perimeter every 4 cm; Perometer®), and foot volume (water displacement; figure-of-eight method). Concurrent validity was assessed with correlation coefficients. Measurements were timed and practical limitations were reviewed. Clinical trial registration number: NCT: 05269264. RESULTS Measurements of the total volume of different regions showed weak to very high intraclass correlation coefficients (ICCs) (0.131-998). Absolute and relative volume differences had lower ICC values (0.360-0.976). A strong correlation was found between the total volumes of the same region. The Perometer® and figure-of-eight method were the fastest method for leg and foot volume, respectively. CONCLUSIONS The assessed total volumes might be more valuable in assessing the evolution of volume in bilateral LLL than the calculated absolute and relative differences between both limbs. The Perometer® and figure-of-eight method were the most time efficient for leg and foot volume, respectively.Implications for rehabilitationLymphedema is a chronic condition for which a reliable and clinically feasible assessment of volume is essential for the diagnosis, treatment decisions, and the evaluation of the treatment.This study shows that the total leg/foot volumes were more reliable than the calculated absolute and relative differences between both limbs and could therefore more valuable to evaluate bilateral lower limb lymphedema.For the assessment of leg volume, the Perometer® was the most reliable and fastest method.For the evaluation of the foot volume, the figure-of-eight method was overall the best method.
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Affiliation(s)
- An-Kathleen Heroes
- Department of Rehabilitation Sciences, Research Group for Rehabilitation in Internal Disorders (GRID), KU Leuven, University of Leuven, Leuven, Belgium
- Department of Physical Medicine and Rehabilitation and, Department of Vascular Surgery, Centre for Lymphedema, University Hospitals Leuven, Leuven, Belgium
| | - Nele Devoogdt
- Department of Rehabilitation Sciences, Research Group for Rehabilitation in Internal Disorders (GRID), KU Leuven, University of Leuven, Leuven, Belgium
- Department of Physical Medicine and Rehabilitation and, Department of Vascular Surgery, Centre for Lymphedema, University Hospitals Leuven, Leuven, Belgium
- Member European reference Network ERN (VASCERN PPL)
| | - Robert J Damstra
- Dutch Expertise Centre of Lympho-Vascular Medicine, Hospital Nij Smellinghe, Drachten, The Netherlands
- Member European reference Network ERN (VASCERN PPL)
| | - Inge Fourneau
- Department of Physical Medicine and Rehabilitation and, Department of Vascular Surgery, Centre for Lymphedema, University Hospitals Leuven, Leuven, Belgium
- Department of Cardiovascular Sciences, Research Unit Vascular Surgery, KU Leuven-University of Leuven, Leuven, Belgium
| | - Kristiana Gordon
- Department of Lymphovascular Medicine, St George's University Hospitals NHS Foundation Trust, London, UK
- Partner European reference Network ERN (VASCERN PPL)
| | - Vaughan Keeley
- Derby Lymphoedema Service, University Hospitals of Derby and Burton NHS Trust, Derby, UK
- Partner European reference Network ERN (VASCERN PPL)
| | - Sarah Thomis
- Department of Physical Medicine and Rehabilitation and, Department of Vascular Surgery, Centre for Lymphedema, University Hospitals Leuven, Leuven, Belgium
- Department of Cardiovascular Sciences, Research Unit Vascular Surgery, KU Leuven-University of Leuven, Leuven, Belgium
- Member European reference Network ERN (VASCERN PPL)
| | - Charlotte Van Calster
- Department of Rehabilitation Sciences, Research Group for Rehabilitation in Internal Disorders (GRID), KU Leuven, University of Leuven, Leuven, Belgium
| | - Malou Van Zanten
- Department of Lymphovascular Medicine, St George's University Hospitals NHS Foundation Trust, London, UK
| | - Tessa De Vrieze
- Department of Rehabilitation Sciences, Research Group for Rehabilitation in Internal Disorders (GRID), KU Leuven, University of Leuven, Leuven, Belgium
- Department of Rehabilitation Sciences and Physiotherapy (REVAKI), Research Group MOVANT, University of Antwerp, Wilrijk, Belgium
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Taneja S, Barbee DL, Cohen RF, Malin M. Implementation of a Stereoscopic Camera System for Clinical Electron Simulation and Treatment Planning. Pract Radiat Oncol 2024; 14:e291-e300. [PMID: 38325547 DOI: 10.1016/j.prro.2024.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 12/14/2023] [Accepted: 01/08/2024] [Indexed: 02/09/2024]
Abstract
PURPOSE A 3-dimensinal (3D) stereoscopic camera system developed by .decimal was commissioned and implemented into the clinic to improve the efficiency of clinical electron simulations. Capabilities of the camera allowed simulations to be moved from the treatment vault into any room with a flat surface that could accommodate patient positioning devices, eliminating the need for clinical patient setup timeslots on the treatment machine. This work describes the process used for these simulations and compares the treatment parameters determined by the system to those used in delivery. METHODS AND MATERIALS The Decimal3D scanner workflow consisted of: scanning the patient surface; contouring the treatment area; determining gantry, couch, collimator, and source-to-surface distance (SSD) parameters for en face entry of the beam with sufficient clearance at the machine; and ordering custom electron cutouts when needed. Transparencies showing the projection of in-house library cutouts at various clinical SSDs were created to assist in choosing an appropriate library cutout. Data from 73 treatment sites were analyzed to evaluate the accuracy of the scanner-determined beam parameters for each treatment delivery. RESULTS Clinical electron simulations for 73 treatment sites, predominately keloids, were transitioned out of the linear accelerator (LINAC) vault using the new workflow. For all patients, gantry, collimator, and couch parameters, along with SSD and cone size, were determined using the Decimal3D scanner with 57% of simulations using library cutouts. Tolerance tables for patient setup were updated to allow differences of 10, 20, and 5° for gantry, collimator, and couch, respectively. Approximately 7% of fractions (N = 181 total fractions) were set up outside of the tolerance table based on physician direction during treatment. This reflects physician preference to adjust the LINAC rather than patient position during treatment setup. No scanner-derived plan was untreatable because of cutout shape inaccuracy or clearance issues. CONCLUSIONS Clinical electron simulations were successfully transitioned out of the LINAC vault using the Decimal3D scanner without loss of setup accuracy, as measured through machine parameter determination and electron cutout shape.
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Affiliation(s)
- Sameer Taneja
- Department of Radiation Oncology, New York University Langone Medical Center, New York, New York.
| | - David L Barbee
- Department of Radiation Oncology, New York University Langone Medical Center, New York, New York
| | - Richard F Cohen
- Department of Radiation Oncology, New York University Langone Medical Center, New York, New York
| | - Martha Malin
- Department of Radiation Oncology, New York University Langone Medical Center, New York, New York
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Taha W, Benigni JP, Uhl JF, Carpentier PH, Filori P, Bishara R. Performance of an adjustable compression wrap in occupational leg swelling. Phlebology 2024; 39:302-309. [PMID: 38193832 DOI: 10.1177/02683555231226385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2024]
Abstract
BACKGROUND Edema in some subjects worsens over time and wraps help to reduce the leg volume. MATERIAL AND METHODS An adjustable compression wrap was tried on volunteers for 5 h and volumes measured in each limb before and after wrapping using a 3D surface scanner (HandySCAN 3D®) to estimate the volume of the leg. The contralateral leg was used as control. RESULTS We observed a significant decrease in volume in the wrap legs and an increase in the control legs (p < .001), both in the lower part of leg (p = .001) and in the upper part (p = .001). CONCLUSIONS Using the Readywrap® for 5 hours significantly reduces the leg volume. This study enables Readywrap to be studied in a population that is easy to observe in the context of a research program. The Handyscan3D® was shown accurate and reproducible to assess leg volume in future studies.
