title: Computed tomography-based quantitative assessment of lower extremity lymphedema following treatment for gynecologic cancer.
abstract: OBJECTIVE
  To develop an algorithmic quantitative skin and subcutaneous tissue volume measurement protocol for lower extremity lymphedema (LEL) patients using computed tomography (CT), to verify the usefulness of the measurement techniques in LEL patients, and to observe the structural characteristics of subcutaneous tissue according to the progression of LEL in gynecologic cancer.
  
  
  METHODS
  A program for algorithmic quantitative analysis of lower extremity CT scans has been developed to measure the skin and subcutaneous volume, muscle compartment volume, and the extent of the peculiar trabecular area with a honeycombed pattern. The CT venographies of 50 lower extremities from 25 subjects were reviewed in two groups (acute and chronic lymphedema).
  
  
  RESULTS
  A significant increase in the total volume, subcutaneous volume, and extent of peculiar trabecular area with a honeycombed pattern except quantitative muscle volume was identified in the more-affected limb. The correlation of CT-based total volume and subcutaneous volume measurements with volumetry measurement was strong (correlation coefficient: 0.747 and 0.749, respectively). The larger extent of peculiar trabecular area with a honeycombed pattern in the subcutaneous tissue was identified in the more-affected limb of chronic lymphedema group.
  
  
  CONCLUSIONS
  CT-based quantitative assessments could provide objective volume measurements and information about the structural characteristics of subcutaneous tissue in women with LEL following treatment for gynecologic cancer.
authors.affiliation: Rehabilitation Medicine, Research Institute and Hospital, National Cancer Center, Goyang, Korea.
authors.forename: Ji Sung
authors.identifier: http://orcid.org/0000-0003-3559-8412
authors.initials: JS
authors.lastname: Yoo
authors.affiliation: Rehabilitation Medicine, Research Institute and Hospital, National Cancer Center, Goyang, Korea.
authors.forename: Seung Hyun
authors.initials: SH
authors.lastname: Chung
authors.affiliation: Gynecologic Cancer Branch, Center for Uterine Cancer, and Center for Clinical Trials, Research Institute and Hospitaland Cancer Control and Policy, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea.
authors.forename: Myong Cheol
authors.identifier: http://orcid.org/0000-0001-8964-7158
authors.initials: MC
authors.lastname: Lim
authors.affiliation: Biomedical Engineering Branch, Division of Precision Medicine and Cancer Informatics, Research Institute, National Cancer Center, Goyang, Korea.
authors.forename: Young Jae
authors.initials: YJ
authors.lastname: Kim
authors.affiliation: Biomedical Engineering Branch, Division of Precision Medicine and Cancer Informatics, Research Institute, National Cancer Center, Goyang, Korea.
authors.forename: Kwang Gi
authors.initials: KG
authors.lastname: Kim
authors.affiliation: Department of Physical and Rehabilitation Medicine, Center for Supportive Care, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Ji Hye
authors.initials: JH
authors.lastname: Hwang
authors.affiliation: Department of Physical and Rehabilitation Medicine, Center for Prevention and Rehabilitation, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. yunkim@skku.edu.
authors.forename: Yun Hee
authors.identifier: http://orcid.org/0000-0001-6101-8851
authors.initials: YH
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005833:Genital Neoplasms, Female / Q000601:surgery*; D006801:Humans; D035002:Lower Extremity; D008209:Lymphedema / Q000000981:diagnostic imaging* / Q000473:pathology; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D040521:Subcutaneous Tissue / Q000000981:diagnostic imaging* / Q000473:pathology; D014057:Tomography, X-Ray Computed / Q000379:methods*
keywords: Genital Neoplasms, Female; Lymphedema; Quantitative Evaluation; Tomography, X-Ray Computed