title: Repeatability of Volume and Regional Body Composition Measurements of the Lower Limb Using Dual-energy X-ray Absorptiometry.
abstract: Lower limb lymphedema is a dynamic condition in which tissue composition and volume measurements are affected. Various definitions of lower limb lymphedema exist but volume differences between the limbs are widely used. It is therefore necessary to have a readily available noninvasive measurement technique allowing multiple measurements of the lower limbs. This study investigated the repeatability of duplicate volume and regional body composition measurements of the lower limb using the GE Lunar Prodigy dual-energy X-ray absorptiometry (DXA) scanner Prodigy (GE Medical Systems, Madison, WI). Twenty-seven participants (54 limbs), 14 women and 13 men aged 33-71 years with body mass index ranging from 14 to 32 kg/m2were recruited. Duplicate whole-body DXA scans were performed with repositioning between examinations. Regions of interest were manually drawn for the thigh, lower leg, and foot, and total volume was calculated using the density of bone mineral content, fat, and lean mass. The repeatability of the volume of the lower limb and regional thigh and lower leg tissue composition (bone mineral content, fat, and lean mass) was good with intraclass correlation coefficient values of 0.97 to 0.99, and narrow limits of agreement on the Bland-Altman plots. These results confirm DXA to be a highly repeatable method for volume and tissue composition measurements of the lower limb. In a population at risk of lymphedema, DXA offers a clinically readily available noninvasive method allowing multiple measurements of volume and tissue composition on a routine basis, important for diagnosing, monitoring, managing, and researching lymphedema.
authors.affiliation: Department of Plastic Surgery, Herlev and Gentofte Hospital, University of Copenhagen, Denmark. Electronic address: caroline@gjorup.com.
authors.forename: Caroline A
authors.initials: CA
authors.lastname: Gjorup
authors.affiliation: Department of Clinical Physiology and Nuclear Medicine, Herlev and Gentofte Hospital, University of Copenhagen, Denmark.
authors.forename: Bo
authors.initials: B
authors.lastname: Zerahn
authors.affiliation: Department of Plastic Surgery, Herlev and Gentofte Hospital, University of Copenhagen, Denmark.
authors.forename: Sarah
authors.initials: S
authors.lastname: Juul
authors.affiliation: Department of Clinical Physiology and Nuclear Medicine, PET-center, Herlev and Gentofte Hospital, University of Copenhagen, Denmark.
authors.forename: Helle W
authors.initials: HW
authors.lastname: Hendel
authors.affiliation: Department of Public Health, University of Copenhagen, Denmark.
authors.forename: Karl Bang
authors.initials: KB
authors.lastname: Christensen
authors.affiliation: Department of Plastic Surgery, Herlev and Gentofte Hospital, University of Copenhagen, Denmark.
authors.forename: Lisbet R
authors.initials: LR
authors.lastname: Hölmich
mesh_terms: D015502:Absorptiometry, Photon; D000273:Adipose Tissue / Q000000981:diagnostic imaging; D000328:Adult; D000368:Aged; D001823:Body Composition; D015519:Bone Density; D005260:Female; D006801:Humans; D007866:Leg / Q000000981:diagnostic imaging* / Q000473:pathology; D035002:Lower Extremity / Q000000981:diagnostic imaging / Q000473:pathology; D008209:Lymphedema / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D015203:Reproducibility of Results; D013848:Thigh / Q000000981:diagnostic imaging* / Q000473:pathology
keywords: Body composition; dimensional measurement accuracy; dual-energy X-ray absorptiometry; lower extremity; lymphedema