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Background
Lymphedema is a common complication of breast cancer treatment that affects one in five breast cancer survivors, yet there is no reliable method to detect lymphedema in the subclinical range. The objective of this study was to determine the feasibility and reliability of using an infrared 3D scanning device (ISD) as a peri-operative limb...
Citations
... Besides laser and camera, there are various way that used for distances measurement tools in 3D scanning: infrared [18]- [21], ultrasonic sensor [22]- [26], scanning from heating methods [27] are various ways using imaging and sensors methods [19], [28]- [31] for 3D image reconstruction. ...
Three-Dimensional scanning is a method to convert various distances set into object visualization in 3-dimensional form. Developing a 3D scanner has various methods and techniques depending on the 3d scanner's purpose and the size of the object target. This research aims to build a prototype of a 3D scanner scanning small objects with dimensions maximum(10x7x23)cm. The study applied an a-three dimensional(3D) scanner using infrared and a motor to move the infrared upward to get Z-ordinate. The infrared is used to scan an object and visualize the result based on distance measurement by infrared. At the same time, the motor for rotating objects gets the (X, Y) ordinates. The object was placed in the center of the scanner, and the maximum distance of the object from infrared was 20cm. The model uses infrared to measure the object's distance, collect the result for each object's height, and visualize it in the graphic user interface. In this research, we tested the scanner with the distance between the object and infrared were 7 cm, 10 cm, 15 cm, and 20 cm. The best result was 80% accurate, with the distance between the object and the infrared being 10cm. The best result was obtained when the scanner was used on a cylindrical object and an object made of a non-glossy material. The design of this study is not recommended for objects with edge points and metal material.
... The scanning process is typically quick and comfortable for the patient, as it does not involve direct contact or radiation exposure [73]. Additionally, the digital models generated by 3D scanning provide a comprehensive visualization of the limb, allowing for a detailed assessment of volume, shape, and symmetry [74]. ...
... Ideally, a volumetric assessment method should provide consistent results when repeated on the same limb. Studies have shown that methods such as perometry, BIS, and 3D scanning techniques demonstrate good intra-and inter-rater reliability [7,10,44,46,74,75]. However, factors such as operator experience, the positioning of the limb, and the calibration of the equipment can influence the reliability of the measurements. ...
... The water displacement and centimetric methods are relatively costeffective, whereas MRI and CT can be more expensive due to equipment costs and associated imaging expenses [3,69,79]. BIS and 3D scanning techniques can have varying costs depending on the specific technology and equipment used [9,10,41,42,52,54,74]. ...
Upper-limb lymphedema is a chronic condition characterized by the accumulation of lymphatic fluid in the arm or hand, resulting in swelling and functional impairment. The accurate and reliable volumetric assessment of limb volume is crucial for the correct management of lymphedema. This narrative review provides an overview of the different methods proposed in the literature for the volumetric assessment of upper-limb lymphedema. In more detail, several methods of volumetric assessment have been proposed in recent years, including water displacement, the centimetric method, perometry, bioimpedance spectroscopy, dual-energy X-ray absorptiometry, magnetic resonance imaging, computed tomography, and three-dimensional laser scanning techniques. On the other hand, each method is characterized by specific strengths and limitations in terms of accuracy, reliability, practicality, and cost-effectiveness. Moreover, factors including operator experience, equipment availability, and patient population characteristics might have several implications in the optimal assessment of upper-limb volume. In this context, a precise volumetric assessment is crucial to improving the rehabilitation framework, patient education, and research outcomes. As a result, the integration of emerging technologies is needed to improve the tailored management of patients with upper-limb lymphedema. In conclusion, volumetric assessment methods provide valuable insights in the management of upper-limb lymphedema, improving patient care, treatment outcomes, and research advancements. Future research should focus on testing these innovative solutions on larger samples of patients to enhance the reproducibility, accuracy, accessibility, and clinical utility of volumetric assessment methods in the complex treatment framework of upper-limb lymphedema.
... However, these tools are relatively complex and require high financial investment, which prevents many clinics to obtain these tools [1]. White at al. [31] developed an infrared 3D scanning tool for measuring limb volume in breast cancer patients, and compared the accuracy of their device with that of traditional measurement techniques such as WD and CM methods. They suggested that the infrared 3D scanning could be a useful addition to the standard tools used to assess and monitor lymphedema in breast cancer patients. ...
