Abstract: CT Volumetric Assessment Correlates Strongly with Circumferential Measurement in Patients with Lymphedema and Vascularized Lymph Node Transfers (Plastic Surgery The Meeting (September 28

Sunday, September 30, 2018: 10:55 AM

Ming-Huei Cheng, MD, MBA, FACS , Plastic and Reconstructive Surgery, Chang-Gung Memorial Hospital, Taoyuan, Taiwan

Olivia A Ho, MD , Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan

Sung-Yu Chu, MD , Chang Gung Memorial Hospital, Taoyuan, Taiwan

Yen-Ling Huang, MD , Department of Medical Imaging and Interventional Radiology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan

Wen-Hui Chen, MD , Department of Medical Imaging and Interventional Radiology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan

Chia-Yu Lin, MSc , Plastic and Reconstructive Surgery and Nursing, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan

BACKGROUND:

Circumferential measurement of lymphedematous limbs at designated anatomic distances has been the primary mode for measuring lymphedematous extremities. However, this approach has been criticized for not being an accurate assessment of the volume of the affected limbs. CT imaging produces accurate, consistent, and hygienic measurements of volume and is a direct representation of the limb. Thus, CT imaging is an excellent standard for comparing other measurement methods. This study aims to compare circumferential measurements to volumetric studies using CT imaging and to assess their correlation.
METHODS:

Patients with lymphedema who had vascularized lymph node transfers from January 2013 to May 2016 were assessed. CT and circumferential methods were compared using the same standardized position points and the same anatomical landmarks. Cost analysis of the two modalities was performed.

RESULTS:

Seventy-six patients were evaluated. Their CT volume measurements significantly correlated with their respective circumferential measurement differentials and were found to have the same Pearson correlation coefficient of r = +0.7, which was statistically significant (p = 0.03), indicating a strong positive correlation between the circumferential measurement differentials and the actual limb volume changes as determined by CT imaging. Circumferential measurement differentials are more cost effective than CT volume assessments and provide an accurate measurement of clinical improvement after treatment.

CONCLUSIONS:

Standardized circumferential limb measurement differentials that are currently used are comparable to unbiased CT volumetric measurements and can be used as a reliable, reproducible, minimally invasive, low cost, and accurate method of measuring the lymphedematous limbs.

35613 CT Volumetric Assessment Correlates Strongly with Circumferential Measurement in Patients with Lymphedema and Vascularized Lymph Node Transfers