J Gynecol Oncol.
2017 Mar;28(2):e18. 10.3802/jgo.2017.28.e18.
Computed tomography-based quantitative assessment of lower extremity lymphedema following treatment for gynecologic cancer
- Affiliations
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- 1Rehabilitation Medicine, Research Institute and Hospital, National Cancer Center, Goyang, Korea.
- 2Gynecologic Cancer Branch, Center for Uterine Cancer, and Center for Clinical Trials, Research Institute and Hospitaland Cancer Control and Policy, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea.
- 3Biomedical Engineering Branch, Division of Precision Medicine and Cancer Informatics, Research Institute, National Cancer Center, Goyang, Korea.
- 4Department of Physical and Rehabilitation Medicine, Center for Supportive Care, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
- 5Department of Physical and Rehabilitation Medicine, Center for Prevention and Rehabilitation, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. yunkim@skku.edu
- KMID: 2413457
- DOI: http://doi.org/10.3802/jgo.2017.28.e18
Abstract
OBJECTIVE
To develop an algorithmic quantitative skin and subcutaneous tissue volume measurement protocol for lower extremity lymphedema (LEL) patients using computed tomography (CT), to verify the usefulness of the measurement techniques in LEL patients, and to observe the structural characteristics of subcutaneous tissue according to the progression of LEL in gynecologic cancer.
METHODS
A program for algorithmic quantitative analysis of lower extremity CT scans has been developed to measure the skin and subcutaneous volume, muscle compartment volume, and the extent of the peculiar trabecular area with a honeycombed pattern. The CT venographies of 50 lower extremities from 25 subjects were reviewed in two groups (acute and chronic lymphedema).
RESULTS
A significant increase in the total volume, subcutaneous volume, and extent of peculiar trabecular area with a honeycombed pattern except quantitative muscle volume was identified in the more-affected limb. The correlation of CT-based total volume and subcutaneous volume measurements with volumetry measurement was strong (correlation coefficient: 0.747 and 0.749, respectively). The larger extent of peculiar trabecular area with a honeycombed pattern in the subcutaneous tissue was identified in the more-affected limb of chronic lymphedema group.
CONCLUSION
CT-based quantitative assessments could provide objective volume measurements and information about the structural characteristics of subcutaneous tissue in women with LEL following treatment for gynecologic cancer.
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