Quantitative comparison between the laser scanner three-dimensional method and the circumferential method for evaluation of arm volume in patients with lymphedema.

OBJECTIVE: Several methods are used to evaluate arm volumes. The most commonly used methods are water displacement and the circumferential method (CM), but these techniques have some limitation in application in clinical settings and accuracy. Recently, the laser scanner three-dimensional (LS3D) method was successfully proposed as a valid method for volume measurements of the upper limb in healthy individuals. The aim of the study was to compare, in terms of intraobserver and interobserver reliability, the CM and LS3D method to measure the upper limb in a group of women with upper limb lymphedema. METHODS: There were 200 women with upper limb lymphedema (mean age, 64 ± 9 years; body mass index, 24.72 ± 2.94 kg/m2) involved in this study. Arm measurements were obtained with both the CM and LS3D method. Statistical analysis was conducted to compare the CM and LS3D method. RESULTS: Both the CM and LS3D method have a satisfactory level of agreement, but we found some statistically significant differences in terms of some measurements (both circumferential and volume measurements). CONCLUSIONS: The data obtained in this study indicate that the LS3D method could represent a reliable, valid method to measure arm circumferences and volumes in arms with lymphedema, suitable for daily clinical use. It combines precision, reproducibility, and ease of use with the possibility of measuring geometric parameters and shape information of scanned limbs.

Cytotoxic extravasation: an issue disappearing or a problem without solution?

PURPOSE: The incidence and management of antitumoral compound extravasation that occurred in our medical day hospital unit were registered in a 10-year period. METHODS: A total of 114 episodes were consecutively recorded out of an estimated number of 211,948 administrations performed (0.05%). Type of compound, localization, timing, symptoms, treatment, resolution, or sequelae were documented. RESULTS: Extravasations after anthracyclines (17/114), platinum compounds (34/114), vinca alkaloids (7/114), and taxanes (34/114) were more frequently associated with edema and erythema ± pain. Five cases of monoclonal antibodies extravasation were observed without sequelae. With the involvement of an interdisciplinary task force and the use of dedicated guidelines, conservative management was successful in all patients. In the great majority of cases, recovery was complete within 48 hours after antidote administration. The support of our pharmacy was crucial. Physiatric evaluation was considered in several cases. No patients required surgery. CONCLUSIONS: We confirm that the adopted standardized approach to this event resulted in a satisfactory outcome and could be suggested as appropriate for managing extravasation in a large clinical context.

Comparative study between circumferential method and laser scanner 3D method for the evaluation of arm volume in healthy subjects.

OBJECTIVE: Accurate and convenient measurement of upper limb volume is an important clinical tool to measure incidence of lymphedema and response to treatments. There are several methods used to evaluate arm volumes. The most commonly used methods include water displacement and circumferential method (CM), but these techniques have some limitation in use and accuracy that needs the use of a new technique for volume and swelling detection: laser scanner 3D method (LS3D). The aim of the study was to compare, in terms of intra- and interreliability, the CM and LS3D methods for the upper limb measure in a healthy subject group. METHODS: Twelve healthy adults (average age, 29 ± 5.39 years; average weight, 63.88 ± 7.97 kg; and average height, 168.38 ± 7.29 cm) participated. Arm measurements were done using both CM and LS3D methods. Statistical analysis was conducted, and intra- and inter-reliability was investigated. CM and LS3D methods were also compared in terms of level of agreement. RESULTS: Both CM and LS3D methods have a high inter- and intrarater reliability and a satisfactory level of agreement, but we found a statistically significant difference in terms of volume. The laser scanner is a more accurate volume instrument, and our results shown a statistically significant difference of volumes between methods. CONCLUSIONS: Our findings provide LS3D is an innovative method of measuring the upper limb volume that could be used instead of CM. It combines precision, reproducibility, ease of use, and the ability to measure geometrical parameters and shape information of the scanned limb.