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Affiliation(s)
- Wassila Taha
- General Secretary of Egyptian African Venous Lymphatic Association, Cairo, Egypt
| | | | | | | | - Pascal Filori
- Physiotherapist, Private Practice Marseille, Marseille, France
| | - Rashad Bishara
- President of Egyptian African Venous Lymphatic Association, Cairo, Egypt
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Hall JM, De Silva NL, Ruben J, Thilakarathne SS, Yahathugoda TC, Budge PJ. Efficacy and Feasibility of Short-Stretch Compression Therapy for Filarial Lymphedema in Sri Lanka. Am J Trop Med Hyg 2024; 110:936-942. [PMID: 38531106 PMCID: PMC11066340 DOI: 10.4269/ajtmh.23-0496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 12/20/2023] [Indexed: 03/28/2024] Open
Abstract
The WHO-recommended essential package of care (EPC) for filarial limb lymphedema consists of daily limb washing, entry lesion management, limb protection, exercises, and elevation. Decongestive therapy (DT) with compression bandaging by trained lymphedema therapists adds additional benefit but is unavailable for most in low- and middle-income countries (LMICs). To determine whether DT using self-adjustable, short-stretch compression garments (SSCG), prefitted using portable, three-dimensional infrared imaging (3DII), would be effective and feasible in LMIC settings, we conducted a pilot 6-week, interventional, single-group, open-label pilot study in Galle, Sri Lanka. Ten participants with Dreyer stage 3 lymphedema used SSCG for 2 weeks after a 4-week lead-in EPC period. Effect of EPC and compression on quality of life was assessed using the 12-item WHO Disability Assessment Schedule 2.0 (WHODAS 2.0). Median participant age was 73 years (range: 32-85 years). Median percent limb volume reduction due to compression was 11.3% (range: 1.1-27.2%). WHODAS 2.0 scores did not change significantly between enrollment and study end. Garment acceptability was high throughout the study. These results provide proof of concept for 3DII-enabled SSCG in LMICs where trained therapists for filarial lymphedema may not be available.
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Affiliation(s)
- Jaimee M. Hall
- Department of Pediatrics, Washington University in St. Louis, St. Louis, Missouri
- Department of Parasitology, Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka
| | | | - Janaka Ruben
- Department of Parasitology, Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka
| | | | | | - Philip J. Budge
- Department of Medicine, Washington University in St. Louis, St. Louis, Missouri
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Anik AR, Hasan K, Islam MM, Hasan MM, Ali MF, Das SK. Non-Invasive Portable Technologies for Monitoring Breast Cancer Related Lymphedema to Facilitate Telehealth: A Scoping Review. IEEE J Biomed Health Inform 2023; 27:4524-4535. [PMID: 37247315 DOI: 10.1109/jbhi.2023.3280196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Breast cancer related lymphedema (BCRL) is a common, debilitating condition that can affect up to one in five breast cancer surviving patients (BCSP). BCRL can significantly reduce the quality of life (QOL) of patients and poses a significant challenge to healthcare providers. Early detection and continuous monitoring of lymphedema is crucial for the development of client-centered treatment plans for post-cancer surgery patients. Therefore, this comprehensive scoping review aimed to investigate the current technology methods used for the remote monitoring of BCRL and their potential to facilitate telehealth in the treatment of lymphedema. Initially, five electronic databases were systematically searched and analyzed following the PRISMA flow diagram. Studies were included, specifically if they provided data on the effectiveness of the intervention and were designed for the remote monitoring of BCRL. A total of 25 included studies reported 18 technological solutions to remotely monitor BCRL with significant methodological variation. Additionally, the technologies were categorized by method of detection and wearability. The findings of this comprehensive scoping review indicate that state-of-the-art commercial technologies were found to be more appropriate for clinical use than home monitoring, with portable 3D imaging tools being popular (SD 53.40) and accurate (correlation 0.9, p 0.05) for evaluating lymphedema in both clinic and home settings with expert practitioners and therapists. However, wearable technologies showed the most future potential for accessible and clinical long-term lymphedema management with positive telehealth outcomes. In conclusion, the absence of a viable telehealth device highlights the need for urgent research to develop a wearable device that can effectively track BCRL and facilitate remote monitoring, ultimately improving the quality of life for patients following post-cancer treatment.
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Bianchi LMG, Irmici G, Cè M, D'Ascoli E, Della Pepa G, Di Vita F, Casati O, Soresina M, Menozzi A, Khenkina N, Cellina M. Diagnosis and Treatment of Post-Prostatectomy Lymphedema: What's New? Curr Oncol 2023; 30:4512-4526. [PMID: 37232799 DOI: 10.3390/curroncol30050341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 04/24/2023] [Accepted: 04/24/2023] [Indexed: 05/27/2023] Open
Abstract
Lymphedema is a chronic progressive disorder that significantly compromises patients' quality of life. In Western countries, it often results from cancer treatment, as in the case of post-radical prostatectomy lymphedema, where it can affect up to 20% of patients, with a significant disease burden. Traditionally, diagnosis, assessment of severity, and management of disease have relied on clinical assessment. In this landscape, physical and conservative treatments, including bandages and lymphatic drainage have shown limited results. Recent advances in imaging technology are revolutionizing the approach to this disorder: magnetic resonance imaging has shown satisfactory results in differential diagnosis, quantitative classification of severity, and most appropriate treatment planning. Further innovations in microsurgical techniques, based on the use of indocyanine green to map lymphatic vessels during surgery, have improved the efficacy of secondary LE treatment and led to the development of new surgical approaches. Physiologic surgical interventions, including lymphovenous anastomosis (LVA) and vascularized lymph node transplant (VLNT), are going to face widespread diffusion. A combined approach to microsurgical treatment provides the best results: LVA is effective in promoting lymphatic drainage, bridging VLNT delayed lymphangiogenic and immunological effects in the lymphatic impairment site. Simultaneous VLNT and LVA are safe and effective for patients with both early and advanced stages of post-prostatectomy LE. A new perspective is now represented by the combination of microsurgical treatments with the positioning of nano fibrillar collagen scaffolds (BioBridgeTM) to favor restoring the lymphatic function, allowing for improved and sustained volume reduction. In this narrative review, we proposed an overview of new strategies for diagnosing and treating post-prostatectomy lymphedema to get the most appropriate and successful patient treatment with an overview of the main artificial intelligence applications in the prevention, diagnosis, and management of lymphedema.
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Affiliation(s)
| | - Giovanni Irmici
- Postgraduation School in Radiodiagnostics, University of Milan, 20122 Milan, Italy
| | - Maurizio Cè
- Postgraduation School in Radiodiagnostics, University of Milan, 20122 Milan, Italy
| | - Elisa D'Ascoli
- Postgraduation School in Radiodiagnostics, University of Milan, 20122 Milan, Italy
| | - Gianmarco Della Pepa
- Postgraduation School in Radiodiagnostics, University of Milan, 20122 Milan, Italy
| | - Filippo Di Vita
- Postgraduation School in Plastic Surgery, University of Milan, Via Festa del Perdono, 7, 20122 Milan, Italy
| | - Omar Casati
- Postgraduation School in Plastic Surgery, University of Milan, Via Festa del Perdono, 7, 20122 Milan, Italy
| | - Massimo Soresina
- Plastic Surgery Department, Fatebenefratelli Hospital, ASST Fatebenefratelli Sacco, 20121 Milan, Italy
| | - Andrea Menozzi
- Plastic Surgery Department, Fatebenefratelli Hospital, ASST Fatebenefratelli Sacco, 20121 Milan, Italy
| | - Natallia Khenkina
- Postgraduation School in Radiodiagnostics, University of Milan, 20122 Milan, Italy
| | - Michaela Cellina
- Radiology Department, Fatebenefratelli Hospital, ASST Fatebenefratelli Sacco, 20121 Milan, Italy
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Nascimben M, Lippi L, Fusco N, Invernizzi M, Rimondini L. A Software Suite for Limb Volume Analysis Applicable in Clinical Settings: Upper Limb Quantification. Front Bioeng Biotechnol 2022; 10:863689. [PMID: 36798789 PMCID: PMC9928154 DOI: 10.3389/fbioe.2022.863689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 04/18/2022] [Indexed: 02/01/2023] Open
Abstract
In medicine, tridimensional scanning devices produce digital surfaces that replicate the bodies of patients, facilitating anthropometric measurement and limb volume quantification in pathological conditions. Free programs that address this task are not commonly found, with doctors mainly relying on proprietary software. This aspect brings reduced reproducibility of studies and evaluation of alternative measures. A software package made up of three programs has been developed and released together with supporting materials to enhance reproducibility and comparisons between medical centers. In this article, the functions of the programs and steps for volume assessment were introduced together with a pilot study for upper limb volume quantification. This initial experiment aimed to also verify the performance of digital volumes derived from the convex-hull gift-wrapping algorithm and the alternative analysis methods enclosed in the software. Few of these digital volumes are parameter-dependent, requiring a value selection. The experiment was conducted on a small mixed-gender group of young adults without correction for factors like arm dominance or specific physical training. In the sample under investigation, the analysis confirmed the substantial agreement between the clinical and current configurations of digital volumes produced by the package (R 2 interval from 0.93 to 0.97, r ranged from 0.965 to 0.984); in addition, as a general consideration, gender appears as a variable that could influence upper limb volume quantification if a single model is built.
