Quantitative and Morphologic Change Associated with Breast Cancer-Related Lymphedema. Comparison of 3.0T MRI to External Measures
Quantitative and Morphologic Change Associated with Breast Cancer-Related Lymphedema. Comparison of 3.0T MRI to External Measures
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DOI：
10.1089/lrb.2013.0026
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发表时间：
2014-06-01
影响因子：
1.4
通讯作者：
O'Brien, Patricia J.
中科院分区：
文献类型：
--
作者：
Gardner, Gregory C.;Nickerson, Joshua P.;O'Brien, Patricia J.
简介：淋巴水肿是一种对癌症幸存者越来越重要的慢性疾病。用于淋巴水肿的卷尺测量工具依赖于基于外周长的间接体积计算，这可能无法准确反映异常积液的真实程度。流体敏感的 MRI 序列可能能够更准确地描述这种情况的严重程度，从而监测对治疗的反应。方法和结果：招募了 8 名因临床诊断的乳腺癌相关淋巴水肿而接受物理治疗的患者参与本研究。对所有受试者进行外部测量和上肢 MRI。计算每种方法的臂围、臂体积和淋巴水肿体积。磁共振成像检测到所有研究对象均出现淋巴水肿。外周测量值与 3.0T MRI 之间存在相关性 (r = 0.9368)。根据临床测量计算的淋巴水肿体积与 MR 成像之间的相关性较差 (r = 0.5539)。结论：外部测量并不能准确测量与乳腺癌淋巴水肿相关的淋巴水肿体积。 MRI 是获得上肢周长和体积测量的可靠方法。 MRI 能够评估与乳腺癌相关淋巴水肿相关的形态变化。淋巴水肿研究需要综合使用工具来进一步描述疾病随时间的变化过程，量化组织变化的分布，并提高测量的灵敏度和特异性。
Introduction: Lymphedema is a chronic disease of increasing importance to cancer survivors. A tape measurement tool used for lymphedema relies on indirect volume calculations based on external circumference, which may not reflect the true extent of abnormal fluid accumulation accurately. Fluid-sensitive MRI sequences may be able to delineate the severity of this condition more precisely and thus also monitor response to therapy. Methods and Results: Eight patients being followed by physical therapy for clinically diagnosed breast cancer-related lymphedema were recruited to participate in this study. External measurements and upper extremity MRI were performed on all subjects. Arm circumference, arm volume, and lymphedema volumes were calculated for each method. MR imaging detected lymphedema in all study subjects. Correlation was found between external circumferential measurements and with the 3.0T MRI (r = 0.9368). There was poor correlation between lymphedema volumes calculated from clinical measurements and MR imaging (r = 0.5539). Conclusions: External measurements were not found to be an accurate measure of lymphedema volume associated with breast cancer lymphedema. MRI is a reliable means to obtain upper extremity circumferential and volume measurements. MRI is able to evaluate morphologic change associated with breast cancer-related lymphedema. Lymphedema research requires integrated use of tools to further describe the disease process over time, quantitate the distribution of tissue changes, and improve the sensitivity and specificity of the measurements.