Department of Nursing, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Japanese Red Cross Nagoya Daini Hospital, Nagoya, Japan.
Lymphat Res Biol. 2023 Apr;21(2):179-186. doi: 10.1089/lrb.2022.0021. Epub 2022 Sep 16.
Lymphedema often affects the trunk after breast cancer surgery. Measuring volume baseline can help detect lymphedema-related changes early, thereby allowing for early intervention efforts. However, there is no quantitative method for detecting truncal lymphedema. As a preliminary investigation into the development of a new method for measuring truncal lymphedema, this study aimed to investigate the reliability and define the minimal detectable change (MDC) in posterior truncal thickness using a three-dimensional (3D) scanning system. This observational study included 21 women who had undergone a mastectomy for breast cancer. The 3D images of every subject's trunk were captured by a handheld 3D scanner at two time points. The acquired 3D images were used to calculate the differences in thickness between the affected and unaffected sides at eight points on the trunk. The reliability was determined by checking for agreement between the trials (intraclass correlation coefficient) and by investigating the presence of systematic bias between the measurement error and true value (Bland-Altman analysis). Then, the MDC was calculated. For 14 of the 21 participants, 3D images without missing data at both time points were obtained. Analysis indicated that there was no systematic bias regarding the mean value at the seven body points. Fair-to-excellent reliability was shown at the five points in the middle of the trunk (MDC: 4.14-9.79 mm). The other three points (at the top and bottom of the trunk) had limited reliability. The 3D scanning system effectively measured the differences in thickness between the affected and unaffected sides of participants' posterior trunks, with fair-to-excellent reliability in the middle of the trunk.
乳腺癌手术后,淋巴水肿通常会影响躯干。测量基线体积有助于早期发现与淋巴水肿相关的变化,从而可以进行早期干预。但是,目前尚无定量方法来检测躯干淋巴水肿。作为开发测量躯干淋巴水肿的新方法的初步研究,本研究旨在使用三维(3D)扫描系统来研究后躯干厚度的可靠性和定义最小可检测变化(MDC)。
这项观察性研究包括 21 名因乳腺癌接受乳房切除术的女性。每位患者的躯干的 3D 图像通过手持 3D 扫描仪在两个时间点捕获。使用所获得的 3D 图像来计算躯干上八个点处受影响侧和未受影响侧之间的厚度差异。通过检查试验之间的一致性(组内相关系数)和测量误差与真实值之间是否存在系统偏差(Bland-Altman 分析)来确定可靠性。然后计算 MDC。在 21 名参与者中的 14 名中,获得了两个时间点均无缺失数据的 3D 图像。分析表明,七个身体部位的平均值不存在系统偏差。在躯干中部的五个部位显示出良好到极好的可靠性(MDC:4.14-9.79mm)。躯干顶部和底部的另外三个部位的可靠性有限。3D 扫描系统有效地测量了参与者后躯干受影响侧和未受影响侧之间的厚度差异,在躯干中部具有良好到极好的可靠性。