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Affiliation(s)
- Mauro Nascimben
- Department of Health Sciences, Center for Translational Research on Autoimmune and Allergic Diseases-CAAD, Università Del Piemonte Orientale (UPO), Novara, Italy,Enginsoft SpA, Padova, Italy,*Correspondence: Mauro Nascimben ,
| | - Lorenzo Lippi
- Physical and Rehabilitative Medicine Unit, Department of Health Sciences, Università Del Piemonte Orientale (UPO), Novara, Italy
| | - Nicola Fusco
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy,Division of Pathology, European Institute of Oncology IRCCS, Milan, Italy
| | - Marco Invernizzi
- Physical and Rehabilitative Medicine Unit, Department of Health Sciences, Università Del Piemonte Orientale (UPO), Novara, Italy,Dipartimento Attività Integrate Ricerca e Innovazione (DAIRI), Translational Medicine, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Lia Rimondini
- Department of Health Sciences, Center for Translational Research on Autoimmune and Allergic Diseases-CAAD, Università Del Piemonte Orientale (UPO), Novara, Italy
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Bennett JP, Liu YE, Quon BK, Kelly NN, Wong MC, Kennedy SF, Chow DC, Garber AK, Weiss EJ, Heymsfield SB, Shepherd JA. Assessment of clinical measures of total and regional body composition from a commercial 3-dimensional optical body scanner. Clin Nutr 2022; 41:211-218. [PMID: 34915272 PMCID: PMC8727542 DOI: 10.1016/j.clnu.2021.11.031] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 11/16/2021] [Accepted: 11/24/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND The accurate assessment of total body and regional body circumferences, volumes, and compositions are critical to monitor physical activity and dietary interventions, as well as accurate disease classifications including obesity, metabolic syndrome, sarcopenia, and lymphedema. We assessed body composition and anthropometry estimates provided by a commercial 3-dimensional optical (3DO) imaging system compared to criterion measures. METHODS Participants of the Shape Up! Adults study were recruited for similar sized stratifications by sex, age (18-40, 40-60, >60 years), BMI (under, normal, overweight, obese), and across five ethnicities (non-Hispanic [NH] Black, NH White, Hispanic, Asian, Native Hawaiian/Pacific Islander). All participants received manual anthropometry assessments, duplicate whole-body 3DO (Styku S100), and dual-energy X-ray absorptiometry (DXA) scans. 3DO estimates provided by the manufacturer for anthropometry and body composition were compared to the criterion measures using concordance correlation coefficient (CCC) and Bland-Altman analysis. Test-retest precision was assessed by root mean square error (RMSE) and coefficient of variation. RESULTS A total of 188 (102 female) participants were included. The overall fat free mass (FFM) as measured by DXA (54.1 ± 15.2 kg) and 3DO (55.3 ± 15.0 kg) showed a small mean difference of 1.2 ± 3.4 kg (95% limits of agreement -7.0 to +5.6) and the CCC was 0.97 (95% CI: 0.96-0.98). The CCC for FM was 0.95 (95% CI: 0.94-0.97) and the mean difference of 1.3 ± 3.4 kg (95% CI: -5.5 to +8.1) reflected the difference in FFM measures. 3DO anthropometry and body composition measurements showed high test-retest precision for whole body volume (1.1 L), fat mass (0.41 kg), percent fat (0.60%), arm and leg volumes, (0.11 and 0.21 L, respectively), and waist and hip circumferences (all <0.60 cm). No group differences were observed when stratified by body mass index, sex, or race/ethnicity. CONCLUSIONS The anthropometric and body composition estimates provided by the 3DO scanner are precise and accurate to criterion methods if offsets are considered. This method offers a rapid, broadly available, and automated method of body composition assessment regardless of body size. Further studies are recommended to examine the relationship between measurements obtained by 3DO scans and metabolic health in healthy and clinical populations.
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Affiliation(s)
- Jonathan P Bennett
- Graduate Program in Human Nutrition, University of Hawai'i Manoa, Agricultural Science Building, 1955 East-West Rd, Honolulu, HI, 96822, USA; Department of Epidemiology, University of Hawai'i Cancer Center, 701 Ilalo St, Honolulu, HI, 96813, USA.
| | - Yong En Liu
- Department of Epidemiology, University of Hawai'i Cancer Center, 701 Ilalo St, Honolulu, HI, 96813, USA
| | - Brandon K Quon
- Department of Epidemiology, University of Hawai'i Cancer Center, 701 Ilalo St, Honolulu, HI, 96813, USA
| | - Nisa N Kelly
- Department of Epidemiology, University of Hawai'i Cancer Center, 701 Ilalo St, Honolulu, HI, 96813, USA
| | - Michael C Wong
- Graduate Program in Human Nutrition, University of Hawai'i Manoa, Agricultural Science Building, 1955 East-West Rd, Honolulu, HI, 96822, USA; Department of Epidemiology, University of Hawai'i Cancer Center, 701 Ilalo St, Honolulu, HI, 96813, USA
| | - Samantha F Kennedy
- Pennington Biomedical Research Center, Louisiana State University, 6400 Perkins Rd, Baton Rouge, LA, 70808, USA
| | - Dominic C Chow
- John A. Burns School of Medicine, University of Hawaii, 651 Ilalo St, Honolulu, HI, 96813, USA
| | - Andrea K Garber
- Division of Adolescent & Young Adult Medicine, University of California, San Francisco, 3333 California Street, Suite 245, CA, 94118, USA
| | - Ethan J Weiss
- University of California School of Medicine, 555 Mission Bay Blvd South, San Francisco, CA, 94158, USA
| | - Steven B Heymsfield
- Pennington Biomedical Research Center, Louisiana State University, 6400 Perkins Rd, Baton Rouge, LA, 70808, USA
| | - John A Shepherd
- Graduate Program in Human Nutrition, University of Hawai'i Manoa, Agricultural Science Building, 1955 East-West Rd, Honolulu, HI, 96822, USA; Department of Epidemiology, University of Hawai'i Cancer Center, 701 Ilalo St, Honolulu, HI, 96813, USA
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10
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Douglass J, Martindale S, Mableson H, Jhara ST, Karim MJ, Rahman MM, Kawsar AA, Khair A, Mahmood ASMS, Rahman AKMF, Chowdhury SM, Hailekiros F, Tamiru M, Seife F, Bishaw T, Nigussie M, Meribo K, Agidew G, Betts H, Taylor MJ, Kelly-Hope LA. Insights on Lymphedema Self-Care Knowledge and Practice in Filariasis and Podoconiosis-Endemic Communities in Bangladesh and Ethiopia. FRONTIERS IN TROPICAL DISEASES 2021. [DOI: 10.3389/fitd.2021.767045] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Lymphedema is a life-long sequelae to several neglected tropical diseases (NTD). In Bangladesh the main cause is lymphatic filariasis (LF) and Ethiopia is endemic for both LF and podoconiosis. The World Health Organization (WHO) recommends daily self-care including meticulous washing and drying of affected skin and attention to entry lesions, limb exercises and elevation. Adherence to this regime reduces secondary infections which cause disabling episodes of acute dermato-lymphangitis (ADL). Self-care practices must be integrated into family life, supported by community and monitored by health staff; however, little is known about the influence of personal and socio-demographic factors on adherence. People affected by lymphedema (n=272), adult caregivers (n=272), and health workers (n=68) in Bangladesh and Ethiopia were trained in lymphedema management according to WHO recommendations. Surveys on the causes and management of lymphedema were collected at baseline and 24-weeks, and patients completed a daily journal of self-care activities and symptoms. At baseline knowledge on causes and management of lymphedema was greater among health workers (>70%) than patients and caregivers (<20%) in both countries, and there were significant between-country differences in patient reported use of limb washing (Bangladesh = 7.7%. Ethiopia = 51.1%, p = 0.001). At 24-weeks knowledge on lymphedema causes and management had increased significantly among patients and caregivers, there was <70% adherence to limb washing and exercises, but lesser use of limb elevation in both countries. A range of patient characteristics were associated with significant variation in self-care, except for limb washing. Performance of fewer leg exercises was significantly associated with increased age or severe lymphedema in Bangladesh, and with being female or in paid work in Ethiopia. Patient journals recorded ADL symptoms and working days lost due to lymphedema more frequently than were reported by recall during the 24-week survey. Core elements of lymphedema self-care education, training and monitoring are the same for multiple etiologies. This creates opportunities for cross-cutting implementation of integrated service delivery across several skin NTDs. Sustainability will depend on community level ownership and research on factors affecting adherence to lymphedema self-care are urgently needed.
