Upper Extremity Volume/Total Body Volume Ratio for Evaluation of Upper Extremity Lymphedema

Measurement of extremity volume is the most commonly used method for evaluation of lymphedema. However, volumetry would be inappropriate for comparing patients with different physiques, because body-type significantly affects extremity volume. Thus, we cannot evaluate using absolute values. To overcome this problem, we developed a simple index of proportion of the upper-extremity volume to total body volume (upper-extremity volume/total body volume ratio [UVR]) for body type-corrected volume evaluation of upper-extremity lymphedema. The purpose of this study was to compare upper-extremity volume and UVR in nonedematous upper extremities and to establish normative values of UVR in adult women.

Eighty-five normal female subjects were included in this study. The average age was 38 ± 12 years, and the average body mass index (BMI) was 21.4 ± 2.9. Volumetry of both upper extremities using water displacement method was tested in all subjects. Upper-extremity volume/total body volume ratio was calculated by dividing upper-extremity volume by total body volume. Total body volume was calculated by dividing body weight (g) by body density (g/mL). We used linear regression equation (body density = 1.0560 - 0.0005 × age) to calculate body density.

UVR of 170 upper extremities averaged 2.580 ± 0.202%. Although there was significant relationship between upper-extremity volume and BMI, there was no relationship between UVR and BMI.

Although further studies are necessary to establish usefulness of UVR, UVR has a potential to allow better body type-corrected volume evaluation for upper-extremity lymphedema.