Validity and reliability of three-dimensional imaging to measure limb volume: A systematic review

• Published in: Physical therapy reviews 2020-01, Vol.25 (1), p.21-28
• Main Authors: Kremer, Rachel L., Wolfe, Madison E., Brueckner, Noah J., Viola, Michaela C., Fisher, Mary Insana
• Format: Article
• Language: English
• Subjects: breast neoplasms; infrared scanning; lymphedema; measurement; psychometrics
• ISSN: 1083-3196; 1743-288X
• DOI: 10.1080/10833196.2019.1698160

Introduction: Approximately 30% of women treated for breast cancer will develop lymphedema, yet early identification can prevent this occurrence. It is important to accurately and efficiently measure limb volume to identify pre-clinical lymphedema. Three-dimensional (3 D) imaging is emerging as a potential method to meet the need for accuracy and efficiency. The purpose of this review was to evaluate the psychometrics of 3 D imaging to measure limb volume. Methods: A systematic search of 4 databases was conducted for articles using 3 D imaging to measure limb volume. Articles were included that compared 3 D imaging to water displacement using human subjects, from 2000 to present. Data related to relevant psychometrics (validity, reliability, responsiveness) and patient populations were extracted from each article and analyzed. Risk of bias in study design was also assessed for each article. Results: The initial search of publications included 141 articles, 27 of which were selected based on the title and abstract. Only 13 articles were selected after full text review. Evidence from a preponderance of high-quality studies demonstrates that 3 D imaging is valid and reliable. Discussion: 3 D scanning can provide an accurate and efficient alternative means of measuring limb volume in breast cancer related lymphedema when compared to the reference standard of water displacement. Limitations to immediate clinical adoption include lack of information related to diagnostic accuracy and responsiveness, as well as a uniform definition of lymphedema.