Document Detail

A new technique for the quantification of peripheral edema with application in both unilateral and bilateral cases.
MedLine Citation:
PMID:  11863308     Owner:  NLM     Status:  MEDLINE    
Current noninvasive techniques for the routine and frequent quantification of peripheral lymphedema in patients are total limb volume measurement (by water immersion or by circumferential measurements) and bioelectrical impedance analysis (BIA). However both of these techniques require standardizing the measurement using a contralateral measurement from the unaffected limb. Hence these techniques are essentially restricted to unilateral lymphedema. This paper describes the results from a preliminary study to investigate an alternative approach to the analysis of the data from multiple frequency BIA to produce an index of lymphedema without the need for normalization to another body segment. Twenty patients receiving surgical treatment for breast cancer were monitored prior to surgery and again after diagnosis with unilateral lymphedema. The data recorded were total limb volume, by circumferential measurements; and BIA measurements of both limbs. From these measurements total limb volumes and extracellular fluid volumes were calculated and expressed as ratios of the affected limb to that of the unaffected limb. An index of the ratio of the extracellular fluid volume to the intracellular fluid volume was determined. This ECW/ICW index was calculated for both the affected and unaffected limbs at both measurement times. Results confirmed that the established techniques of total limb volume and extracellular fluid volume normalized to the unaffected contralateral limb were accurate in the detection of lymphedema (p < 10(-6)). Comparison of the ECW/ICW index from the affected limb after diagnosis with that from the pre-surgery measurement revealed a significant (p < 10(-6)) and considerable (75%) increase. The results of this pilot study suggest that by using multiple frequency bioelectrical impedance analysis, an index of the ECW/ICW ratio can be obtained and this index appears to have an equal, or better, sensitivity than the other techniques in detecting lymphedema. More importantly, this index does not require normalization to another body segment and can be used to detect all types of peripheral edema including both unilateral and bilateral lymphedema.
Bruce H Cornish; Brian J Thomas; Leigh C Ward; Cherrell Hirst; Ian H Bunce
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Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Angiology     Volume:  53     ISSN:  0003-3197     ISO Abbreviation:  Angiology     Publication Date:    2002 Jan-Feb
Date Detail:
Created Date:  2002-02-26     Completed Date:  2002-03-21     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0203706     Medline TA:  Angiology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  41-7     Citation Subset:  IM    
Centre for Medical and Health Physics, Queensland University of Technology, University of Queensland, Brisbane, Australia.
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MeSH Terms
Breast Neoplasms / complications*,  physiopathology,  surgery
Data Interpretation, Statistical
Electric Impedance / diagnostic use*
Extracellular Space / physiology
Extremities / physiopathology
Functional Laterality / physiology*
Intracellular Fluid / physiology
Lymphedema / diagnosis*,  etiology,  physiopathology*
Mathematical Computing*
Middle Aged
Pilot Projects
Sensitivity and Specificity

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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