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Deribe K, Mackenzie CD, Newport MJ, Argaw D, Molyneux DH, Davey G. Podoconiosis: key priorities for research and implementation. Trans R Soc Trop Med Hyg 2021; 114:889-895. [PMID: 33169167 PMCID: PMC7738650 DOI: 10.1093/trstmh/traa094] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 07/31/2020] [Accepted: 08/27/2020] [Indexed: 12/14/2022] Open
Abstract
Podoconiosis is a non-infectious tropical lymphoedema causing swelling of the lower legs. Podoconiosis is associated with stigma, depression and reduced productivity, resulting in significant socio-economic impacts for affected individuals, families and communities. It is caused by barefoot exposure to soils and affects disadvantaged populations. Evidence from the past 5 y suggests that podoconiosis is amenable to public health interventions, e.g. footwear and hygiene-based morbidity management, which reduce acute clinical episodes. Although much has been learned in recent years, advances in care for these patients and worldwide control requires further reliable and relevant research. To develop a comprehensive global control strategy, the following key research priorities are important: better understanding of the global burden of podoconiosis through extended worldwide mapping, development of new point-of-care diagnostic methods and approaches to define the presence of the environmental characteristics that contribute to the development of the condition, improving treatment through an increased understanding of the pathogenesis of dermal changes over time, improved understanding of optimal ways of providing patient care at the national level, including research to optimize behavioural change strategies, determine the optimum package of care and integrate approaches to deliver robust surveillance, monitoring and evaluation of control programmes.
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Affiliation(s)
- Kebede Deribe
- Brighton and Sussex Centre for Global Health Research, Department of Global Health and Infection, Brighton and Sussex Medical School, Brighton BN1 9PX, UK.,School of Public Health, College of Health Sciences, Addis Ababa University, PO Box 9086, Addis Ababa, Ethiopia
| | | | - Melanie J Newport
- Brighton and Sussex Centre for Global Health Research, Department of Global Health and Infection, Brighton and Sussex Medical School, Brighton BN1 9PX, UK
| | - Daniel Argaw
- World Health Organization, Control of Neglected Tropical Diseases, Geneva 1211, Switzerland
| | | | - Gail Davey
- Brighton and Sussex Centre for Global Health Research, Department of Global Health and Infection, Brighton and Sussex Medical School, Brighton BN1 9PX, UK.,School of Public Health, College of Health Sciences, Addis Ababa University, PO Box 9086, Addis Ababa, Ethiopia
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Bucci LK, Brunelle CL, Bernstein MC, Shui AM, Gillespie TC, Roberts SA, Naoum GE, Taghian AG. Subclinical Lymphedema After Treatment for Breast Cancer: Risk of Progression and Considerations for Early Intervention. Ann Surg Oncol 2021; 28:8624-8633. [PMID: 34117574 DOI: 10.1245/s10434-021-10173-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 03/29/2021] [Indexed: 01/04/2023]
Abstract
BACKGROUND Breast cancer-related lymphedema (BCRL) is a devastating complication of breast cancer (BC) treatment. The authors hypothesized that identifying subclinical lymphedema (SCL) presents an opportunity to prevent BCRL development. They aimed to assess rates of SCL progression (relative volume change [RVC], 5-10%) to BCRL (RVC, ≥10%) in women undergoing axillary surgery for BC via axillary lymph node dissection (ALND) or sentinel lymph node biopsy (SLNB). METHODS Patients treated for BC were prospectively screened at preoperative baseline and throughout the follow-up period using the perometer. The cohort was stratified according to nodal surgery (ALND or SLNB) to analyze rates of progression to BCRL. RESULTS The study cohort included 1790 patients. Of the 1359 patients who underwent SLNB, 331 (24.4%) experienced SCL, with 38 (11.5%) of these patients progressing to BCRL. Of the 431 patients who underwent ALND, 171 (39.7%) experienced SCL, with 67 (39.2%) of these patients progressing to BCRL. Relative to the patients without SCL, those more likely to experience BCRL were the ALND patients with early SCL (< 3 months postoperatively; hazard ratio [HR], 2.60; 95% confidence interval [CI], 1.58-4.27; p = 0.0002) or late SCL (≥3 months postoperatively; HR, 3.14; 95% CI, 1.95-5.05; p < 0.0001) and the SLNB patients with early SCL (HR, 6.75; 95% CI, 3.8-11.98; p < 0.0001 or late SCL (HR, 3.02; 95% CI, 1.65-5.50; p = 0.0003). CONCLUSION The study suggests that patients with SCL after axillary nodal surgery for BC are more likely to progress to BCRL than those who do not experience SCL. This presents a tremendous opportunity for early intervention to prevent BCRL and improve the quality of life for women treated for BC.
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Affiliation(s)
- Loryn K Bucci
- Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Cheryl L Brunelle
- Department of Physical and Occupational Therapy, Massachusetts General Hospital, Boston, MA, USA
| | - Madison C Bernstein
- Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Amy M Shui
- Biostatistics Center, Massachusetts General Hospital, Boston, MA, USA
| | - Tessa C Gillespie
- Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Sacha A Roberts
- Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - George E Naoum
- Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Alphonse G Taghian
- Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
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Infrared Thermal Imaging as a Novel Non-Invasive Point-of-Care Tool to Assess Filarial Lymphoedema. J Clin Med 2021; 10:jcm10112301. [PMID: 34070599 PMCID: PMC8198125 DOI: 10.3390/jcm10112301] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 05/19/2021] [Accepted: 05/21/2021] [Indexed: 12/13/2022] Open
Abstract
Lymphatic filariasis causes disfiguring and disabling lymphoedema, which is commonly and frequently exacerbated by acute dermatolymphangioadenitis (ADLA). Affected people require long-term care and monitoring but health workers lack objective assessment tools. We examine the use of an infrared thermal imaging camera as a novel non-invasive point-of-care tool for filarial lower-limb lymphoedema in 153 affected adults from a highly endemic area of Bangladesh. Temperature differences by lymphoedema stage (mild, moderate, severe) and ADLA history were visualised and quantified using descriptive statistics and regression models. Temperatures were found to increase by severity and captured subclinical differences between no lymphoedema and mild lymphoedema, and differences between moderate and severe stages. Toes and ankle temperatures detected significant differences between all stages other than between mild and moderate stages. Significantly higher temperatures, best captured by heel and calf measures, were found in participants with a history of ADLA, compared to participants who never had ADLA, regardless of the lymphoedema stage. This novel tool has great potential to be used by health workers to detect subclinical cases, predict progression of disease and ADLA status, and monitor pathological tissue changes and stage severity following enhanced care packages or other interventions in people affected by lymphoedema.
