Use of a Novel Portable Three-Dimensional Imaging System to Measure Limb Volume and Circumference in Patients with Filarial Lymphedema

Channa Yahathugoda Filariasis Research Training and Service Unit, Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka;

Search for other papers by Channa Yahathugoda in
Current site
Google Scholar
PubMed
Close
,
Michael J. Weiler LymphaTech, Atlanta, Georgia;

Search for other papers by Michael J. Weiler in
Current site
Google Scholar
PubMed
Close
,
Ramakrishna Rao Infectious Diseases Division, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri;

Search for other papers by Ramakrishna Rao in
Current site
Google Scholar
PubMed
Close
,
Lalindi De Silva Filariasis Research Training and Service Unit, Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka;

Search for other papers by Lalindi De Silva in
Current site
Google Scholar
PubMed
Close
,
J. Brandon Dixon George W. Woodruff School of Mechanical Engineering, Parker H. Petit Institute of Biotechnology and Bioscience, Georgia Institute of Technology, Atlanta, Georgia

Search for other papers by J. Brandon Dixon in
Current site
Google Scholar
PubMed
Close
,
Mirani V. Weerasooriya Filariasis Research Training and Service Unit, Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka;

Search for other papers by Mirani V. Weerasooriya in
Current site
Google Scholar
PubMed
Close
,
Gary J. Weil Infectious Diseases Division, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri;

Search for other papers by Gary J. Weil in
Current site
Google Scholar
PubMed
Close
, and
Philip J. Budge Infectious Diseases Division, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri;

Search for other papers by Philip J. Budge in
Current site
Google Scholar
PubMed
Close
Restricted access

The World Health Organization’s Global Program to Eliminate Lymphatic Filariasis (LF) has reduced LF transmission worldwide, but millions remain affected by filarial lymphedema. Tools for clinically monitoring lymphedema in developing nations are limited. We tested a novel, portable, infrared three-dimensional imaging system (3DIS) against water displacement (WD) and tape measurement of limb circumference (TMLC) among patients with filarial leg lymphedema in Galle, Sri Lanka. Outcomes were accuracy and reproducibility of imaging system measurements. In parallel, we also tested the reproducibility of skin thickness ultrasound (STU) measurements. We examined 52 patients (104 limbs) with lymphedema of stages 0–6 (N = 28, 19, 20, 21, 2, 4, and 10, respectively). 3DIS measurements correlated nearly perfectly with WD (r2 = 0.9945) and TMLC values (r2 > 0.9801). The median time required to acquire imaging system measurements for both legs was 2.1 minutes, compared with 17, 7, and 29 minutes, respectively, for WD, TMLC, and STU. Median interexaminer coefficients of variation (CVs) for volume measurements were 1.1% (interquartile range [IQR] 0.5–2.1%) for WD and 1.7% (IQR 1.2–2.4%) for the 3DIS. CVs for circumference measurements were 1.4% (IQR 0.8–2.4%) by TMLC and 1.3% (0.8–1.9%) by 3DIS. Median interexaminer CV for STU was 13.7% (IQR 8.5–21.3%). The portable imaging system noninvasively provided accurate and reproducible limb volume and circumference measurements in approximately 2 minutes per patient. This portable technology has the potential to greatly improve assessment and monitoring of lymphedema in the clinic and in the field.

    • Supplemental Materials (PDF 39 KB)
    • Supplemental Materials (AVI 3895 KB)
    • Supplemental Materials (M4V 47873 KB)

Author Notes

Address correspondence to Philip Budge, Washington University School of Medicine, Campus Box 8051, 660 S. Euclid Ave, St. Louis, MO 63110-1093. E-mail: pbudge@wustl.edu

Financial support: This study was funded in part by Washington University in St. Louis and USAID. P. J. B. is supported by grant K08AI121422 from the National Institutes of Allergy and Infectious Diseases. R. R., G. J. W., and P. J. B. are supported by Grant GH5342 from the Bill & Melinda Gates Foundation. G. J. W. and R. R. are also supported by a grant from the Barnes-Jewish Hospital Foundation. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the article.

