TY - JOUR
T1 - Reference Values for Assessment of Unilateral Limb Lymphedema with Dual-Energy X-Ray Absorptiometry
AU - Gjorup, Caroline A
AU - Hendel, Helle W
AU - Klausen, Tobias W
AU - Zerahn, Bo
AU - Hölmich, Lisbet R
PY - 2018/2
Y1 - 2018/2
N2 - Introduction: The clinical assessment of unilateral limb lymphedema is commonly based on measurements of interlimb volume differences. Reference values for interlimb percentage differences of the volume, fat mass, and lean mass measured with dual-energy X-ray absorptiometry (DXA) scan are, however, not established. The aim of the study was to establish and categorize these reference values in normal limbs. Methods and Results: DXA scans of the normal arms of 167 and normal legs of 196 melanoma patients (aged 18-75 years, body mass index <40), respectively, were performed. The interlimb percentage difference is calculated as follows: ("Limb-of-interest" - contralateral)/contralateral × 100. The interlimb percentage differences for the limb-of-interest were stratified to upper (according to handedness) and lower limbs and categorized as none/mild, moderate, or severe, respectively, based on whether the value is below, in between, or above the two prediction limits. The prediction limits for interlimb total volume percentage difference were 6% and 10%, 0% and 4%, and 3% and 6% for the dominant arm, nondominant arm, and leg, respectively. Further data are given for interlimb percentage differences of regional (upper arm, lower arm, hand, thigh, lower leg, and foot) and total volume, fat mass, and lean mass, respectively. Conclusions: The provided clinical reference values allow for identifying and categorizing pathophysiological differences of limbs-of-interest and evaluating tissue composition.
AB - Introduction: The clinical assessment of unilateral limb lymphedema is commonly based on measurements of interlimb volume differences. Reference values for interlimb percentage differences of the volume, fat mass, and lean mass measured with dual-energy X-ray absorptiometry (DXA) scan are, however, not established. The aim of the study was to establish and categorize these reference values in normal limbs. Methods and Results: DXA scans of the normal arms of 167 and normal legs of 196 melanoma patients (aged 18-75 years, body mass index <40), respectively, were performed. The interlimb percentage difference is calculated as follows: ("Limb-of-interest" - contralateral)/contralateral × 100. The interlimb percentage differences for the limb-of-interest were stratified to upper (according to handedness) and lower limbs and categorized as none/mild, moderate, or severe, respectively, based on whether the value is below, in between, or above the two prediction limits. The prediction limits for interlimb total volume percentage difference were 6% and 10%, 0% and 4%, and 3% and 6% for the dominant arm, nondominant arm, and leg, respectively. Further data are given for interlimb percentage differences of regional (upper arm, lower arm, hand, thigh, lower leg, and foot) and total volume, fat mass, and lean mass, respectively. Conclusions: The provided clinical reference values allow for identifying and categorizing pathophysiological differences of limbs-of-interest and evaluating tissue composition.
KW - Absorptiometry, Photon
KW - Adipose Tissue/diagnostic imaging
KW - Adolescent
KW - Adult
KW - Aged
KW - Arm/diagnostic imaging
KW - Body Mass Index
KW - Cross-Sectional Studies
KW - Female
KW - Humans
KW - Leg/diagnostic imaging
KW - Lymphedema/diagnostic imaging
KW - Male
KW - Melanoma/diagnostic imaging
KW - Middle Aged
KW - Reference Values
KW - Skin Neoplasms/diagnostic imaging
U2 - 10.1089/lrb.2016.0064
DO - 10.1089/lrb.2016.0064
M3 - Journal article
C2 - 28486005
SN - 1539-6851
VL - 16
SP - 75
EP - 84
JO - Lymphatic Research and Biology
JF - Lymphatic Research and Biology
IS - 1
ER -