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14
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Mackenzie CD, Mante S. Caring for patients in the global programme to eliminate lymphatic filariasis. Int Health 2021; 13:S48-S54. [PMID: 33349884 PMCID: PMC7753172 DOI: 10.1093/inthealth/ihaa080] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 08/12/2020] [Accepted: 09/23/2020] [Indexed: 11/16/2022] Open
Abstract
Clinical lymphatic filariasis (LF) is a debilitating, disfiguring medical condition with severe psychosocial consequences for patients and their families. Addressing these patients’ medical needs is a major component of the global programme to eliminate lymphatic filariasis (GPELF). In the 20 y of providing a minimal package of care many thousands of surgical operations to correct LF hydrocoeles been performed and national programmes in >90% of LF endemic countries have received the training needed to care for their patients. The creation of educational materials detailing appropriate patient care, together with increased funding, have been key catalysts in increasing awareness of clinical LF in recent years. Nevertheless, the implementation of care for these patients has often faced challenges that have led to delays in fully implementing the patient care component of GPELF; these include locating these often stigmatised individuals, maintaining provision of the necessary consumables (e.g. soaps and creams) and maintaining programme support within already overstretched national LF teams. As the LF global programme moves to achieve success by 2030 it will be vital to continue to focus efforts on the care and rehabilitation of those suffering from lymphoedema and hydrocoeles, learning from the experiences of the past 20 y.
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Affiliation(s)
| | - Sunny Mante
- African Filariasis Morbidity Project, Korle BU, Accra, Ghana
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Krishnasastry S, Mackenzie CD. Alternative approaches to lymphoedema care in lymphatic filariasis. PLoS Negl Trop Dis 2021; 15:e0009293. [PMID: 33914741 PMCID: PMC8084153 DOI: 10.1371/journal.pntd.0009293] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Suma Krishnasastry
- WHO Collaborating Centre for Lymphatic Filariasis Morbidity, Government TD Medical College, Alappuzha, Kerala, India
| | - Charles D. Mackenzie
- Neglected Tropical Diseases Support Center, Task Force for Global Health, Atlanta, Georgia, United States of America
- * E-mail:
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White BN, Okoli J, Dixon JB, Yuan L, Yang S, Gabram-Mendola SGA. Use of a portable infrared 3D scanning device measuring limb volume in a safety net hospital breast clinic. Breast J 2021; 27:559-561. [PMID: 33724606 DOI: 10.1111/tbj.14221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 02/25/2021] [Accepted: 02/25/2021] [Indexed: 11/27/2022]
Affiliation(s)
| | - Joel Okoli
- Morehouse School of Medicine/Grady Memorial Hospital, Atlanta, GA, USA
| | | | - Liu Yuan
- Winship Cancer Institute, Atlanta, GA, USA
| | - Steven Yang
- School of Medicine, Emory University, Atlanta, GA, USA
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Sundrasekaran A, Abdalla E, Sobani S, Shafi M, Al-Mudahka NR. Physiotherapy Management Response for Patients With Lymphedema Amid the COVID-19 Pandemic in the State of Qatar: A Perspective Study. REHABILITATION ONCOLOGY 2021. [DOI: 10.1097/01.reo.0000000000000255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Havens LM, Brunelle CL, Gillespie TC, Bernstein M, Bucci LK, Kassamani YW, Taghian AG. Use of technology to facilitate a prospective surveillance program for breast cancer-related lymphedema at the Massachusetts General Hospital. Mhealth 2021; 7:11. [PMID: 33634194 PMCID: PMC7882272 DOI: 10.21037/mhealth-19-218] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Accepted: 04/29/2020] [Indexed: 11/06/2022] Open
Abstract
Breast cancer-related lymphedema (BCRL) is a negative sequela of breast cancer (BC) caused by trauma to the lymphatic system during surgery or radiation to the axillary lymph nodes. BCRL affects approximately one in five patients treated for BC, and patients are at a lifelong risk for BCRL after treatment. Early diagnosis of BCRL may prevent its progression and reduce negative effects on quality of life, necessitating comprehensive prospective screening. This paper provides an overview of technology that may be used as part of a BCRL screening program, including objective measures such as perometry, bioimpedance spectroscopy, tissue tonometry, and three-dimensional optical imaging. Furthermore, this paper comprehensively reviews the technology incorporated into the established prospective screening program at Massachusetts General Hospital. Our prospective screening program consists of longitudinal measurements via perometry, symptoms assessment, and clinical examination by a certified lymphedema therapist (CLT) as needed. Discussion about use of perometry within the screening program and incorporation of arm volume measurements into equations to determine change over time and accurate diagnosis is included [relative volume change (RVC) and weight-adjusted change (WAC) equations]. Use of technology throughout the program is discussed, including a HIPPA-compliant online research database, the patient's electronic medical record, and incorporation of BCRL-related symptoms [BC and lymphedema symptom experience index (BCLE-SEI) survey]. Ultimately, both subjective and objective data are used to inform BCRL diagnosis and treatment by the CLT. In conclusion, the role of technology in facilitating BCRL screening is indispensable, and the continued development of objective assessment methods that are not only reliable and valid, but also cost-effective and portable will help establish BCRL screening as the standard of care for patients treated for BC.
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Affiliation(s)
- Lauren M. Havens
- Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA, USA
| | - Cheryl L. Brunelle
- Department of Physical and Occupational Therapy, Massachusetts General Hospital, Boston, MA, USA
| | - Tessa C. Gillespie
- Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA, USA
| | - Madison Bernstein
- Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA, USA
| | - Loryn K. Bucci
- Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA, USA
| | - Yara W. Kassamani
- Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA, USA
| | - Alphonse G. Taghian
- Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA, USA
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White BN, Lu IM, Kao LS, Dixon JB, Weiler MJ, Frank ND, Binkley J, Subhedar P, Okoli J, Buhariwalla K, Suarez-Ligon A, Gabram-Mendola SGA. An infrared 3D scanning device as a novel limb volume measurement tool in breast cancer patients. World J Surg Oncol 2020; 18:278. [PMID: 33109204 PMCID: PMC7592580 DOI: 10.1186/s12957-020-02043-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 10/02/2020] [Indexed: 12/24/2022] Open
Abstract
Abstract Background Lymphedema is a common complication of breast cancer treatment that affects one in five breast cancer survivors, yet there is no reliable method to detect lymphedema in the subclinical range. The objective of this study was to determine the feasibility and reliability of using an infrared 3D scanning device (ISD) as a peri-operative limb volume measurement tool. Methods Fifteen patients were analyzed based on inclusion criteria. Peri-operative measurements were obtained using tape measure and an ISD. Volumes were calculated using a standard algorithm for tape measure and a custom algorithm for ISD measurements. Linear regression models were used to assess ISD and tape measurement volume and circumference correlation. One-way ANOVA was used to compare change in percent difference at set time points post-operatively (2–3 weeks, 4–6 weeks, and 7–12 weeks) for both ISD and tape measure. t tests for unequal variances with the Bonferroni correction were performed among these groups. Results There is a positive linear correlation (R2 = 0.8518) between absolute volume measurements by the ISD and tape measure. Analyses over 2–10 weeks post-operatively showed that the ISD was able to detect volume changes in both the unaffected and the affected arm. Furthermore, the affected arm tended to have a greater increase in volume in the majority of patients, indicating these patients could be at risk for lymphedema. Conclusions Technology utilizing infrared 3D scanners can reliably measure limb volume pre- and post-treatment similarly to tape measure in a small sample of patients. Further research using 3D scanning technology with a longer follow up is warranted.
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Affiliation(s)
- Bernadette N White
- Emory University School of Medicine and Grady Memorial Hospital Avon Comprehensive Breast Center, Atlanta, GA, USA
| | - Iris M Lu
- Georgia Institute of Technology, Atlanta, GA, USA
| | - LeslieAnn S Kao
- Emory University School of Medicine and Grady Memorial Hospital Avon Comprehensive Breast Center, Atlanta, GA, USA
| | | | | | | | - Jill Binkley
- TurningPoint Breast Cancer Rehabilitation, Atlanta, GA, USA
| | - Preeti Subhedar
- Emory University School of Medicine and Grady Memorial Hospital Avon Comprehensive Breast Center, Atlanta, GA, USA
| | - Joel Okoli
- Morehouse School of Medicine, Atlanta, GA, USA
| | | | | | - Sheryl G A Gabram-Mendola
- Emory University School of Medicine and Grady Memorial Hospital Avon Comprehensive Breast Center, Atlanta, GA, USA.
