Lymphedema of upper limbs is a condition that usually arises after breast cancer treatment. The partial or total removal of axillary lymph nodes and the subsequent radiotherapy could lead to an incorrect discharge of lymph, which stagnates in the skin tissues by causing an incremental swelling of the whole arm, i.e. the lymphedema. The prevention and treatment of lymphedema is carried out in hospitals and rehabilitation centres through specific assessment methods based on the measure of the limb volume. These methods allow defining the severity of patient’s condition and permit to gather the measures for standard or custom orthopaedic stocking.
The presentation introduces a novel procedure based on ICT technologies for lymphedema assessment. The procedure is based on the 3D scanning of the arm and an ad-hoc developed application, named Lym 3DLab, which automatically computes linear and volumetric measurements starting from the arm virtual model. Acquired measurements can be also used to design the compression stockings for lymphedema treatment.
A validation test has been performed to compare the measurements computed by Lym 3DLab with both water displacement and circumference measurements, which are the most common methods for linear and volumetric measurement of a limb. Furthermore, a specific usability test has been performed to evaluate the 3D scanning procedure involving physiotherapists. The comparison between the volumes has highlighted how all the 3D acquired models have their volumes inside a range of acceptability. This range has been defined by considering the sensitivity error of the tape measure used to measure the water displacement. The comparison between the perimeters of cross sections computed with Lym 3DLab and the circumference measurements has shown results that are accurate with an average difference of 2 mm. The measure errors have been considered negligible by the medical personnel who evaluated the proposed procedure very promising. The test with physiotherapists has shown a high level of usability of the whole virtual environment, but the 3D scanning procedure requires an appropriate training of the personnel to make the 3D acquisition as fast and efficient as possible.
The achieved results and the physiotherapists’ feedback permit to plan a future test with patients affected by lymphedema in collaboration with the hospital and design orthopaedic compression stockings.
Dr.Andrea Vitali is an Assistant Professor at University of Bergamo. Since 2012, he carried out research activities relative to the development of methods and computer-aided tools for the design of custom-fit products by integrating several technologies (e.g., CAD-CAE systems,motion capture systems, hand-tracking devices, 3D scanners and virtual reality). The deep knowledge of these technologies also allowed research activities to design innovative applications and web-platforms for rehabilitation processes of several categories of patients, such as patient with multiple sclerosis, spinal cord injured patients, patients with a brain stroke and patient affected by lymphedema. The research activities have been funded by several national and regional research projects in collaboration with public and private hospitals of Lombardy region.