Limits...
Computed Tomography as an Objective Measurement Tool for Secondary Lymphedema Treated With Extracorporeal Shock Wave Therapy.

Kim SY, Bae H, Ji HM - Ann Rehabil Med (2015)

Bottom Line: We used a manual tracing method using PiViewSTAR software to calculate the volume of the upper extremities.There was a decrease in the volume of the subcutaneous compartment measured by CT before and after ESWT.CT may be helpful in determining the treatment target area of ESWT and to monitor the effect of treatment by measuring the changes in volume before and after ESWT in patients with lymphedema.

View Article: PubMed Central - PubMed

Affiliation: Department of Rehabilitation Medicine, Ewha Womans University School of Medicine, Seoul, Korea.

ABSTRACT
Two patients with stage three secondary lymphedema of the upper extremities underwent treatment for breast cancer, including surgery, chemotherapy, and radiotherapy. They were examined with computed tomography (CT) before and after extracorporeal shock wave therapy (ESWT). We used a manual tracing method using PiViewSTAR software to calculate the volume of the upper extremities. There was a decrease in the volume of the subcutaneous compartment measured by CT before and after ESWT. CT may be helpful in determining the treatment target area of ESWT and to monitor the effect of treatment by measuring the changes in volume before and after ESWT in patients with lymphedema. Therefore, CT may have good clinical potential for treatment and follow-up in the management of lymphedema.

No MeSH data available.


Related in: MedlinePlus

Computed tomography based on the volume measurement method for lymphedema of the upper extremity whole extremity (1), the sum of bone and muscle (2).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4496522&req=5

Figure 2: Computed tomography based on the volume measurement method for lymphedema of the upper extremity whole extremity (1), the sum of bone and muscle (2).

Mentions: After 16 sessions of ESWT, a CT scan of the upper extremity was performed to determine the therapeutic effects (Fig. 1B). The volume of the upper extremity was measured using a manual tracing technique with PiViewSTAR software (INFINITT Co. Ltd., Seoul, Korea) in order to examine the changes in volume in the areas with edema (Fig. 2). The cross-sectional area observed in each section of the coronal CT scan was multiplied by the slice thickness (10 mm in this study) of the CT scan to obtain the volume of each section. The volume in the ROI was measured by adding up the volume of each section in the ROI. The volume of the subcutaneous fat layers was obtained by subtracting the volume of the bones and muscles from the volume of the entire upper extremity. The volume of the entire upper extremity was measured by summing up the volumes of the regions from the distal radial and ulnar styloid process to the acromion process. The volume of the areas between 5 cm below and 5 cm above the elbow was calculated and compared before and after treatment. The volume of the entire right upper extremity and the subcutaneous fat layers was reduced from 210,878.4 mm3 to 205,970.1 mm3 and from 122,562.2 mm3 to 113,154.2 mm3, respectively. The volumes of the entire areas at 5 cm above the elbow and subcutaneous fat layers were reduced from 25,014.7 mm3 to 24,735.3 mm3 and from 14,732.6 mm3 to 13,315.2 mm3, respectively. The volumes of the entire areas at 5 cm below the elbow and subcutaneous fat layers were reduced from 28,799.8 mm3 to 28,535.9 mm3 and from 15,243.2 mm3 to 13,935.6 mm3, respectively (Table 1). In addition, when the circumferences of both arms were compared, differences of 2.8 cm and 4.3 cm at 5 cm above and below the elbow, respectively, were noted. These circumference measurements were smaller than the initial measurements. However, the presence of Stemmer sign and peau d'orange changes persisted after therapy.


Computed Tomography as an Objective Measurement Tool for Secondary Lymphedema Treated With Extracorporeal Shock Wave Therapy.

Kim SY, Bae H, Ji HM - Ann Rehabil Med (2015)

Computed tomography based on the volume measurement method for lymphedema of the upper extremity whole extremity (1), the sum of bone and muscle (2).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4496522&req=5

Figure 2: Computed tomography based on the volume measurement method for lymphedema of the upper extremity whole extremity (1), the sum of bone and muscle (2).
Mentions: After 16 sessions of ESWT, a CT scan of the upper extremity was performed to determine the therapeutic effects (Fig. 1B). The volume of the upper extremity was measured using a manual tracing technique with PiViewSTAR software (INFINITT Co. Ltd., Seoul, Korea) in order to examine the changes in volume in the areas with edema (Fig. 2). The cross-sectional area observed in each section of the coronal CT scan was multiplied by the slice thickness (10 mm in this study) of the CT scan to obtain the volume of each section. The volume in the ROI was measured by adding up the volume of each section in the ROI. The volume of the subcutaneous fat layers was obtained by subtracting the volume of the bones and muscles from the volume of the entire upper extremity. The volume of the entire upper extremity was measured by summing up the volumes of the regions from the distal radial and ulnar styloid process to the acromion process. The volume of the areas between 5 cm below and 5 cm above the elbow was calculated and compared before and after treatment. The volume of the entire right upper extremity and the subcutaneous fat layers was reduced from 210,878.4 mm3 to 205,970.1 mm3 and from 122,562.2 mm3 to 113,154.2 mm3, respectively. The volumes of the entire areas at 5 cm above the elbow and subcutaneous fat layers were reduced from 25,014.7 mm3 to 24,735.3 mm3 and from 14,732.6 mm3 to 13,315.2 mm3, respectively. The volumes of the entire areas at 5 cm below the elbow and subcutaneous fat layers were reduced from 28,799.8 mm3 to 28,535.9 mm3 and from 15,243.2 mm3 to 13,935.6 mm3, respectively (Table 1). In addition, when the circumferences of both arms were compared, differences of 2.8 cm and 4.3 cm at 5 cm above and below the elbow, respectively, were noted. These circumference measurements were smaller than the initial measurements. However, the presence of Stemmer sign and peau d'orange changes persisted after therapy.

Bottom Line: We used a manual tracing method using PiViewSTAR software to calculate the volume of the upper extremities.There was a decrease in the volume of the subcutaneous compartment measured by CT before and after ESWT.CT may be helpful in determining the treatment target area of ESWT and to monitor the effect of treatment by measuring the changes in volume before and after ESWT in patients with lymphedema.

View Article: PubMed Central - PubMed

Affiliation: Department of Rehabilitation Medicine, Ewha Womans University School of Medicine, Seoul, Korea.

ABSTRACT
Two patients with stage three secondary lymphedema of the upper extremities underwent treatment for breast cancer, including surgery, chemotherapy, and radiotherapy. They were examined with computed tomography (CT) before and after extracorporeal shock wave therapy (ESWT). We used a manual tracing method using PiViewSTAR software to calculate the volume of the upper extremities. There was a decrease in the volume of the subcutaneous compartment measured by CT before and after ESWT. CT may be helpful in determining the treatment target area of ESWT and to monitor the effect of treatment by measuring the changes in volume before and after ESWT in patients with lymphedema. Therefore, CT may have good clinical potential for treatment and follow-up in the management of lymphedema.

No MeSH data available.


Related in: MedlinePlus