Presentation Title

Noninvasive Assessment of Leg Lymphedema by Tissue Dielectric Constant Ratios

Presenter Credentials

Elham Shams, College Of Osteopathic Medicine, OMS-II, MS, MHS Aakangsha Jain, College Of Osteopathic Medicine, OMS-III, BS

Presenter Degree

MS

Co-Author Credentials

Andrea Astudillo, College Of Osteopathic Medicine, OMS-II, MS Aakangsha Jain, College Of Osteopathic Medicine, OMS-III Harvey N. Mayrovitz, Dr. Kiran C. Patel College of Allopathic Medicine, PhD

College

Dr. Kiran C. Patel College of Osteopathic Medicine

Campus Location

Ft. Lauderdale

Format

Poster

IRB Approval Verification

Yes

Abstract

Objective: The present goal was to determine the applicability of tissue dielectric constant (TDC) threshold criterion in women with lower extremity lymphedema (LEL). Background: LEL accompanies many conditions including gynecological surgery. Recently a method was put forward to detect and track LEL based on measurements of TDC in which the ratio of leg-to-arm TDC ratios was the diagnostic parameter. This concept was based on the fact that TDC is highly dependent on localized tissue water. From measurements done in healthy adults free of LEL, a normal reference threshold of 1.352 was put forward as a value above defined the presence of LEL. However, this criterion’s validity has not been evaluated in patients having LEL. Methods: Intended TDC measurement sites on calf and forearm were identified on subjects. Calf sites were measured on the visually most edematous leg at a location that was eight cm proximal to the medial malleolus on the medial and lateral sides. The forearm site was on the same side as the measured leg at a site five cm distal to the antecubital fossa. TDC was measured prior to the subject receiving lymphedema treatment. TDC measurements, which are strongly dependent on localized tissue water, were made in triplicate with the noninvasive LymphScanner (Delfin Technologies, Kuopio Finland). The ratio of the calf-to-arm TDC values (medial and lateral) were calculated from the triplicate averages. Results: Absolute TDC values measured on calf medial and lateral sites were 49.9 ± 8.0 and 46.1 ± 11.1 respectively. Forearm values were 27.5 ± 3.8. Medial calf-to-forearm ratio was 1.845 ± 0.335 and lateral calf-to-forearm ratio was 1.736 ± 0.322. All calf-to-forearm ratios were greater than the 1.352 value determined as the LEL threshold based on healthy subjects. Conclusions: Based on the present findings it appears that the proposed calf/forearm TDC ratio threshold of 1.352 can be used as a quantitative measure for detecting lower extremity lymphedema or edema. It is also likely that changes in the calf/forearm ratio may also be used to track temporal changes in lymphedema that are related to treatment interventions.

Selection Criteria

1

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Noninvasive Assessment of Leg Lymphedema by Tissue Dielectric Constant Ratios

Objective: The present goal was to determine the applicability of tissue dielectric constant (TDC) threshold criterion in women with lower extremity lymphedema (LEL). Background: LEL accompanies many conditions including gynecological surgery. Recently a method was put forward to detect and track LEL based on measurements of TDC in which the ratio of leg-to-arm TDC ratios was the diagnostic parameter. This concept was based on the fact that TDC is highly dependent on localized tissue water. From measurements done in healthy adults free of LEL, a normal reference threshold of 1.352 was put forward as a value above defined the presence of LEL. However, this criterion’s validity has not been evaluated in patients having LEL. Methods: Intended TDC measurement sites on calf and forearm were identified on subjects. Calf sites were measured on the visually most edematous leg at a location that was eight cm proximal to the medial malleolus on the medial and lateral sides. The forearm site was on the same side as the measured leg at a site five cm distal to the antecubital fossa. TDC was measured prior to the subject receiving lymphedema treatment. TDC measurements, which are strongly dependent on localized tissue water, were made in triplicate with the noninvasive LymphScanner (Delfin Technologies, Kuopio Finland). The ratio of the calf-to-arm TDC values (medial and lateral) were calculated from the triplicate averages. Results: Absolute TDC values measured on calf medial and lateral sites were 49.9 ± 8.0 and 46.1 ± 11.1 respectively. Forearm values were 27.5 ± 3.8. Medial calf-to-forearm ratio was 1.845 ± 0.335 and lateral calf-to-forearm ratio was 1.736 ± 0.322. All calf-to-forearm ratios were greater than the 1.352 value determined as the LEL threshold based on healthy subjects. Conclusions: Based on the present findings it appears that the proposed calf/forearm TDC ratio threshold of 1.352 can be used as a quantitative measure for detecting lower extremity lymphedema or edema. It is also likely that changes in the calf/forearm ratio may also be used to track temporal changes in lymphedema that are related to treatment interventions.