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Tischer T, Oye S, Wolf A, Feldhege F, Jacksteit R, Mittelmeier W, Bader R, Mau-Moeller A. Measuring lower limb circumference and volume – introduction of a novel optical 3D volumetric measurement system. ACTA ACUST UNITED AC 2020; 65:237-241. [DOI: 10.1515/bmt-2018-0100] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2018] [Accepted: 06/24/2019] [Indexed: 11/15/2022]
Abstract
AbstractThis study comprised two experiments: (1) the reliability of a novel optical three-dimensional (3D) volumetric measurement system (BODYTRONIC® 600) for the assessment of lower limb circumference and volume; (2) the comparison of data obtained from BODYTRONIC® 600 with that provided by computed tomography (CT) for accuracy estimation. Reliability was assessed in 20 healthy subjects. Accuracy was determined by comparing the deviations in the surface topology of two 3D models obtained from BODYTRONIC® 600 and CT. Reliability was very high for leg circumference measures [coefficient of variations (CVs) range 0.3%–1.3%] and slightly lower for foot circumference (CVs around 2.0%). Reliability of leg volume was also found to be very high (CVs ≤ 2.5%). Differences in surface topology between BODYTRONIC® 600 and CT were primarily below 1 mm indicating high accuracy. The volumes of the foot were higher (range 0.9%–1.7%) and that of the leg, lower (range 1.0%–1.3%) compared to CT. The BODYTRONIC® 600 system provides fast, highly reliable and accurate measures of lower limb circumference and volume and can be considered as a valuable measurement tool for use in various research and clinical applications.
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Affiliation(s)
- Thomas Tischer
- Department of Orthopaedics, University Medicine Rostock, Doberaner Strasse 142, D-18057 Rostock, Germany
| | - Sebastian Oye
- Department of Orthopaedics, University Medicine Rostock, Doberaner Strasse 142, D-18057 Rostock, Germany
| | - Andreas Wolf
- Department of Orthopaedics, University Medicine Rostock, Doberaner Strasse 142, D-18057 Rostock, Germany
| | - Frank Feldhege
- Department of Orthopaedics, University Medicine Rostock, Doberaner Strasse 142, D-18057 Rostock, Germany
| | - Robert Jacksteit
- Department of Orthopaedics, University Medicine Rostock, Doberaner Strasse 142, D-18057 Rostock, Germany
| | - Wolfram Mittelmeier
- Department of Orthopaedics, University Medicine Rostock, Doberaner Strasse 142, D-18057 Rostock, Germany
| | - Rainer Bader
- Department of Orthopaedics, University Medicine Rostock, Doberaner Strasse 142, D-18057 Rostock, Germany
| | - Anett Mau-Moeller
- Department of Orthopaedics, University Medicine Rostock, Doberaner Strasse 142, D-18057 Rostock, Germany
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Horton J, Klarmann-Schulz U, Stephens M, Budge PJ, Coulibaly Y, Debrah A, Debrah LB, Krishnasastry S, Mwingira U, Ngenya A, Wanji S, Weerasooriya M, Yahathugoda C, Kroidl I, Deathe D, Majewski A, Sullivan S, Mackenzie C, Nutman TB, Shott JP, Weil G, Ottesen E, Hoerauf A. The design and development of a multicentric protocol to investigate the impact of adjunctive doxycycline on the management of peripheral lymphoedema caused by lymphatic filariasis and podoconiosis. Parasit Vectors 2020; 13:155. [PMID: 32228663 PMCID: PMC7106687 DOI: 10.1186/s13071-020-04024-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 03/16/2020] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND As new lymphatic filariasis infections are eliminated through mass chemotherapy, previously affected individuals are left with the sequellae, especially chronic progressive lymphoedema. Currently this is managed by careful attention to limb hygiene to prevent infection. Studies over the past 15 years have suggested that the incorporation of doxycycline treatment may arrest or even reverse progression of lymphoedema. Most of this work has been observational or based on small studies, and if this intervention is effective, studies need to be conducted on a larger scale and under diverse geographical and social conditions before it can be incorporated into treatment policy. METHODS/DESIGN The double-blind, placebo-controlled study was designed to investigate the impact of six weeks treatment with doxycycline added to standard limb hygiene on early stage filarial lymphoedema in five sites in Africa and the Indian subcontinent. One site in Cameroon is selected for studying lymphoedema in podoconiosis. Each site was individually powered with the potential to undertake a meta-analysis on completion. Evaluation methods followed those used in Ghana in 2012 with additions resulting from advances in technology. The details of the core protocol and how it was varied to take account of differing situations at each of the sites are provided. The study will enrol up to 1800 patients and will complete in mid-2021. CONCLUSIONS This paper provides details of what challenges were faced during its development and discusses the issues and how they were resolved. In particular, the reasons for inclusion of new technology and the problems encountered with the supply of drugs for the studies are described in detail. By making these details available, it is hoped that the study protocol will help others interested in improving treatment for filarial lymphoedema in the design of future studies. Trial registration India: Clintrials.gov. NCT02929121 registered 10 Oct 2016: https://clinicaltrials.gov/ct2/show/NCT02929121 Mali: Clintrials.gov. NCT02927496 registered 7 Oct 2016: https://clinicaltrials.gov/ct2/show/NCT0292749 Sri Lanka: Clintrials.gov. NCT02929134 registered 10 Oct 2016: https://clinicaltrials.gov/ct2/show/NCT02929134 Ghana: ISRCTN. 14042737 registered 10 July 2017: https://doi.org/10.1186/ISRCTN14042737 Tanzania: ISRCTN. 65756724 registered 21 July 2017: https://doi.org/10.1186/ISRCTN65756724 Cameroon: ISRCTN. 1181662 registered 25 July 2017: https://doi.org/10.1186/ISRCTN11881662.
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Affiliation(s)
- John Horton
- Tropical Projects, 24 The Paddock, Hitchin, UK
| | - Ute Klarmann-Schulz
- Institute for Medical Microbiology, Immunology and Parasitology (IMMIP), German Centre for Infection Research (DZIF), Bonn-Cologne Site, University Hospital Bonn, Venusberg-Campus 1, 53105 Bonn, Germany
| | - Mariana Stephens
- Neglected Tropical Diseases Support Center, Task Force for Global Health, Decatur, GA USA
| | | | - Yaya Coulibaly
- Filariasis Research Unit, International Center for Excellence in Research, ICER-Mali, Bamako, Mali
| | - Alex Debrah
- Faculty of Allied Health Sciences, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana
| | - Linda Batsa Debrah
- Department of Microbiology, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana
| | - Suma Krishnasastry
- Filariasis Research Unit, Govt. T D Medical College, Kerala, 699005 India
| | - Upendo Mwingira
- National Institute for Medical Research, Dar es Salaam, Tanzania
| | - Abdallah Ngenya
- National Institute for Medical Research, Dar es Salaam, Tanzania
| | - Samuel Wanji
- Department of Microbiology and Parasitology, University of Buea, Buea, SW State Cameroon
| | - Mirani Weerasooriya
- Filariasis Research Training and Services Unit (FRTSU), Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka
| | - Channa Yahathugoda
- Filariasis Research Training and Services Unit (FRTSU), Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka
| | - Inge Kroidl
- Division of Infectious Diseases and Tropical Medicine, University Hospital of the University of Munich (LMU), Munich, Germany
| | - Drew Deathe
- Neglected Tropical Diseases Support Center, Task Force for Global Health, Decatur, GA USA
| | - Andrew Majewski
- Neglected Tropical Diseases Support Center, Task Force for Global Health, Decatur, GA USA
| | - Sarah Sullivan
- Neglected Tropical Diseases Support Center, Task Force for Global Health, Decatur, GA USA
| | - Charles Mackenzie
- Neglected Tropical Diseases Support Center, Task Force for Global Health, Decatur, GA USA
| | - Thomas B. Nutman
- Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892 USA
| | - Joseph P. Shott
- Division of Neglected Tropical Diseases, US Agency for International Development, 1300 Pennsylvania Ave NW, Washington, DC USA
| | - Gary Weil
- Washington University School of Medicine, St. Louis, MO USA
| | - Eric Ottesen
- Neglected Tropical Diseases Support Center, Task Force for Global Health, Decatur, GA USA
| | - Achim Hoerauf
- Institute for Medical Microbiology, Immunology and Parasitology (IMMIP), German Centre for Infection Research (DZIF), Bonn-Cologne Site, University Hospital Bonn, Venusberg-Campus 1, 53105 Bonn, Germany
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Binkley JM, Weiler MJ, Frank N, Bober L, Dixon JB, Stratford PW. Assessing Arm Volume in People During and After Treatment for Breast Cancer: Reliability and Convergent Validity of the LymphaTech System. Phys Ther 2020; 100:457-467. [PMID: 32043125 DOI: 10.1093/ptj/pzz175] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/22/2019] [Indexed: 11/12/2022]
Abstract
BACKGROUND There are challenges related to the accurate and efficient measurement of lymphedema in people with breast cancer. The LymphaTech 3D Imaging System (LymphaTech, Atlanta, GA, USA) is a mobile, noninvasive platform that provides limb geometry measurements. OBJECTIVE The objective of this study was to estimate the reliability and validity of the LymphaTech for measuring arm volume in the context of women seeking care in a specialty breast cancer rehabilitation clinic. DESIGN This was a cross-sectional reliability and convergent validity study. METHODS People who had stage I to IV breast cancer with lymphedema or were at risk for it were included. Arm volume was measured in 66 participants using the LymphaTech and perometer methods. Test-retest reliability for a single measure, limb volume difference, and agreement between methods was analyzed for 30 participants. A method-comparison analysis was also used to assess convergent validity between methods. RESULTS Both LymphaTech and perometer methods displayed intraclass correlation coefficients (ICCs) of ≥0.99. The standard errors of measurement for the LymphaTech and length-matched perometer measurements were nearly identical. Similar intraclass correlation coefficients (0.97) and standard errors of measurement (38.0-40.7 mL) were obtained for the between-limb volume difference for both methods. The convergent validity analyses demonstrated no systematic difference between methods. LIMITATIONS The sample size was not based on a formal sample size calculation. LymphaTech measurements included interrater variance, and perometer measurements contained intrarater variance. CONCLUSIONS The LymphaTech had excellent test-retest reliability, and convergent validity was supported. This technology is efficient and portable and has a potential role in prospective surveillance and management of lymphedema in clinical, research, and home settings.
