Postmastectomy lymphoedema: different patterns of fluid distribution visualised by ultrasound imaging compared with magnetic resonance imaging

Tassenoy, An; Mey, Johan De; Ridder, Filip De; Schuerbeeck, P. Van; Vanderhasselt, Tim; Lamote, Jan; Lievens, Pierre

doi:10.1016/j.physio.2010.08.003

Cited by 50 publications

(51 citation statements)

References 22 publications

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“…4 On both computed tomography (CT) and magnetic resonance imaging (MRI), a characteristic pattern of circumferential edema and 'honeycombing' with infiltration of fibrotic tissue in the subcutaneous region, along with an increase in fat around the circumference of the limb, is seen with both primary and secondary lymphedema. [4][5][6] With dual-energy x-ray absorptiometry (DXA), increases in the volume of fat, muscle, and bone have been found with severe lymphedema. 7 Changes in tissue composition are considered in staging systems for lymphedema, 8,9 but not clinically as lymphedema is not routinely detected or monitored using any imaging modality.…”

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confidence: 99%

Tissue Composition Changes and Secondary Lymphedema

Dylke

Ward

Meerkin³

et al. 2013

Lymphatic Research and Biology

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confidence: 99%

Tissue Composition Changes and Secondary Lymphedema

Dylke

Ward

Meerkin³

et al. 2013

Lymphatic Research and Biology

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“…28 Abnormal fluid accumulation in the dermal layer was detected in all patients with clinically apparent lymphedema. In the cases of recent onset lymphedema, bright T2 weighted signal was easily identified in all test subjects, even subjects with what was assessed to be low-grade lymphedema.…”

Section: Discussionmentioning

confidence: 93%

“…Other tools include perometry for volume measurements, 20 bioimpedance spectroscopy for changes in electrical conductance, 21,22 tonometry for changes in skin texture and resistance, 23 ultrasound, 24,25 computed tomography, 5 and magnetic resonance imaging. [26][27][28] Circumferential measurements have been found to have a strong correlation with water volumetry, [29][30][31] and because of their ease of application are the most frequently used clinical measure. 18 One clinical approach utilizes a specialized measuring tape, Gulic measuring tape, which has a built-in tension device that gauges how tightly the tape is pressed against the skin to prevent excess compression of tissue.…”

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confidence: 99%

“…Three specific patterns of structural change associated with breast cancer-related lymphedema have been characterized, including fluid in adipose tissue, fluid accumulation between fibrous septa and fat globules, and fat globule hypertrophy. 28 Previous studies have used 1.5T MRI. 28 In this study, 3.0T MRI has been used, which provides better signal and superior contrast between water and fat.…”

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confidence: 99%

“…28 Previous studies have used 1.5T MRI. 28 In this study, 3.0T MRI has been used, which provides better signal and superior contrast between water and fat. 3.0T MRI is particularly suited for this task because of an increased difference in the resonance frequencies of water and fat.…”

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confidence: 99%

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Quantitative and Morphologic Change Associated with Breast Cancer-Related Lymphedema. Comparison of 3.0T MRI to External Measures

Gardner

Nickerson

Watts

et al. 2014

Lymphatic Research and Biology

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Introduction: Lymphedema is a chronic disease of increasing importance to cancer survivors. A tape measurement tool used for lymphedema relies on indirect volume calculations based on external circumference, which may not reflect the true extent of abnormal fluid accumulation accurately. Fluid-sensitive MRI sequences may be able to delineate the severity of this condition more precisely and thus also monitor response to therapy. Methods and Results: Eight patients being followed by physical therapy for clinically diagnosed breast cancerrelated lymphedema were recruited to participate in this study. External measurements and upper extremity MRI were performed on all subjects. Arm circumference, arm volume, and lymphedema volumes were calculated for each method. MR imaging detected lymphedema in all study subjects. Correlation was found between external circumferential measurements and with the 3.0T MRI (r = 0.9368). There was poor correlation between lymphedema volumes calculated from clinical measurements and MR imaging (r = 0.5539). Conclusions: External measurements were not found to be an accurate measure of lymphedema volume associated with breast cancer lymphedema. MRI is a reliable means to obtain upper extremity circumferential and volume measurements. MRI is able to evaluate morphologic change associated with breast cancer-related lymphedema. Lymphedema research requires integrated use of tools to further describe the disease process over time, quantitate the distribution of tissue changes, and improve the sensitivity and specificity of the measurements.

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Efficacy of Ultrasound and Shear Wave Elastography for the Diagnosis of Breast Cancer–Related Lymphedema

Polat

Öztürk

POLAT

et al. 2019

J of Ultrasound Medicine

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Objectives To assess the feasibility of ultrasound and shear wave elastography (SWE) in the diagnosis of breast cancer–related lymphedema. Methods Forty‐one patients with a history of unilateral breast surgery and axillary dissection or sentinel lymph node excision were included in this prospective study. The patients were classified as having normal findings, latent lymphedema, and clinical lymphedema on the basis of a physical examination, lymphedema index scores, and limb circumference measurements. The thickness and stiffness of the cutaneous and subcutaneous tissue of the forearm and arm were measured by ultrasound and SWE. The thickness and stiffness of the cutaneous and subcutaneous tissue of the affected limb and contralateral limbs of the normal, latent lymphedema, and clinical lymphedema groups were compared. Results The mean age ± SD of the 41 patients was 55.42 ± 10.12 years. There were 15 patients with normal findings, 10 with latent lymphedema, and 16 with clinical lymphedema. In the latent lymphedema group, the thickness measurements of the cutaneous tissue of the affected forearm and the cutaneous and subcutaneous tissue of the affected arm were significantly greater than those of the contralateral forearm and arm (P = .034; P = .022; and P = .002, respectively), and the stiffness measurements of the cutaneous and subcutaneous tissue of the affected forearm were significantly greater than those of the contralateral forearm (P = .011; and P = .002). In the clinical lymphedema group, the thickness and stiffness measurements of the cutaneous and subcutaneous tissue of the affected forearm and arm were significantly greater than those of the contralateral limb (P < .001–P = .032). Conclusions Ultrasound and SWE are effective for diagnosing breast cancer–related lymphedema even at a latent stage.

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Postmastectomy lymphoedema: different patterns of fluid distribution visualised by ultrasound imaging compared with magnetic resonance imaging

Cited by 50 publications

References 22 publications

Tissue Composition Changes and Secondary Lymphedema

Tissue Composition Changes and Secondary Lymphedema

Quantitative and Morphologic Change Associated with Breast Cancer-Related Lymphedema. Comparison of 3.0T MRI to External Measures

Efficacy of Ultrasound and Shear Wave Elastography for the Diagnosis of Breast Cancer–Related Lymphedema

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