Multi-Segment Bioimpedance for Diagnosis and Follow-Up of Treatment for Lymphedema

Henrique Jose Pereira de Godoy, Ana Carolina Pereira de Godoy, Lívia Maria Pereira de Godoy, Maria de Fatima Guerreiro Godoy, Jose Maria Pereira de Godoy

 
For citation: Pereira de Godoy HJ, Pereira de Godoy AC, Pereira de Godoy LM, Guerreiro Godoy MF, Jose Maria Pereira de Godoy JM. Multi-Segment Bioimpedance for Diagnosis and Follow-Up of Treatment for Lymphedema. International Journal of Biomedicine. 2024;14(3):454-457. doi:10.21103/Article14(3)_OA10
 
Originally published September 6, 2024

Abstract: 

Background: The present study aimed to evaluate the use of multi-frequency, multi-segment bioimpedance for the diagnosis and therapeutic follow-up of clinical stages II and III lymphedema of the lower limbs.
Methods and Results: A diagnostic clinical trial was conducted to evaluate the sensitivity and specificity of multi-frequency, multi-segment bioimpedance compared to volumetry for diagnosing and therapeutically following up clinical stages II and III lymphedema of the lower limbs. Treatment comprised the intensive Godoy Method® (eight hours per day for five days). One hundred limbs from 50 patients were evaluated, with 64 true-positive diagnoses, two false positives, three false negatives, and 31 true negatives, resulting in a sensitivity of 95.52% and specificity of 93.94%.
Conclusion: Multi-frequency and multi-segment bioimpedance analysis is effective in the diagnosis and therapeutic follow-up of clinical stages II and III lymphedema of the lower limbs, achieving similar results to those obtained using water displacement volumetry.

Keywords: 
lymphedema • multi-segment bioimpedance • diagnosis • treatment
References: 
  1. Gasparis AP, Kim PS, Dean SM, Khilnani NM, Labropoulos N. Diagnostic approach to lower limb edema. Phlebology. 2020 Oct;35(9):650-655. doi: 10.1177/0268355520938283. Epub 2020 Jul 6. PMID: 32631171; PMCID: PMC7536506. 
  2. Pereira de Godoy AC, Pereira de Godoy JM, Guerreiro Godoy MF. Primary Congenital Lymphedema with More Than 10 Years of Treatment Using the Godoy Method Through to Adolescence. Pediatr Rep. 2021 Feb 20;13(1):91-94. doi: 10.3390/pediatric13010012. PMID: 33672755; PMCID: PMC8006030.
  3. Chaput G, Ibrahim M, Towers A. Cancer-related lymphedema: clinical pearls for providers. Curr Oncol. 2020 Dec;27(6):336-340. doi: 10.3747/co.27.7225. Epub 2020 Dec 1. PMID: 33380866; PMCID: PMC7755442.
  4. Pereira de Godoy JM, Guerreiro Godoy MF, Barufi S, Pereira de Godoy HJ. Intensive Treatment of Lower-Limb Lymphedema and Variations in Volume Before and After: A Follow-Up. Cureus. 2020 Oct 1;12(10):e10756. doi: 10.7759/cureus.10756. PMID: 33033665; PMCID: PMC7532877.
  5. Lee BB, Antignani PL, Baroncelli TA, Boccardo FM, Brorson H, Campisi C, Damstra RJ, Flour M, Giannoukas A, Laredo J, Liu NF, Michelini S, Piller N, Rockson SG, Scuderi A, Szolnoky G, Yamamoto T. IUA-ISVI consensus for diagnosis guideline of chronic lymphedema of the limbs. Int Angiol. 2015 Aug;34(4):311-32. Epub 2014 Mar 19. PMID: 24699525.
  6. Forte AJ, Boczar D, Huayllani MT, Lu X, Ciudad P. Lymphoscintigraphy for Evaluation of Lymphedema Treatment: A Systematic Review. Cureus. 2019 Dec 12;11(12):e6363. doi: 10.7759/cureus.6363. PMID: 31886094; PMCID: PMC6907718.
  7. Dylke ES, Ward LC. Three Decades of Bioelectrical Impedance Spectroscopy in Lymphedema Assessment: An Historical Perspective. Lymphat Res Biol. 2021 Jun;19(3):206-214. doi: 10.1089/lrb.2020.0085. Epub 2020 Nov 25. PMID: 33232645
  8. Spitz JA, Chao AH, Peterson DM, Subramaniam V, Prakash S, Skoracki RJ. Bioimpedance spectroscopy is not associated with a clinical diagnosis of breast cancer-related lymphedema. Lymphology. 2019;52(3):134-142. PMID: 31874125.
  9. Mills M, van Zanten M, Borri M, Mortimer PS, Gordon K, Ostergaard P, Howe FA. Systematic Review of Magnetic Resonance Lymphangiography From a Technical Perspective. J Magn Reson Imaging. 2021 Jun;53(6):1766-1790. doi: 10.1002/jmri.27542. Epub 2021 Feb 24. PMID: 33625795; PMCID: PMC7611641.
  10. Pereira de Godoy JM, Pereira de Godoy HJ, Pereira de Godoy AC, Graciano de Marqui T, Guerreiro Godoy MF. Lymphedema and the mobilization of intracellular and extracellular fluids with intensive treatment. Acta Phlebol. 2019;20:57-60. doi: 10.23736/S1593-232X.19.00446-6
  11. Kim WJ, Kim J, Kang M, Park DH, Jeon JY. Usefulness of computed tomography venography in gynecologic cancer patients with lower extremity edema. Medicine (Baltimore). 2020 Sep 11;99(37):e21818. doi: 10.1097/MD.0000000000021818. PMID: 32925718; PMCID: PMC7489682.
  12. Pereira de Godoy JM, Pereira de Godoy LM, Guerreiro Godoy MF. Prevalence of Subclinical Systemic Lymphedema in Patients Following Treatment for Breast Cancer and Association with Body Mass Index. Cureus. 2020 Mar 16;12(3):e7291. doi: 10.7759/cureus.7291. PMID: 32300510; PMCID: PMC7159174.
  13. de Godoy JMP. Systemic subclinical lymphedema due to obesity as the cause of clinical lymphedema: A new concept. Med Hypotheses. 2019 Oct;131:109312. doi: 10.1016/j.mehy.2019.109312. Epub 2019 Jul 20. PMID: 31443775.
  14. de Godoy JMP,. Diagnostic Criteria and Clinical Evolution of Systemic Lymphedema Caused by Obesity: Bioimpedance Analysis. Ann Med Health Sci Res. 2019;9:420-421
  15. Pereira de Godoy LM, Pereira de Godoy HJ, Pereira de Godoy Capeletto P, Guerreiro Godoy MF, Pereira de Godoy JM. Lipedema and the Evolution to Lymphedema With the Progression of Obesity. Cureus. 2020 Dec 2;12(12):e11854. doi: 10.7759/cureus.11854. PMID: 33282608; PMCID: PMC7714724.
  16. de-Godoy JMP, de-Godoy HJP, de-Godoy ACP, Godoy MFG. Obesity and systemic lymphedema: New concept evaluated by multisegmental bioimpedance analysis. Medical Science. 2021;25(112):1269-1271.

Download Article
Received July 17, 2024.
Accepted August 31, 2024.
©2024 International Medical Research and Development Corporation.