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Affiliation(s)
- Jill M Binkley
- TurningPoint Breast Cancer Rehabilitation, 8010 Roswell Road, Suite 120, Atlanta, GA 30350 (USA); and Oncology Rehabilitation Consultant, Atlanta, Georgia
| | | | | | - Lauren Bober
- TurningPoint Breast Cancer Rehabilitation, Atlanta, Georgia
| | - J Brandon Dixon
- LymphaTech; and Woodruff School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, Georgia
| | - Paul W Stratford
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
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23
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Lu IM, Weiler MJ, Frank ND, Jordi J, Dixon JB. Monitoring Leg Lymphedema Over the Course of Therapy Using an Infrared System. Lymphat Res Biol 2019; 18:333-339. [PMID: 31800362 DOI: 10.1089/lrb.2019.0036] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: There are many techniques of monitoring leg lymphedema during physical therapy. Taking volumetric measurements with a tape measure is among the most common clinically, and changes in volume are typically used to measure therapy efficacy. This study shows how the Kinect infrared (IR) sensor with custom algorithms can assess leg circumferences and volumes comparable with tape measurements taken by a trained therapist while exploring regional leg changes to determine uniformity of change. Methods and Results: Leg volumes were measured in 38 lymphedema patients using the tape measure circumference method and the Kinect IR system. Changes in circumferences in various leg regions over the course of therapy were analyzed in 23 patients. The leg circumferences (R2 = 0.9522) and volumes ( R2 = 0.9847) strongly correlated between the two methods. The Bland-Altman analysis indicated a circumference percent different bias of 1.6 (6.2%), requiring a minor correction factor between the two methods. Over the course of therapy, patients with a reduction in leg volume, defined as a change >6.5% have greater reduction most distal to the body. Conclusion: The Kinect IR system explored can be used clinically for leg volume measurements to monitor leg lymphedema patients over the course of their therapy. Implementing analysis of regional leg changes can better inform physical therapy to improve efficacy of treatment.
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Affiliation(s)
- Iris M Lu
- Bioinformatics Program, School of Biology, Georgia Institute of Technology, Atlanta, Georgia, USA
| | | | | | - John Jordi
- BenchMark Rehab Partners, LLC, Chattanooga, Tennessee
| | - J Brandon Dixon
- Bioinformatics Program, School of Biology, Georgia Institute of Technology, Atlanta, Georgia, USA.,LymphaTech, Inc., Atlanta, Georgia, USA.,George W. Woodruff School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, Georgia, USA.,Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, Georgia, USA
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24
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Kremer RL, Wolfe ME, Brueckner NJ, Viola MC, Fisher MI. Validity and reliability of three-dimensional imaging to measure limb volume: A systematic review. PHYSICAL THERAPY REVIEWS 2019. [DOI: 10.1080/10833196.2019.1698160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Rachel L. Kremer
- Department of Physical Therapy, University of Dayton, Dayton, Ohio, USA
| | - Madison E. Wolfe
- Department of Physical Therapy, University of Dayton, Dayton, Ohio, USA
| | - Noah J. Brueckner
- Department of Physical Therapy, University of Dayton, Dayton, Ohio, USA
| | - Michaela C. Viola
- Department of Physical Therapy, University of Dayton, Dayton, Ohio, USA
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25
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Zhou C, Yahathugoda C, De Silva L, Rathnapala U, Owen G, Weerasooriya M, Rao RU, Weil GJ, Budge PJ. Portable infrared imaging for longitudinal limb volume monitoring in patients with lymphatic filariasis. PLoS Negl Trop Dis 2019; 13:e0007762. [PMID: 31584959 PMCID: PMC6795459 DOI: 10.1371/journal.pntd.0007762] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Revised: 10/16/2019] [Accepted: 09/08/2019] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The Global Programme to Eliminate Lymphatic Filariasis (LF) emphasizes hygiene, exercise, and other measures to reduce morbidity and disability related to LF. We recently reported that a portable, three-dimensional, infrared imaging system (3DIS) provides accurate limb volume measurements in patients with filarial lymphedema. To assess the practical utility of repeated 3DIS measurements for longitudinal lymphedema management, we examined intraday and day-to-day leg volume changes in adults with filarial lymphedema in southern Sri Lanka. METHODOLOGY AND PRINCIPAL FINDINGS We assessed 41 participants with lower extremity lymphedema (stages 1-6) in their homes in the mornings (6:00-9:00 AM) and afternoons (2:00-6:00 PM) of three days within one calendar week. Two examiners performed replicate 3DIS volume measurements at each visit. Median coefficient of variation among replicate volume measurements was 1.7% (IQR 1.1% - 2.3%) for left legs and 2.2% (IQR 1.6% - 2.8%) for right legs. Median intraday volume increase was 3.0%. Range among daily volume measurements tended to be lower for afternoon measurements (median 2.25%, IQR 1.4%- 5.4%) than for morning measurements (median 3.0%, IQR 1.4% - 8.4%). CONCLUSIONS AND SIGNIFICANCE Limb volume measurements by 3DIS are accurate and reproducible, and this technique is feasible for use in patients' homes. We have developed practical suggestions for optimal outcomes with 3DIS. Duplicate measurements should be performed and repeat assessments should be done at approximately the same time of day to minimize bias. Duplicate measures that vary by more than 8% should prompt review of scanning technique with a repeat measurement. With proper training and attention to technique, 3DIS can be a valuable tool for healthcare workers who work with lymphedema patients.
