Assessing Arm Volume in People During and After Treatment for Breast Cancer: Reliability and Convergent Validity of the LymphaTech System

Abstract

Background There are challenges related to the accurate and efficient measurement of lymphedema in people with breast cancer. The LymphaTech 3D Imaging System (LymphaTech, Atlanta, GA, USA) is a mobile, noninvasive platform that provides limb geometry measurements. Objective The objective of this study was to estimate the reliability and validity of the LymphaTech for measuring arm volume in the context of women seeking care in a specialty breast cancer rehabilitation clinic. Design This was a cross-sectional reliability and convergent validity study. Methods People who had stage I to IV breast cancer with lymphedema or were at risk for it were included. Arm volume was measured in 66 participants using the LymphaTech and perometer methods. Test-retest reliability for a single measure, limb volume difference, and agreement between methods was analyzed for 30 participants. A method-comparison analysis was also used to assess convergent validity between methods. Results Both LymphaTech and perometer methods displayed intraclass correlation coefficients (ICCs) of ≥0.99. The standard errors of measurement for the LymphaTech and length-matched perometer measurements were nearly identical. Similar intraclass correlation coefficients (0.97) and standard errors of measurement (38.0–40.7 mL) were obtained for the between-limb volume difference for both methods. The convergent validity analyses demonstrated no systematic difference between methods. Limitations The sample size was not based on a formal sample size calculation. LymphaTech measurements included interrater variance, and perometer measurements contained intrarater variance. Conclusions The LymphaTech had excellent test-retest reliability, and convergent validity was supported. This technology is efficient and portable and has a potential role in prospective surveillance and management of lymphedema in clinical, research, and home settings.

Use of a portable infrared 3D scanning device measuring limb volume in a safety net hospital breast clinic

“…Prior studies comparing PISD to water displacement, tape measurements, and perometry have documented accurate and reliable measurements of limb volume. 4,5 The primary aim was to determine the feasibility of implementing a PISD to measure limb volume prospectively in a BC clinic. The secondary aim was to identify associations between demographics and limb volume/functionality changes.…”

Can 3D Camera Imaging Provide Improved Information to Assess and Manage Lymphoedema in Clinical Practice?

“…This device was compared to perometry by comparing limb volume and limb volume differences. Binkley et al (2020) concluded that their 3DCI provided similar limb volumes to perometry and found that the results supported the reliability and validity of their LymphaTech system.…”

“…Nine papers reported good to excellent ICC values for perometry. Pooled ICC data showed an ICCintra value of 0.97 (95% CI=0.85, 1.00) (Czerniec et al, 2010;Lee et al, 2011;Dylke et al, 2012;Adriaenssens et al, 2013;Bulley et al, 2013;Sharkey et al, 2018;De Vrieze et al, 2019;Spinelli et al, 2019;Binkley et al, 2020) and an ICCinter value of 0.98 (95% CI=0.90, 1.00) (Lee et al, 2011;Bulley et al, 2013;De Vrieze et al, 2019;Spinelli et al, 2019). The weighted mean SEM was 3.4% (=4.6%) and the weighted mean SDC was 9.4% (=12.8%) (Czerniec et al, 2010;Foroughi et al, 2011;Dylke et al, 2012;Adriaenssens et al, 2013;Bulley et al, 2013;Lu et al, 2013;Batista et al, 2018;Sharkey et al, 2018;Binkley et al, 2020).…”

“…Disadvantages of perometry are that it is cost-prohibitive (Adriaenssens et al, 2013;Lu et al, 2013;Sharkey et al, 2018;Binkley et al, 2020), bulky in size requiring space for setting up (Binkley et al, 2020), calculates total limb volume thus is unable to discriminate between fat, fluid, muscle and bone (Czerniec et al, 2010), does not easily capture the extremity and root of the limb (Czerniec et al, 2010;Sun et al, 2018), and most devices are not portable (Lu et al, 2013). The images built from the data are not quantifiable and other than confirming the observed visual differences in shape, the images provide no further information to the therapist.…”

“…Thus researchers who had hoped to expand the use of this camera system into a clinical setting will have to source a new 3D camera system and validate its use. The newest method of 3DCI technology is the LymphaTech system (Binkley et al, 2020) which consists of a commercially available depth camera (Structure Sensor;…”