Measuring head and neck lymphedema: The "ALOHA" trial
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Updated: Apr 24, 2026

Ultrasonographic Evaluation of Breast Cancer-related Lymphedema
Published on: January 12, 2017
Amanda Purcell1, Jodie Nixon1, Jennifer Fleming2
1Department of Occupational Therapy, Princess Alexandra Hospital, Queensland, Australia.
Background:
There is no clinical assessment available to measure head and neck lymphedema. This study proposes the use of a tape measurement system and the MoistureMeterD (MMD) to evaluate head and neck lymphedema.
Methods:
The reliability and validity of these assessments was examined in 20 patients with head and neck lymphedema and 20 matched healthy controls.
Results:
Interrater reliability for the MMD and 3 of the 4 tape measurements was excellent (intraclass correlation coefficients [ICCs] >0.90). Intrarater reliability of the MMD was 0.97. The MMD discriminated between patients with head and neck lymphedema and healthy controls, t(19) = 8.97, p < .001, whereas the tape measurements did not. Correlation between MMD score and head and neck lymphedema level ratings was significant (rho = 0.59) indicating convergent validity. Three of the tape measurements were significantly correlated with MMD scores (rho = 0.37-0.38) but not with ratings of head and neck lymphedema.
Conclusion:
The tape measurement system and MMD show potential as objective measurements of head and neck lymphedema with the exception of 1 tape measurement point.
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