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Affiliation(s)
- Celia Zhou
- Department of Biochemistry and Molecular Biology, Wake Forest University, Winston-Salem, North Carolina, United States of America
- Summer Research Program, Institute of Public Health, Washington University School of Medicine, St. Louis, Missouri, United States of America
| | - Channa Yahathugoda
- Filariasis Research Training and Services Unit, Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka
| | - Lalindi De Silva
- Filariasis Research Training and Services Unit, Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka
| | - Upeksha Rathnapala
- Filariasis Research Training and Services Unit, Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka
| | - Grant Owen
- Infectious Diseases Division, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri, United States of America
| | - Mirani Weerasooriya
- Filariasis Research Training and Services Unit, Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka
| | - Ramakrishna U. Rao
- Infectious Diseases Division, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri, United States of America
| | - Gary J. Weil
- Infectious Diseases Division, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri, United States of America
| | - Philip J. Budge
- Infectious Diseases Division, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri, United States of America
- * E-mail:
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26
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Lu IM, Dixon JB. Assessment of Upper Extremity Swelling Among Breast Cancer Survivors with a Commercial Infrared Sensor. Lymphat Res Biol 2019; 17:424-433. [DOI: 10.1089/lrb.2018.0010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Affiliation(s)
- Iris M. Lu
- Bioinformatics Program, School of Biology, Georgia Institute of Technology, Atlanta, Georgia
| | - J. Brandon Dixon
- Bioinformatics Program, School of Biology, Georgia Institute of Technology, Atlanta, Georgia
- George W. Woodruff School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, Georgia
- Wallace H Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, Georgia
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27
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Wolfs JA, Bijkerk E, Schols RM, Keuter XH, van der Hulst RR, Qiu SS. Evaluation of a Novel Water-Based Volumetric Device for Measuring Upper Limb Lymphedema: First Experience with Healthy Volunteers. Lymphat Res Biol 2019; 17:434-439. [DOI: 10.1089/lrb.2018.0037] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Joost A.G.N. Wolfs
- Department of Plastic and Reconstructive Surgery, Maastricht University Medical Center +, Maastricht, The Netherlands
| | - Ennie Bijkerk
- Department of Plastic and Reconstructive Surgery, Maastricht University Medical Center +, Maastricht, The Netherlands
| | - Rutger M. Schols
- Department of Plastic and Reconstructive Surgery, Maastricht University Medical Center +, Maastricht, The Netherlands
| | - Xavier H.A. Keuter
- Department of Plastic and Reconstructive Surgery, Maastricht University Medical Center +, Maastricht, The Netherlands
| | - René R.W.J. van der Hulst
- Department of Plastic and Reconstructive Surgery, Maastricht University Medical Center +, Maastricht, The Netherlands
| | - Shan S. Qiu
- Department of Plastic and Reconstructive Surgery, Maastricht University Medical Center +, Maastricht, The Netherlands
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28
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Speir EJ, Matthew Hawkins C, Weiler MJ, Briones M, Swerdlin R, Park S, Brandon Dixon J. Volumetric Assessment of Pediatric Vascular Malformations Using a Rapid, Hand-Held Three-Dimensional Imaging System. J Digit Imaging 2019; 32:260-268. [PMID: 30761440 DOI: 10.1007/s10278-019-00183-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
The effect of percutaneous, surgical, and medical therapies for vascular malformations (VMs) is often difficult to quantify volumetrically using cross-sectional imaging. Volumetric measurement is often estimated with serial, expensive MRI examinations which may require sedation or anesthesia. We aim to explore whether a portable 3D scanning device is capable of rapid, accurate volumetric analysis of pediatric VMs. Using an iPad-mounted infrared scanning device, 3D scans of patient faces, arms, and legs were acquired over an 8-month study period. Proprietary software was use to perform subsequent volumetric analysis. Of a total of 30 unilateral VMs involving either the face, arms, or legs, 26 (86.7%) VMs were correctly localized by discerning the larger volume of the affected side compared to the normal contralateral side. For patients with unilateral facial VMs (n = 10), volume discrepancy between normal and affected sides differed compared with normal controls (n = 19). This was true for both absolute (60 cc ± 55 vs 15 cc ± 8, p = 0.03) as well as relative (18.1% ± 13.2 vs 4.0% ± 2.1, p = 0.008) volume discrepancy. Following treatment, two patients experienced change in leg volume discrepancy ranging from - 17.3 to - 0.4%. Using a portable 3D scanning device, we were able to rapidly and noninvasively detect and quantify volume discrepancy resulting from VMs of the face, arms, and legs. Preliminary data suggests this technology can detect volume reduction of VMs in response to therapy.
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Affiliation(s)
- Ethan J Speir
- Emory University School of Medicine, Atlanta, GA, USA.
| | - C Matthew Hawkins
- Department of Radiology and Imaging Sciences, Division of Interventional Radiology and Image Guided Medicine, Emory University School of Medicine, Atlanta, GA, USA.,Department of Radiology and Imaging Sciences, Division of Pediatric Radiology, Children's Healthcare of Atlanta - Vascular Anomalies Clinic, Atlanta, GA, USA
| | | | - Michael Briones
- Department of Pediatrics, Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta and Emory University, Atlanta, GA, USA
| | - Rachel Swerdlin
- Department of Radiology and Imaging Sciences, Division of Pediatric Radiology, Children's Healthcare of Atlanta - Vascular Anomalies Clinic, Atlanta, GA, USA
| | - Solomon Park
- Emory University School of Medicine, Atlanta, GA, USA
| | - J Brandon Dixon
- George W. Woodruff School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, GA, USA
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29
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Kelly-Hope LA, Blundell HJ, Macfarlane CL, Molyneux DH. Innovative Surveillance Strategies to Support the Elimination of Filariasis in Africa. Trends Parasitol 2018; 34:694-711. [PMID: 29958813 DOI: 10.1016/j.pt.2018.05.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Revised: 05/18/2018] [Accepted: 05/30/2018] [Indexed: 01/18/2023]
Abstract
Lymphatic filariasis (LF) and onchocerciasis are two neglected tropical diseases (NTDs) of public health significance targeted for global elimination. The World Health Organization (WHO) African Region is a priority region, with the highest collective burden of LF and onchocerciasis globally. Coendemic loiasis further complicates elimination due to the risk of adverse events associated with ivermectin treatment. A public health framework focusing on health-related data, systematic collection of data, and analysis and interpretation of data is used to highlight the range of innovative surveillance strategies required for filariasis elimination. The most recent and significant developments include: rapid point-of-care test (POCT) diagnostics; clinical assessment tools; new WHO guidelines; open-access online data portals; mHealth platforms; large-scale prevalence maps; and the optimisation of mathematical models.
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Affiliation(s)
- Louise A Kelly-Hope
- Department of Parasitology, Liverpool School of Tropical Medicine, Liverpool, UK.
| | - Harriet J Blundell
- Department of Parasitology, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Cara L Macfarlane
- Department of Parasitology, Liverpool School of Tropical Medicine, Liverpool, UK
| | - David H Molyneux
- Department of Parasitology, Liverpool School of Tropical Medicine, Liverpool, UK
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30
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Hageman DJ, Wu S, Kilbreath S, Rockson SG, Wang C, Knothe Tate ML. Biotechnologies toward Mitigating, Curing, and Ultimately Preventing Edema through Compression Therapy. Trends Biotechnol 2018; 36:537-548. [PMID: 29606499 DOI: 10.1016/j.tibtech.2018.02.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2017] [Revised: 02/26/2018] [Accepted: 02/27/2018] [Indexed: 11/15/2022]
Abstract
For a century-old problem, edema and its treatment have gone remarkably unnoticed by the biomedical community. Given the prevalence of lymphedema and its debilitating repercussions, there is an acute need for both efficacy-based measures and clinical standards to guide compression garment design and therapeutic application. This review outlines the current state of the art in compression treatment and suggests an integrated biomedical engineering approach going forward. Characterizing the pressure gradient profiles of commercial compression sleeves is necessary to better understand the role of compression treatment in the mitigation of swelling. Integration of pressure sensor technologies with advanced materials design and manufacture provides a critical path not only to elucidate the mechanisms of but also to improve on current compression-based therapies and associated therapeutic devices.
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Affiliation(s)
- Daniel J Hageman
- Graduate School of Biomedical Engineering, University of New South Wales, Sydney, Australia
| | - Shuying Wu
- School of Mechanical Engineering, University of New South Wales, Sydney, Australia
| | - Sharon Kilbreath
- Breast Cancer Research Laboratory, Division of Health Sciences, Sydney University, Sydney, Australia
| | - Stanley G Rockson
- Center for Lymphatic and Venous Disorders, Stanford University Hospital, Palo Alto, CA, USA
| | - Chun Wang
- School of Mechanical Engineering, University of New South Wales, Sydney, Australia
| | - Melissa L Knothe Tate
- Graduate School of Biomedical Engineering, University of New South Wales, Sydney, Australia.
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31
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Blei F. Update February 2018. Lymphat Res Biol 2018. [DOI: 10.1089/lrb.2018.29035.fb] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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