... However, it suffers from the potential errors mainly because of oversimplifying the shape of the arm to a sequence of few conic segments, neglecting the swelling of the edematous arm [13]. With rapid development of computer vision, portable scanning systems are attracting more and more attention [9,[15][16][17][18][27][28][29]31]. Although existing scanning tools have achieved high precision, they typically need multiple providers assisting with the tool, significant financial resources, and substantial room due to a large number of sensors and cameras used in the tool [40]. ...
... On the other hand, complex scanners with high accuracy are expensive. For example, the tool in [16,31] utilizes 15 highdefinition cameras which makes it very expensive to access in rehabilitation centers. The proposed tool requires less financial/ setup cost, as it comprises a simple fixture with two cameras. ...
... In yet another step closer to the point-of-care lymphedema assessment, Yahathugoda et al. used an infrared sensor integrated with a computer table for a fully portable, fast, and reproducible assessment of lymphedema [90]. A recent study used a 3D infrared scanner for peri-operative follow-up of upper limb volume in breast cancer, with the potential for identifying patients at risk for lymphedema development [91]. ...
Lymphedema is a chronic progressive disorder that significantly compromises patients’ quality of life. In Western countries, it often results from cancer treatment, as in the case of post-radical prostatectomy lymphedema, where it can affect up to 20% of patients, with a significant disease burden. Traditionally, diagnosis, assessment of severity, and management of disease have relied on clinical assessment. In this landscape, physical and conservative treatments, including bandages and lymphatic drainage have shown limited results. Recent advances in imaging technology are revolutionizing the approach to this disorder: magnetic resonance imaging has shown satisfactory results in differential diagnosis, quantitative classification of severity, and most appropriate treatment planning. Further innovations in microsurgical techniques, based on the use of indocyanine green to map lymphatic vessels during surgery, have improved the efficacy of secondary LE treatment and led to the development of new surgical approaches. Physiologic surgical interventions, including lymphovenous anastomosis (LVA) and vascularized lymph node transplant (VLNT), are going to face widespread diffusion. A combined approach to microsurgical treatment provides the best results: LVA is effective in promoting lymphatic drainage, bridging VLNT delayed lymphangiogenic and immunological effects in the lymphatic impairment site. Simultaneous VLNT and LVA are safe and effective for patients with both early and advanced stages of post-prostatectomy LE. A new perspective is now represented by the combination of microsurgical treatments with the positioning of nano fibrillar collagen scaffolds (BioBridgeTM) to favor restoring the lymphatic function, allowing for improved and sustained volume reduction. In this narrative review, we proposed an overview of new strategies for diagnosing and treating post-prostatectomy lymphedema to get the most appropriate and successful patient treatment with an overview of the main artificial intelligence applications in the prevention, diagnosis, and management of lymphedema.
... It cannot determine whether the measurement is evidence of a change in lymphatic fluid, or due to other physiological factor as it measures total volume. It is also important to recognise that perometer measurements are perceived as unreliable in detecting subclinical chronic oedema, when there are no obvious skin changes (White, Lu, Kao et al., 2020). ...
Introduction Coproduction is a term which refers to how customers and service-users contribute to the planning, design, delivery, and implementation of goods and services, with service providers. Contemporary coproduction literature reflects a paternalistic perception of service-users with lower socioeconomic status and their interactions and relationships with specialist and non-specialist health professionals. Background Within the contemporary coproduction literature there is a suggestion that that individuals living within a context of socioeconomic deprivation are less equipped to coproduce care. Whilst service-users living with LTCs may have the knowledge, skills to manage their LTC despite socioeconomic disadvantage, there is a lack of research exploring these experiences. This study explored how coproduction is operationalised, and the impact of socioeconomic position and social capital, within the context of ongoing care across hospital and home settings. Theories of coproduction were applied, to explore shared-decision making, the implementation of care “at home”, and the dynamics of power between service-providers and service-users living with long-term conditions (LTC). Methods A mixed methods study was undertaken using, in-depth, face-to-face interviews of service-users from two Lymphoedema Clinics (City and rural) within a regional service; overt non-participant observations within the clinics, to observe the dynamic between the service-users and specialist health professionals. Service-users, partial postcodes and the addresses of General Practitioner” (GPs) were documented to identify the distribution of service-users attending the clinic 1, and to contextualise socioeconomic position of the study setting. NHS ethical approval for the study was obtained through the Regional Ethics Committee, and permission was gained to access all study Sites within the NHS organisations. Findings The findings of this study indicate that socioeconomic status does not prevent service-users from coproducing their care, in terms of their skills and knowledge or the “operant resources” they uses to engage in shared-decision making. However, a lack of economic resources and social capital, or “operand resources”, makes the coproduction of care more challenging for service-users; especially when treatment options are limited, and the implementation of care is within the “home”. In addition, service-users often perceived that non-specialist health professionals lacked the skills, knowledge and expertise to meet their care needs. Care was described by the participants as based upon a traditional, hierarchical and often biomedical model of care. This approach did not always align with the daily life of the participants, which involved balancing condition management against the desire to maintain normality, and achieve the goals that they identified as important The mitigating factor for many of the participants was the social capital and network of support they developed with the SHPs and their significant others; this evolved as an “operand resource”, in terms of trust and reciprocity and the tangible effect of co-implementing and co-delivering care. Conclusion This study addresses the research gaps related to exploration of coproduction for people with LTC, between hospital and home, and the need for more research to empirically evidence service-users’ experience. Social capital, trust, accountability, responsibility, and reciprocity are perceived as essential to operationalise the coproduction of care and actualise a more equitable partnership between service-users and service-providers.
