A new technique for the quantification of peripheral edema with application in both unilateral and bilateral cases

Cornish, B. H., Thomas, B. J., Ward, L. C., Hirst, C. and Bunce, I. H. (2002) A new technique for the quantification of peripheral edema with application in both unilateral and bilateral cases. Angiology, 53 1: 41-47. doi:10.1177/000331970205300106

Author Cornish, B. H.
Thomas, B. J.
Ward, L. C.
Hirst, C.
Bunce, I. H.
Title A new technique for the quantification of peripheral edema with application in both unilateral and bilateral cases
Journal name Angiology   Check publisher's open access policy
ISSN 0003-3197
Publication date 2002
Sub-type Article (original research)
DOI 10.1177/000331970205300106
Volume 53
Issue 1
Start page 41
End page 47
Total pages 7
Place of publication New York
Publisher Westminster Publications
Collection year 2002
Language eng
Subject C1
321015 Oncology and Carcinogenesis
730108 Cancer and related disorders
Abstract Current noninvasive techniques for the routine and frequent quantification of peripheral lymphedema in patients are total limb volume measurement (by water immersion or by circumferential measurements) and bioelectrical impedance analysis (BIA). However both of these techniques require standardizing the measurement using a contralateral measurement from the unaffected limb, Hence these techniques are essentially restricted to unilateral lymphedema. This paper describes the results from a preliminary study to investigate an alternative approach to the analysis of the data from multiple frequency BIA to produce an index of lymphedema without the need for normalization to another body segment. Twenty patients receiving surgical treatment for breast cancer were monitored prior to surgery and again after diagnosis with unilateral lymphedema. The data recorded were total limb volume, by circumferential measurements; and BIA measurements of both limbs. From these measurements total limb volumes and extracellular fluid volumes were calculated and expressed as ratios of the affected limb to that of the unaffected limb. An index of the ratio of the extracellular fluid volume to the intracellular fluid volume was determined. This ECW/ICW index was calculated for both the affected and unaffected limbs at both measurement times. Results confirmed that the established techniques of total limb volume and extracellular fluid volume normalized to the unaffected contralateral limb were accurate in the detection of lymphedema (p < 10(-6)). Comparison of the ECW/ICW index from the affected limb after diagnosis with that from the pre-surgery measurement revealed a significant (p< 10(-6)) and considerable (75%) increase. The results of this pilot study suggest that by using multiple frequency bioelectrical impedance analysis, an index of the ECW/ICW ratio can be obtained and this index appears to have an equal, or better, sensitivity, than the other techniques in detecting lymphedema. More importantly, this index does not require normalization to another body segment and can be used to detect all types of peripheral edema including both unilateral and bilateral lymphedema.
Keyword Peripheral Vascular Disease
Bioelectrical-impedance Analysis
Leg Volume
Q-Index Code C1

Document type: Journal Article
Sub-type: Article (original research)
Collections: Excellence in Research Australia (ERA) - Collection
School of Chemistry and Molecular Biosciences
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