Yuka Sen1, Yi Qian1, Louise Koelmeyer2, Robert Borotkanics3, Robyn Ricketts2, Helen Mackie2, Thomas C Lam2, Kevin Ho Shon2,4, Hiroo Suami2, John Boyages2. 1. 1 Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Macquarie University , Sydney, Australia. 2. 2 Department of Clinical Medicine, Faculty of Medicine and Health Sciences, Macquarie University , Sydney, Australia . 3. 3 Department of Biostatistics and Epidemiology, Faculty of Health and Environmental Sciences, Auckland University of Technology , Auckland, New Zealand . 4. 4 Macquarie Medical Imaging, Macquarie University Hospital, Macquarie University , Sydney, Australia .
Abstract
BACKGROUND: Lymphedema is an iatrogenic complication after breast cancer treatment in which lymph fluid in the affected limb progresses to fat deposition and fibrosis that are amenable to liposuction treatment. Magnetic resonance imaging (MRI) for lymphedema can differentiate fat tissue from fluid, but estimating relative volumes remains problematic. METHODS AND RESULTS: Patients underwent routine bilateral arm MRI both before and after liposuction for advanced lymphedema. The threshold-based level set (TLS) segmentation method was applied to segment the geometric image data and to measure volumes of soft tissue (fat, muscle, and lymph fluid) and bone. Bioimpedance testing (L-Dex®) to detect extracellular fluid was also used. Volumes derived by using TLS or girth measurement were evaluated and showed consistent agreement, whereas L-Dex showed no significant reduction between pre- and postoperative measures. The percentage median volume difference between the affected and unaffected sides was 132.4% for girth measures compared with 137.2% for TLS (p = 0.175) preoperatively, and 99.8% and 98.5%, respectively (p = 0.600), postoperatively. MRI segmentation detected reductions in fat (median 52.6%, p = 0.0163) and lymph fluid (median 66%, p = 0.094), but the volumes of muscle and bone were relatively constant. CONCLUSIONS: MRI imaging with TLS technology may be a useful tool to quantitatively measure fat tissue and fluid for patients with advanced lymphedema and may assist in the selection of eligible liposuction candidates at initial assessment and follow-up of patients who proceed with surgery.
BACKGROUND:Lymphedema is an iatrogenic complication after breast cancer treatment in which lymph fluid in the affected limb progresses to fat deposition and fibrosis that are amenable to liposuction treatment. Magnetic resonance imaging (MRI) for lymphedema can differentiate fat tissue from fluid, but estimating relative volumes remains problematic. METHODS AND RESULTS:Patients underwent routine bilateral arm MRI both before and after liposuction for advanced lymphedema. The threshold-based level set (TLS) segmentation method was applied to segment the geometric image data and to measure volumes of soft tissue (fat, muscle, and lymph fluid) and bone. Bioimpedance testing (L-Dex®) to detect extracellular fluid was also used. Volumes derived by using TLS or girth measurement were evaluated and showed consistent agreement, whereas L-Dex showed no significant reduction between pre- and postoperative measures. The percentage median volume difference between the affected and unaffected sides was 132.4% for girth measures compared with 137.2% for TLS (p = 0.175) preoperatively, and 99.8% and 98.5%, respectively (p = 0.600), postoperatively. MRI segmentation detected reductions in fat (median 52.6%, p = 0.0163) and lymph fluid (median 66%, p = 0.094), but the volumes of muscle and bone were relatively constant. CONCLUSIONS: MRI imaging with TLS technology may be a useful tool to quantitatively measure fat tissue and fluid for patients with advanced lymphedema and may assist in the selection of eligible liposuction candidates at initial assessment and follow-up of patients who proceed with surgery.
Authors: Bailey H Duhon; Thien T Phan; Shannon L Taylor; Rachelle L Crescenzi; Joseph M Rutkowski Journal: Int J Mol Sci Date: 2022-06-14 Impact factor: 6.208
Authors: Rachelle Crescenzi; Paula M C Donahue; Maria Garza; Chelsea A Lee; Niral J Patel; Victoria Gonzalez; R Sky Jones; Manus J Donahue Journal: Breast Cancer Res Treat Date: 2021-10-23 Impact factor: 4.624