Main findings

• Measurements were performed in the affected and unaffected limbs at 10 cm above (proximal) and below (distal) to the elbow.
• Anatomically comparable measurements of arm circumference were then taken from the CT image volume for each arm. An elbow reference location was placed at the slice containing the medial and lateral epicondyles.
• The patient sample included 9 participants with lymphedema affecting the left arm and 6 participants with lymphedema affecting the right arm.
• This study aimed to evaluate the consistency of the Analytic Morphomics method and manual tape measure method in individuals with extremity lymphedema.
• Comparative evaluations show strong consistency among both methods. The percent difference between the 2 methods was 6.65% (SD 3.52%) above the elbow and 2.80% (SD 2.11%) below the elbow, demonstrating minimal error.
• Given the linear concordance between the Analytic Morphomics method and the tape measure method, the 2 cm arm circumference difference above the elbow may be explained by differences in patient position and the physical measurement process. The CT was performed with the patient in the supine position, whereas tape measurements were performed in the upright sitting position with the arms vertical.
• Analytic Morphomics provide supplemental information to circumferential measurements in surveilling individual cases of lymphedema. Reoccurring CT measurement can provide insight into change in adiposity, extracellular fluid volume, muscle volume, and localized swelling.
• This study reports comparable trends and consistent measurements among Analytic Morphomics and the manual tape measure for circumferential measurements in individuals with extremity lymphedema. Analytic Morphomics present an opportunity for a precise, granular measurement of limb composition, for inference of disease state and patient care.