Texture Analysis of Post Breast Cancer Lymphedema Ultrasound Images Obtained Using a Portable Device—A Pilot Study

Ashikaga, Takamaru; Burns, Dylan; O′Brien, Patricia J.; Schaberg, Kurt B.; Huston, Dryver R.

doi:10.1089/lrb.2005.3.147

Cited by 12 publications

(16 citation statements)

References 18 publications

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“…The two points were chosen based on previous ultrasound studies. 16,19,30 However, the lateral elbow point is much less studied and the PT clinicians included the lateral elbow because this area is believed to be a common area for fibrosis and it is a consistent circumferential measurement point.…”

Section: Ultrasound Of Lymphedemamentioning

confidence: 99%

“…PT2 took five US images at each site and analyzed the images using Matlab ( b The MathWorks, Inc., Natick, MA). On each US image, eleven square, horizontal regions of interest (ROI) 16 were created at the top of the image to capture information in the superficial tissue layers up to a depth of 4 mm. Each ROI…”

Section: Ultrasound Of Lymphedemamentioning

confidence: 99%

“…However, a pilot study in 2005 used US imaging texture analysis on a subject with breast cancer-related lymphedema. 16 Texture analysis of US images was used to derive the variables entropy and average pixel intensity (API). 16 Entropy is a measure of randomness within the US image that reflects how organized or disorganized the tissue is.…”

Section: Introductionmentioning

confidence: 99%

“…16 Texture analysis of US images was used to derive the variables entropy and average pixel intensity (API). 16 Entropy is a measure of randomness within the US image that reflects how organized or disorganized the tissue is. API is a measure of brightness within the US image; brighter areas within the tissue correlate to higher echogenicity of the tissue.…”

Section: Introductionmentioning

confidence: 99%

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Ultrasound and Clinical Measures for Lymphedema

Johnson

DeSarno

Ashikaga

et al. 2016

Lymphatic Research and Biology

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Background: Treatment for breast cancer has increased patient survivorship exponentially over the past few decades. With increased survivorship, more women are living with the longstanding effects of breast cancer treatment, such as lymphedema. Patients, health care providers, and payers depend on practical and efficient clinical measures to accurately diagnose and monitor disease progression or regression. However, current clinical measures do not include objective measures that assess lymphedetamous tissue accurately. This study compared current measures to a novel use of ultrasound (US) imaging to quantify tissue texture. Methods and Results: Seventeen women diagnosed with lymphedema completed self-report questionnaires and then were tested twice by two lymphedema physical therapists who measured edema, fibrosis, and limb volume differences. One therapist measured subjects' limbs using US imaging and derived measures of entropy and average pixel intensity. Volume measures were consistent between therapists (p < 0.01) but palpation was not (0.01 < p < 0.72). Therapists' measures correlated better to subjects' self-report of edema (0.01 < p > 0.32) as compared to fibrosis (0.23 < p > 0.90). US measures were reliable (Cronbachs's a = 0.7 and 0.91 for entropy and API, respectively). Entropy measures demonstrated significant differences between subjects' involved versus uninvolved forearms (p = 0.03). Conclusions: Therapists were not consistent with each other when rating edema or fibrosis; however, they were consistent when measuring limb volume differences. US measures (entropy) demonstrated a significant difference between involved and uninvolved. US imaging, as a tool to quantify subcutaneous tissues, holds promise to be a safe, mobile, and effective method to measure lymphedema tissue texture.

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Section: Ultrasound Of Lymphedemamentioning

confidence: 99%

Section: Ultrasound Of Lymphedemamentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Ultrasound and Clinical Measures for Lymphedema

Johnson

DeSarno

Ashikaga

et al. 2016

Lymphatic Research and Biology

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“…[11] Further, reports have confirmed changes in subcutaneous tissue through evaluation of the elasticity of these tissues, using ultrasound imaging. [12,13] Previous studies revealed that ultrasonography had good intra-and inter-rater reliability in evaluating the subcutaneous tissue thickness in healthy subjects. [14] Another study revealed that the compressibility of the affected arm in postmastectomy lymphedema patients decreased as compared to the contralateral arm and that the measurement of compressibility using ultrasonography with the maximal compression technique was a valuable tool for evaluating lymphedema.…”

Section: Introductionmentioning

confidence: 99%

Optimal pressure for measuring objective lymphedema with postoperative ultrasonography in patients with breast cancer

Lim

Hwang

Park

et al. 2016

Computer Assisted Surgery

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Objective: To examine the reliability of ultrasonographic thickness and compressibility along with real-time pressure monitoring to evaluate postmastectomy lymphedema and to suggest a reference range of appropriate pressure. Design: Measurement reliability study. Setting: Research laboratory. Participants: Fifteen patients with prior mastectomy for breast cancer who were diagnosed with secondary lymphedema, and 16 healthy control subjects. Methods: The thickness and compressibility of the subcutaneous layer in the arms of 15 postmastectomy patients with secondary lymphedema were measured using B-mode and M-mode ultrasonography. An ultrasound machine was equipped with a real-time pressure-monitoring device to monitor downward compression pressure on the arms at a constant velocity. The ratio of thickness change defined the compressibility index. Two different experienced examiners participated in the measurement of lymphedema. Intrarater reliability and inter-rater reliability were estimated using the intraclass correlation coefficient. Very good reliability was defined as an ICC of more than 0.8. Main outcome measurements: The thickness of the subcutaneous layer, the compressibility index, and the intrarater and inter-rater reliability were measured.Results: The measured thicknesses demonstrated very good intrarater and inter-rater reliability for the forearm and upper arm. For the compressibility index, the upper arm and forearm had very good intrarater and inter-rater reliability at over 2000 Pa of compression (>0.9). Conclusions: Ultrasonography with real-time pressure monitoring may be useful for evaluating the severity and characteristics of lymphedema, particularly at compression pressures more than 2000 Pa.

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Lymphedema in Cancer Patients

O′Brien

2018

The MASCC Textbook of Cancer Supportive Care and Survivorship

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Texture Analysis of Post Breast Cancer Lymphedema Ultrasound Images Obtained Using a Portable Device—A Pilot Study

Abstract: The second order measure entropy is preferable to that of the first order average pixel intensity as a measure of image texture to characterize ultrasound images of extremity lymphedema.

Cited by 12 publications

References 18 publications

Ultrasound and Clinical Measures for Lymphedema

Ultrasound and Clinical Measures for Lymphedema

Optimal pressure for measuring objective lymphedema with postoperative ultrasonography in patients with breast cancer

Lymphedema in Cancer Patients

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