Diagnostic accuracy of bioimpedance spectroscopy in patients with lymphedema: A retrospective cohort analysis

Qin, Evelyn S.; Bowen, Mindy; Chen, Wei-Fan

doi:10.1016/j.bjps.2018.02.012

Cited by 49 publications

(47 citation statements)

References 33 publications

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“…In 2000, a modality was added to the diagnosis tools for lymphedema called BIS which measures the volume of extracellular fluid via detecting a physical reaction to an impressed electrical current (65). In comparison to conventional methods, the measurement of BIS is more objective and specific (80-99%) (66-69), with a wide range of sensitivity (30-100%) (66-70), but a higher false-negative rate (36%) (71). Notably, BIS permits identification of lymphedema earlier, when it is in the subclinical stage, and tracks disease progression persistently, making timely intervention of lymphedema a reality (72).…”

Section: Diagnosis and Surveillancementioning

confidence: 99%

“…Early-stage lymphoscintigraphy is an effective diagnostic tool; however, it has many disadvantages such as radiation exposure, low resolution, high costs and increased invasiveness (1). Lymphography is a newer, systematic method to evaluate limb edema and lymph circulation without radiation exposure (71). Lymphography has higher specificity and sensitivity, and longer tracking capabilities, ranging from subclinical to more advanced stages, compared with lymphoscintigraphy (77,(80)(81)(82).…”

Section: Diagnosis and Surveillancementioning

confidence: 99%

“…Tonometry is a noninvasive method that can detect subclinical interstitial edema via continuously measuring the dielectric constant in affected tissue and evaluating moisture content (88). BIS is more specific, but lacks sensitivity, and it may be the most frequently utilized modality (71). However, no widely adopted consensus has been reached regarding which technique is the best for the surveillance of BCRL.…”

Section: Diagnosis and Surveillancementioning

confidence: 99%

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Lymphedema in survivors of breast cancer (Review)

et al. 2020

Oncol Lett

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The tremendous improvement of survival in patients with breast cancer can be attributed to several treatment strategies, but these strategies also lead to the occurrence of breast cancer-related lymphedema (BCRL). BRCL is regularly associated with factors such as axillary lymph node dissection and local lymph node radiotherapy and manifests as an increase of >10% in the volume of affected limbs. Being overweight or having obesity (body mass index ≥25 kg/m 2 ), an excessive number of positive lymph nodes (>8) and capsular invasion by a tumor are additional risk factors for lymphedema. It is worth assessing the risk before surgery as this can prevent the occurrence of BCRL at the initial stage of breast cancer management. The clinical utility of many diagnostic tools and lymphedema surveillance allows early stage and even subclinical BCRL to be diagnosed, and allows real-time monitoring of the disease. The early diagnosis of BRCL allows treatment at an early stage, which is beneficial to the reduction of excess limb volume and the improvement of quality of life. At present, the major therapeutic methods of BCRL include complex decongestive therapy, pneumatic compression devices, participating in exercise, microsurgery and liposuction, each of which alleviates lymphedema effectively. No medications for treatment of BRCL have yet been developed. However, the recent findings on the success of molecular therapy in animal models may remedy this deficiency. Furthermore, the volume reduction of swollen limbs without swelling rebound by transplanting autologous stem cells has been successfully reported in some pilot studies, which may provide a new technique for treating BCRL. This review aimed to discuss the pathogenesis, clinical manifestation, risk factors, advantages and disadvantages of diagnostic tools, lymphedema surveillance and the characteristics of traditional and newly emerging BCRL treatments.

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Section: Diagnosis and Surveillancementioning

confidence: 99%

Section: Diagnosis and Surveillancementioning

confidence: 99%

Section: Diagnosis and Surveillancementioning

confidence: 99%

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Lymphedema in survivors of breast cancer (Review)

et al. 2020

Oncol Lett

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“…BIS has only been found to have modest correlation to Perometer, with one study finding R = 0.60 [ 31 ]. In addition, there have been reports that BIS has a false-negative rate of over 30% when compared to directly imaging lymphatic vessels using indocyanine green (ICG) lymphography [ 32 ]. There are also several emerging modalities that allow for the direct imaging of lymphatic vessels to detect abnormalities [ 33 , 34 ].…”

Section: Discussionmentioning

confidence: 99%

An infrared 3D scanning device as a novel limb volume measurement tool in breast cancer patients

et al. 2020

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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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“…Bioimpedence spectroscopy is another diagnostic tool that measures fluid content in tissues by measuring an extremity's resistance to an electrical current. However, in a retrospective cohort study, researchers found that indocyanine green (ICG) lymphography was a more accurate tool for diagnosing lymphedema . With lymphography, near‐infrared fluorescence imaging allows for real‐time imaging of lymph flow.…”

Section: Lymphedemamentioning

confidence: 99%

Lymphedema and Lymphovenous Bypass: Perioperative Nursing Implications

Whitnell¹

2020

AORN Journal

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Lymphedema—the accumulation of fluid in tissues, usually in the upper and lower extremities—often results from lymph node dissection or radiation and can cause painful and debilitating swelling that may interfere with a patient's daily living activities and quality of life. The goal of treatment for lymphedema is to reduce the volume of fluid in the affected area. Lymphedema is staged according to presenting characteristics, and interventions may be surgical or nonsurgical, such as complex decongestive therapy. Lymphovenous bypass is a surgical procedure performed for the management of lymphedema and involves rerouting microvascular channels to allow for the drainage of fluid that has accumulated in the lymphatic tissue of the upper or lower extremities. It requires supermicrosurgery techniques because of the small size of the vessels being anastomosed. Perioperative nursing implications for lymphovenous bypass include OR preparation and providing emotional support for patients living with lymphedema.

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Diagnostic accuracy of bioimpedance spectroscopy in patients with lymphedema: A retrospective cohort analysis

Cited by 49 publications

References 33 publications

Lymphedema in survivors of breast cancer (Review)

Lymphedema in survivors of breast cancer (Review)

An infrared 3D scanning device as a novel limb volume measurement tool in breast cancer patients

Lymphedema and Lymphovenous Bypass: Perioperative Nursing Implications

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