Language：English   Publisher：Lymphatic Research and Biology  

Background: Lymphedema often affects the trunk after breast cancer surgery. Measuring volume baseline can help detect lymphedema-related changes early, thereby allowing for early intervention efforts. However, there is no quantitative method for detecting truncal lymphedema. As a preliminary investigation into the development of a new method for measuring truncal lymphedema, this study aimed to investigate the reliability and define the minimal detectable change (MDC) in posterior truncal thickness using a three-dimensional (3D) scanning system. Methods and Results: This observational study included 21 women who had undergone a mastectomy for breast cancer. The 3D images of every subject's trunk were captured by a handheld 3D scanner at two time points. The acquired 3D images were used to calculate the differences in thickness between the affected and unaffected sides at eight points on the trunk. The reliability was determined by checking for agreement between the trials (intraclass correlation coefficient) and by investigating the presence of systematic bias between the measurement error and true value (Bland-Altman analysis). Then, the MDC was calculated. For 14 of the 21 participants, 3D images without missing data at both time points were obtained. Analysis indicated that there was no systematic bias regarding the mean value at the seven body points. Fair-to-excellent reliability was shown at the five points in the middle of the trunk (MDC: 4.14-9.79 mm). The other three points (at the top and bottom of the trunk) had limited reliability. Conclusions: The 3D scanning system effectively measured the differences in thickness between the affected and unaffected sides of participants' posterior trunks, with fair-to-excellent reliability in the middle of the trunk.

DOI： 10.1089/lrb.2022.0021

Open Access

Web of Science

Scopus

PubMed

CiNii Research

Language：English   Publisher：Lymphatic Research and Biology  

Background: Breast cancer-related lymphedema (BCRL) is a chronic swelling of the arm due to breast cancer treatment. Lymphedema is diagnosed and staged on the basis of limb circumference measurements and the patient’s subjective symptoms, which have poor reproducibility and objectivity: these cannot detect any fluid accumulation in the tissue. Ultrasonography is a feasible noninvasive technique that can be used to evaluate tissue structure in real time. This study aimed to assess the ability of texture features for discriminating the presence of accumulated fluid within the subcutaneous tissue of BCRL using ultrasound (US) imaging. Methods and Results: This study included 20 women who were treated for unilateral breast cancer and who subsequently developed BCRL (International Society of Lymphology stage II). Subcutaneous tissue was scanned through an US system (Sonosite Edge II; Sonosite, Inc., FUJIFILM) using a 6- to 15-MHz linear transducer to assess the ability of texture features for discriminating the presence of accumulated fluid within the subcutaneous tissue of BCRL. Fluid accumulation was observed using a 3-Tesla MR system under double-echo steady-state conditions. There was a significant difference among the three groups (with hyperintense area, without hyperintense area, and unaffected side) in 11 of 14 textural features (p < 0.05). Post hoc analysis (Mann–Whitney U test; Bonferroni correction p < 0.0167) revealed significant differences in seven textural features within the hyperintense area. Conclusions: This study revealed that seven texture features quantified by US imaging data can provide information regarding fluid accumulation in the subcutaneous tissue of lymphedema.

DOI： 10.1089/lrb.2020.0121

Web of Science

Scopus

PubMed

Language：English   Publishing type：Research paper (scientific journal)  

Background: Manual lymph drainage (MLD) is one of the common treatments for breast cancer-related lymphedema (BCRL). Although the primary goal of MLD is to drain the excessive fluid accumulated in the affected upper limb and trunk to an area of the body that drains usually, the use of MLD is decided based on swelling and subjective symptoms, without assessing whether there is fluid accumulated in the affected region. The purpose of this study was to examine truncal fluid distribution in a sample of BCRL patients and investigate any correlation between such fluid distribution and swelling or subjective symptoms. Methods and Results: An observational study was conducted with 13 women who had unilateral, upper extremity BCRL. Fluid distribution was evaluated by using two magnetic resonance imaging (MRI) sequences: half-Fourier acquisition single-shot turbo spin echo and three-dimensional double-echo steady-state. The presence of swelling was determined by lymphedema therapists, and subjective symptoms were measured by using a visual analog scale. On MRI, no participants had any free water signals in the trunk. However, seven had swelling and all 13 had some kind of subjective symptoms on the affected side of their trunk. Conclusions: These results suggest that swelling and subjective symptoms do not correlate with the presence of truncal fluid. For such cases, a different approach than MLD may be needed to address truncal swelling and related subjective symptoms. Checking for the presence of fluid in the truncal region may help MLD be used more appropriately.

DOI： 10.1089/lrb.2020.0075

Authorship：Lead author   Language：English  

Background: Breast cancer-related lymphedema (BCRL) is chronic swelling of the arm that develops from breast cancer treatment. The International Society of Lymphology (ISL) classification is widely used to determine the clinical stage of lymphedema. Lymphedema diagnosis and staging are based on limb circumference measurements and the patient’s subjective symptoms, which have poor reproducibility and objectivity and cannot detect any fluid accumulation in the tissue. This study aimed to evaluate fluid accumulation in the tissue in BCRL (ISL stage II) through MRI.
Material and Methods: This study included 10 women who were treated for unilateral breast cancer and had subsequently developed BCRL(ISL stageⅡ). To observe fluid accumulation using a 3-Tesla MR system under Double Echo Steady State conditions.
Results: Although all the subjects were classified as having stage II lymphedema, they showed mixed results of with or without hyperintensity on MR imaging.
Conclusion: This report found that lymphedema progression was mixed even though patients were receiving the same treatment at the same stage.

DOI： 10.11172/keitaikinou.18.88

Event date： 2023.1

Presentation type：Oral presentation (general)  

Event date： 2022.3

Presentation type：Symposium, workshop panel (nominated)  

Event date： 2022.2

Presentation type：Oral presentation (general)  

Venue：Osaka  

Event date： 2021.12

Presentation type：Poster presentation  

Event date： 2021.12

Presentation type：Poster presentation  

Event date： 2021.12

Presentation type：Poster presentation  

Event date： 2021.11

Presentation type：Oral presentation (general)  

Event date： 2021.9

Presentation type：Oral presentation (general)  

Event date： 2020.12

Event date： 2020.12

Presentation type：Poster presentation  

Event date： 2020.1

Event date： 2019.9

Presentation type：Oral presentation (general)  

Event date： 2018.9

Presentation type：Oral presentation (general)  

Event date： 2018.6

Presentation type：Poster presentation  

Event date： 2018.6

Presentation type：Oral presentation (general)  

Event date： 2017

Presentation type：Oral presentation (general)