title: Validation of lower limb segmental volumetry with hand-held, self-positioning three-dimensional laser scanner against water displacement.
abstract: BACKGROUND
  Measurement of limb volume is helpful for the evaluation and follow-up of edema, especially in patients with chronic venous insufficiency (CVI) or lymphedema. Water displacement (WD) is the reference method for limb volumetry but is not really suitable for clinical routine. Indirect volumetry based on circumference measurements as well as the more expansive but automatic optoelectronic techniques do not allow detailed measurement at the extremity of the limb.
  
  
  METHODS
  We used a self-positioning laser scanner with dynamic referencing for acquisition and real-time three-dimensional (3D) reconstruction of the lower limb volume in 30 patients with CVI, 30 patients with lymphedema, and 30 healthy controls. Two independent observers performed either one or two laser scans, whose results were tested for intra- and interobserver reproducibility and compared with WD volumetry by Lin's concordance correlation coefficient and Bland and Altman graphic analysis.
  
  
  RESULTS
  Automatic volume calculation from 3D laser scanning data failed in one patient with major lymphedema. Lin's concordance correlation coefficient was 0.99 and 0.98, respectively, for intraobserver no. 1 and no. 2, 0.98 for interobserver reproducibility, and 0.98 and 0.96, respectively, for observer no. 1 and observer no. 2 vs WD comparison. The 3D laser scanning yielded 1.99% precision. Accuracy was 3.12% for observer no. 1 and 2.71% for observer no. 2, laser scanning values being 90 mL higher than WD, which could be attributed to the different posture during measurement.
  
  
  CONCLUSIONS
  Three-dimensional laser scanning is accurate and reproducible, and appears suitable for the evaluation of limb volume in patients with CVI or lymphedema.
authors.affiliation: Internal and Vascular Medicine Department, Montpellier University Hospital, Montpellier, France; Dysfunctions of Vascular Interfaces Laboratory EA2992, Montpellier 1, University, Montpellier and Nimes, France. Electronic address: s-mestre@chu-montpellier.fr.
authors.forename: Sandrine
authors.initials: S
authors.lastname: Mestre
authors.affiliation: Montpellier Laboratory of Informatics, Robotics, and Microelectronics, Montpellier, France.
authors.forename: Florent
authors.initials: F
authors.lastname: Veye
authors.affiliation: Dysfunctions of Vascular Interfaces Laboratory EA2992, Montpellier 1, University, Montpellier and Nimes, France; Vascular Medicine Clinics and Laboratory, Nimes University Hospital, Nimes, France.
authors.forename: Antonia
authors.initials: A
authors.lastname: Perez-Martin
authors.affiliation: Internal and Vascular Medicine Department, Montpellier University Hospital, Montpellier, France.
authors.forename: Thomas
authors.initials: T
authors.lastname: Behar
authors.affiliation: Montpellier Laboratory of Informatics, Robotics, and Microelectronics, Montpellier, France.
authors.forename: Jean
authors.initials: J
authors.lastname: Triboulet
authors.affiliation: MARA-Process, Montpellier, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Berron
authors.affiliation: Biostatistics, Epidemiology, Public Health, and Medical Informatics, Nimes University Hospital, Nimes, France.
authors.forename: Christophe
authors.initials: C
authors.lastname: Demattei
authors.affiliation: Internal and Vascular Medicine Department, Montpellier University Hospital, Montpellier, France; Dysfunctions of Vascular Interfaces Laboratory EA2992, Montpellier 1, University, Montpellier and Nimes, France; Clinical Investigation Center, INSERM CIC 1001, Montpellier University Hospital, Montpellier, France.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Quéré