Volume measurement in lymphoedema treatment: examination of formulae

Abstract

The purpose of this study was to examine a variety of mathematical volume formulae and their respective validity in establishing limb volume in monitoring and evaluation of treatment for lymphoedema. Using a random sample of treatment records from the Day Ward, Worthing Hospital, it is shown that the formula most commonly used at present, that for a cylinder, produces imprecise volume data. A simplified formula derived from the formula for a frustum is tested, and is found to produce more accurate data. The paper proposes that the frustum formula is more appropriate in establishing limb volume, and should be adopted by practitioners.

Surgical Prevention of Arm Lymphedema in Breast Cancer Treatment

“…Normal lymphoscintigraphy pattern corresponded to TI less than 10. An impaired LS pattern in our study had a mean TI of 16 (range [12][13][14][15][16][17][18][19]. Moreover, pre-operatively LS had a significant predictive value (TI) in terms of risk of lymphedema appearance.…”

“…LS allowed to confirm the lymphostatic nature of the edema. To quantify visual findings in LS, the Kleinhans transport index (TI) was used (4,13,14). The TI includes the following parameters: transport kinetics (K), distribution of the tracer (D), appearance time of lymph nodes in minutes (T), visualization of lymph nodes (N), visualisation of lymph vessels (V); TI = K + D + (0,04 x T) + N + V (Table 2).…”

“…Sentinel lymph node biopsy (SLNB) was introduced and carried out to prevent lymphedema but, recent studies demonstrated that even with SLNB alone lymphedema rates are not negligible (13,17). Therefore, prevention is of key importance to avoid lymphedema occurrence.…”

Inter- and Intra-Observer Reproducibility and Validity of an Indirect Volume Measurement in Transtibial Amputees

“…Next, the data were fitted into a formula of a truncated cone. 12 Compared to the water displacement volumetric method, this method was able to reliably and validly measure arm volume. If it is applicable and able to reliably and validly measure stump volume in the lower extremity as well, it might be the instrument clinicians are looking for.…”

“…Circumferences of the stump are measured at different, predetermined, segments of the upper and lower part of the limb, usually 4 cm apart. 7,9,11,12 This method is easy to perform, applicable in any location, nonexpensive, and convenient for the patient. There is, however, no consensus on its performance, and reliability and validity data are missing.…”