Assessment of Subfascial Muscle/Water and Fat Accumulation in Lymphedema Patients Using Magnetic Resonance Imaging

Trinh, Lena; Peterson, Pernilla; Brorson, Håkan; Månsson, Sven

doi:10.1089/lrb.2018.0027

Cited by 14 publications

(9 citation statements)

References 25 publications

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“…Two studies, using MRI to assess the same 13 patients with late-stage lymphedema (seven arms and six legs), showed an insignificant increase in water/muscle volume in the subfascial compartment of the affected limb, with a significant reduction after 3, 6, and 12 months. 6 , 39 This, and the findings in this article, supports the theory that a decrease in load after liposuction reduces muscle hypertrophy.…”

Section: Discussionsupporting

confidence: 82%

“…38 Two other studies have reported on the same 13 patients with lymphedema (seven arms and six legs) and found a significant decrease in subfascial muscle/water volume 1 year after liposuction, but no absolute numbers were presented. 6,39 This study aims to follow soft-tissue composition 1 year after the operation in the 18 patients with BCRL for whom preoperative data were previously reported. 9 The follow-up will focus on changes in fat and muscle volume, but also in bone mineral volume.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Liposuction of Breast Cancer-Related Arm Lymphedema Reduces Fat and Muscle Hypertrophy

Karlsson

Ohlin

et al. 2022

Lymphatic Research and Biology

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Introduction: Adipose tissue deposition is a known consequence of lymphedema. A previous study showed that the affected arm in patients with nonpitting breast cancer-related lymphedema (BCRL) had a mean excess volume of 73% fat and 47% muscle. This condition impairs combined physiotherapy as well as more advanced microsurgical methods. Liposuction is, therefore, a way of improving the effects of treatment. Objective: This study aims to evaluate the tissue changes in lymphedematous arms after liposuction and controlled compression therapy (CCT) in patients with nonpitting BCRL. Methods and Results: Eighteen women with an age of 61 years and a duration of arm lymphedema (BCRL) of 9 years were treated with liposuction and CCT. Tissue composition of fat, lean (muscle), and bone mineral was analyzed through dual energy X-ray absorptiometry (DXA) before, and at 3 and 12 months after surgery. Excess volumes were also measured with plethysmography. The median DXA preoperative excess volume was 1425 mL (704 mL fat volume, 651 mL lean volume). The DXA excess volume at 3 months after surgery was 193 mL (-196 mL fat volume, 362 mL lean volume). At 12 months after surgery, the median excess DXA volume was 2 mL (-269 mL fat volume, 338 mL lean volume). From before surgery to 3 months after surgery, the median DXA excess volume reduced by 85% (p < 0.001) (fat volume reduction 128% (p < 0.001), lean volume reduction 37% (p = 0.016)). From before surgery to 12 months after surgery, it reduced by 100% (p < 0.001) (fat volume reduction 139% [p < 0.001], lean volume reduction 54% [p = 0.0013]). Conclusions: Liposuction and CCT effectively remove the excess fat in patients with nonpitting BCRL, and a total reduction of excess arm volume is achievable. A postoperative decrease in excess muscle volume is also seen, probably due to the reduced weight of the arm postoperatively.

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Section: Discussionsupporting

confidence: 82%

Section: Introductionmentioning

confidence: 99%

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Liposuction of Breast Cancer-Related Arm Lymphedema Reduces Fat and Muscle Hypertrophy

Karlsson

Ohlin

et al. 2022

Lymphatic Research and Biology

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“…It is thus likely that such complex changes, that do contribute to arm volume increases, will not directly be reflected as decreases in measured arm impedance. These complexities have been more recently investigated using MRI (132) in which excess fat volume was observed in both intra-and inter muscular compartments of seven patients with BCRL. An increasing relative amount of fat accumulation would increase measured arm impedance even though arm volume was increasing further suggesting a limitation to BIS tracking in such cases.…”

Section: Discussionmentioning

confidence: 99%

Measuring Breast Cancer-Related Lymphedema

Mayrovitz

2022

Breast Cancer

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Breast cancer-related lymphedema (BCRL) presents as swelling in the arm, hand, trunk, or breast at varying times after completion of breast cancer treatment. The reported incidence of BCRL varies widely in part due to its dependence on the type and extent of the treatment, pre-treatment risk factors, and the criteria used to define its presence. Central to this issue are the various quantitative measures that are used to specify lymphedema thresholds for its detection and tracking over time and during treatment.The goal of this chapter is to discuss these issues and the methods available for the non-invasive quantitative assessment of BCRL. Operational principles, advantages and limitations of the various methods, their clinical history of use, and effectiveness are discussed. Covered methods include those used to assess and monitor lymphedema-related changes in tissue water at any anatomical site and also methods used to assess changes only in limbs.Note to the Reader: This chapter is part of the book Breast Cancer (ISBN: 978-0-6453320-3-2), scheduled for publication in July 2022. The book is being published by Exon Publications,

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“…The lymph stasis in lymphedema starts an inflammatory process [7] in the subcutaneous tissue leading to early (potentially within the first year) deposition of fat [8], including intramuscular fat [9,10], which then adversely influences the lymph system, contributing to further increases in swelling. Since lymphedema, that is characterised by increased fat deposition with or without pitting, is time-consuming and costly to treat, it is of great importance to prevent the development of lymphedema.…”

Section: Introductionmentioning

confidence: 99%

Prevention of arm lymphedema through the use of compression sleeves following breast cancer: results from a targeted literature review

Johansson

Ochałek

Hayes

2020

Physical Therapy Reviews

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Background: Breast cancer-related lymphedema (BCRL) is associated with impaired function and poorer quality of life. BCRL is also considered time-consuming and costly to treat. While compression treatment is considered the most efficient and effective form of treatment for early BCRL, its impact on the lymphatic system highlights its potential in the prevention of lymphedema. Objectives: To identify and summarise studies evaluating compression garment as a prevention strategy for BCRL. Methods: This is a targeted literature review of studies that evaluated use of compression garment in the prevention of BCRL, including prevention post-surgery and prevention of progression of subclinical lymphedema. Results: A total of 4 studies were identified that assessed the role of compression garment in the secondary (one randomized, controlled trial; n ¼ 45) or tertiary (three cohort studies; sample size range: 111-508) prevention of BCRL. Together, findings from these studies suggest that use of compression garment was associated with reduced incidence, attenuation of lymphedema or prevention of progression to more severe lymphedema. However, the absence of a randomized, controlled trial in the tertiary setting means causal inferences relationship cannot be made. Conclusion: There is significant scope for further research, with consideration of possible benefits and costs associated with differences in compression class, duration or daily wear time, as well as comparison to other preventive strategies including patient preferences.

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Assessment of Subfascial Muscle/Water and Fat Accumulation in Lymphedema Patients Using Magnetic Resonance Imaging

Cited by 14 publications

References 25 publications

Liposuction of Breast Cancer-Related Arm Lymphedema Reduces Fat and Muscle Hypertrophy

Liposuction of Breast Cancer-Related Arm Lymphedema Reduces Fat and Muscle Hypertrophy

Measuring Breast Cancer-Related Lymphedema

Prevention of arm lymphedema through the use of compression sleeves following breast cancer: results from a targeted literature review

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