... In addition, this technology can detect the volume changes of symptomatic patients. For example, the researchers used a 3D scanner to find that the limb volume of a patient who has been treated for lymphedema has increased by about 15% [25]. ...
Background:
Lymphedema is a common complication of breast cancer treatment, affecting 1/5 of breast cancer survivors, but there is no reliable way to detect subclinical lymphedema.
Objective:
The purpose of this study was to determine the feasibility and reliability of using an oversleeve as a postoperative limb volume measurement tool in breast cancer patients.
Methods:
Fifty patients were analyzed based on inclusion criteria. A body volume measurement kit was designed based on the drainage volume method and the circumference measurement method. Twenty-two normal healthy people were measured by the drainage volume (LV) and oversleeve measuring limb volume (OMLV) methods, so as to verify the accuracy of OMLV. Twenty-eight patients with lymphedema diagnosed by the circumdiameter measurement (CDM) method were measured with OMLV for comparison. The difference in measurements between OMLV and CDM was compared in 50 patients with early lymphedema diagnosed by the LV method.
Results:
There was no significant difference between the sleeve method and the drainage volume method in the normal population (P = 0.74). All patients with lymphedema diagnosed by CDM met the diagnostic criteria by the OMLV method. In patients with early lymphedema diagnosed by LV, the diagnostic rate with OMLV was significantly higher than that with CDM (P = 0.008).
Conclusion:
Similar to LV in the diagnosis of lymphedema, OMLV can effectively improve the diagnostic rate of early lymphedema, providing a new option for the diagnosis and treatment of lymphedema.
... Cancer-related lower extremity lymphedema is associated with treatment modalities such as cancer surgery and radiation therapy, which can injure or remove the lymph nodes [2,3]. Lymphedema is a disabling condition whereby damage to the lymphatic channels causes the accumulation of protein-rich lymphatic fluid in subcutaneous tissues, which can cause abnormal proliferation of subcutaneous adipose tissue [4,5]. Liposuction is a surgical technique that uses various types of equipment to aspirate excess subcutaneous fat through small incisions made in the skin to improve body esthetics, and pressure garments are worn for 3 to 6 months after liposuction [6]. ...
Background
Lymphedema is a progressive, noncurable condition consisting of increases in subcutaneous fat and interstitial fluid in the limbs and fibrosis during later stages. The disease most commonly affects the limbs following injury to or removal of the lymph nodes. The aim of this study was to investigate the therapeutic outcomes of liposuction for cancer-related lower extremity lymphedema.
Methods
Sixty-two patients with cancer-related lymphedema in the unilateral lower extremity were recruited for this study, and all patients underwent liposuction. The volume of hemorrhage and lipids, the operation time, and the volume changes of the affected extremity were compared by applying the t tests, and the subjective feelings of patients were compared with the chi-square tests.
Results
The total lipid volume was 2539 ± 1253.5 ml, and the hemorrhage volume was 828 ± 311.8 ml. For the comparison of objective indices, (1) the percent volume differences (PVDs) before surgery, intraoperatively, and at the 3-month follow-up were 5.5 ± 12.2 vs. 11.6 ± 18.4 vs. 43.2 ± 23.7, P < 0.05, respectively; (2) greater lipid volumes and higher liposuction rates were observed for female patients, as was a smaller volume of hemorrhage; (3) greater hemorrhage volumes were observed in patients with a history of recurrent erysipelas; and (4) greater lipid volumes and liposuction rates (LRs) and smaller hemorrhage volumes were observed for stage II than for stage III patients.