Authors’ addresses: Channa Yahathugoda, Lalindi De Silva, and Mirani V. Weerasooriya, Filariasis Research Training and Service Unit, Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka, E-mails: tcyahath@yahoo.co.uk, lalindidesilva@gmail.com, and miraniweera@yahoo.co.uk. Michael J. Weiler, LymphaTech, Inc. Atlanta, GA, E-mail: mike.weiler@lymphatechnology.com. Ramakrishna Rao, Gary J. Weil, and Philip J. Budge, Infectious Diseases Division, Department of Medicine, Washington University School of Medicine, St. Louis, MO, E-mails: rrao@wustl.edu, gary.j.weil@wustl.edu, and pbudge@wustl.edu. J. Brandon Dixon, George W. Woodruff School of Mechanical Engineering, Parker H. Petit Institute of Biotechnology and Bioscience, Georgia Institute of Technology, Atlanta, GA, E-mail: dixon@gatech.edu.

  • 1.

    WHO, 2015. 489 Global programme to eliminate lymphatic filariasis: progress report, 2014. Wkly Epidemiol Rec 90: 489504.

  • 2.

    Ramaiah KD, Ottesen EA, 2014. Progress and impact of 13 years of the global programme to eliminate lymphatic filariasis on reducing the burden of filarial disease. PLoS Negl Trop Dis 8: e3319.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 3.

    Dreyer G, Addiss D, Dreyer P, Noroes J, 2002. Basic Lymphedema Management: Treatment and Prevention of Problems Associated with Lymphatic Filariasis. Hollis, NJ: Hollis Pub Co.

    • PubMed
    • Export Citation
  • 4.

    Chromy A, Zalud L, Dobsak P, Suskevic I, Mrkvicova V, 2015. Limb volume measurements: comparison of accuracy and decisive parameters of the most used present methods. Springerplus 4: 707.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 5.

    Warren AG, Brorson H, Borud LJ, Slavin SA, 2007. Lymphedema: a comprehensive review. Ann Plast Surg 59: 464472.

  • 6.

    Casley-Smith JR, 1994. Measuring and representing peripheral oedema and its alterations. Lymphology 27: 5670.

  • 7.

    Pani SP, Vanamail P, Yuvaraj J, 1995. Limb circumference measurement for recording edema volume in patients with filarial lymphedema. Lymphology 28: 5763.

  • 8.

    Mand S et al. 2012. Doxycycline improves filarial lymphedema independent of active filarial infection: a randomized controlled trial. Clin Infect Dis 55: 621630.

  • 9.

    Stanton AW, Northfield JW, Holroyd B, Mortimer PS, Levick JR, 1997. Validation of an optoelectronic limb volumeter (Perometer). Lymphology 30: 7797.

  • 10.

    Hameeteman M, Verhulst AC, Vreeken RD, Maal TJ, Ulrich DJ, 2016. 3D stereophotogrammetry in upper-extremity lymphedema: an accurate diagnostic method. J Plast Reconstr Aesthet Surg 69: 241247.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 11.

    Ohberg F, Zachrisson A, Holmner-Rocklov A, 2014. Three-dimensional camera system for measuring arm volume in women with lymphedema following breast cancer treatment. Lymphat Res Biol 12: 267274.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 12

    Lu G, DeSouza GN, Armer J, Anderson B, Shyu CR, 2013. A System for Limb-Volume Measurement using 3D Models from an Infrared Depth Sensor. 2013 IEEE Symposium on Computational Intelligence in Healthcare and e-health (CICARE), 6469.

    • PubMed
    • Export Citation
  • 13

    Moreira R, Magalhães A, Oliveira HP, 2015. A kinect-based system to assess lymphedema impairments in breast cancer patients. Paredes R, Cardoso JS, Pardo XM, eds. Pattern Recognition and Image Analysis. 7th Iberian Conference, IbPRIA 2015, Santiago de Compostela, Spain, June 17–19, 2015. Cham, Germany: Springer International Publishing, 228236.

    • PubMed
    • Export Citation
  • 14.

    WHO ECoF, 1992. Lymphatic Filariasis: The Disease and its Control, Fifth Report of the WHO Expert Committee on Filariasis. Geneva, Switzerland: World Health Organization.

    • PubMed
    • Export Citation
Past two years Past Year Past 30 Days
Abstract Views 475 469 47
Full Text Views 888 23 5
PDF Downloads 410 15 4
 
 
 
 
Affiliate Membership Banner
 
 
Research for Health Information Banner
 
 
CLOCKSS
 
 
 
Society Publishers Coalition Banner
Save