Conclusions
Liposuction is an effective therapy for cancer-related lower extremity lymphedema. Sex, stage, and recurrent erysipelas history influence the course and effect of liposuction.
... Taking advantage of the low-cost, 3D imaging capability of the commercially available Kinect sensor (Microsoft, Redmond, WA), three studies evaluated differences in arm volumes obtained using a 3D scan compared with WD 5,6 or circumference measurements (CMs). 5,7 In a study of cancer survivors with LE, 5 no significant differences in arm volumes were found among the three methods. In another study of healthy participants, which used WD as the comparator, 6 Bland-Altman bias (mean) was -9.9 mL and 95% limits of agreement (LOAs) ranged from -49.6 to 29.8 mL. ...
... Test-retest reliability for both methods and standard errors of measurement were similar. In the most recent study of patients who were assessed before and following surgery, 7 while a positive linear correlation was found between the 3D scan and TM, the 3D volumes were larger. The Bland-Altman analysis demonstrated that with larger arm volumes, the level of agreement between the two methods was lower. ...
Background:
Lymphedema (LE) is a significant clinical problem for breast cancer survivors. While the water displacement test and circumferential assessment using a tape measure (TM) are common methods to assess differences in arm volumes, faster and more reliable methods are needed. Study purposes, in breast cancer survivors (n = 294), were to compare the average total arm volumes and interlimb volume ratios for women with and without a history of LE, using a TM and three-dimensional (3D), whole-body surface scanner (3D scan); compare the level of agreement between arm volumes and interlimb volume ratios obtained using the two devices; and evaluate the percent agreement between the two measures in classifying cases of LE using three accepted thresholds.
Methods and Results:
Measurements were done using a spring-loaded TM and Fit3D ProScanner. Paired t-tests and Bland-Altman analyses were used to achieve the study aims. For circumference and volume comparisons, compared with the 3D scan, values obtained using the TM were consistently smaller. In terms of level of agreement, the Bland-Altman analyses demonstrated large biases and wide limits of agreement for the calculated arm volumes and volume ratios. In terms of the classification of caseness, using the 200-mL interlimb volume difference criterion resulted in 81.6% overall agreement; using the >10% volume difference between the affected and unaffected arms resulted in 78.5% overall agreement; and using the volume ratio ≥1.04 criterion resulted in 62.5% overall agreement. For all three accepted threshold criteria, the percentage of cases was significantly different between the TM and 3D scan techniques.
Conclusions:
The 3D technology evaluated in this study has the potential to be used for self-initiated surveillance for LE. With improvements in landmark identification and software modifications, it is possible that accurate and reliable total arm volumes can be calculated and used for early detection.
... Independently of their precision, they remain difficult, if not impossible, to use in the context of outpatient treatment, as they usually require extensive equipment and very controlled conditions. In the current context where technological development allows the production of computer vision algorithms that can be embedded, this type of approach seems promising for daily and repeated measurements of arm variations [14], [15], allowing for the detection of such an onset. However, at the present time, no truly portable solution seems to be really available, while the problem of undetected serious lymphedema remains unresolved by medical advances [16]. ...
... Therefore it seems possible to test several technologies in this way, more quickly, and also improve our methodology. For example, the significant progress made in computer vision in recent years [14], [15] may suggest that an alternative solution to the connected sleeve could involve the use of videos taken by cell phones, taken in such a way as to perform a 3D reconstruction of the arm. However, such technologies are still consuming in computational time, so our current ambition is to improve the design of the prototype, while at the same time pool the resources for the clinical study. ...
This article describes the preparation of a clinical study on a connected medical device dedicated to facilitate the prevention of lymphedema for patients treated for breast cancer after axillary lymph node dissection (ALND), and to alert them of any manifestation or resurgence in order to prevent its aggravation. A simulator of the entire physical process called digital twin has been developed for this purpose, in a hardware-in-the-loop framework. Statistical calibration of its input parameters, by stochastic inversion and using sensitivity studies, led to establish one or more measurement protocols allowing to capture the signal on a mobile device (phone or tablet) and to detect signal breaks that are physically significant. The measured signal makes it possible to report quickly on the worsening of the patient’s condition and to warn the therapists within a very reasonable period of time. The general methodology of this work seems to us to be easily reproducible in the preparation of clinical studies of other types for connected devices, which aim to develop measurement protocols limiting the often significant cost of such studies. One of the immediate prospects of this work is the initiation of a clinical study on different patients who have been treated by surgery for breast cancer, after improving the robustness of the design of the prototype to take into account the uncertainties affecting the measurements.
