A comprehensive review of computational diagnostic techniques for lymphedema.

Abstract

Lymphedema is localized swelling due to lymphatic system dysfunction, often affecting arms and legs due to fluid accumulation. It occurs in 20% to 94% of patients within 2 to 5 years after breast cancer treatment, with around 20% of women developing breast cancer-related lymphedema (BCRL). This condition involves the accumulation of protein-rich fluid in interstitial spaces, leading to symptoms like swelling, pain, and reduced mobility that significantly impact quality of life. The early diagnosis of lymphedema helps mitigate the risk of deterioration and prevent its progression to more severe stages. Healthcare providers can reduce risks through exercise prescriptions and self-manual lymphatic drainage techniques. Lymphedema diagnosis currently relies on physical examinations and limb volume measurements, but challenges arise from a lack of standardized criteria and difficulties in detecting early stages. Recent advancements in computational imaging and decision support systems have improved diagnostic accuracy through enhanced image reconstruction and real-time data analysis. The aim of this comprehensive review is to provide an in-depth overview of the research landscape in computational diagnostic techniques for lymphedema. The computational techniques primarily include imaging-based, electrical, and machine learning approaches, which utilize advanced algorithms and data analysis. These modalities were compared based on various parameters to choose the most suitable techniques for their applications. Lymphedema detection faces challenges like subtle symptoms and inconsistent diagnostics. The research identifies Bioimpedance Spectroscopy (BIS), Kinect sensor and Machine Learning integration as the promising modalities for early lymphedema detection. BIS can effectively identify lymphedema as early as four months post-surgery with sensitivity of 44.1% and specificity of 95.4% in diagnosing lymphedema whereas in Machine learning, Artificial Neural Network (ANN) achieved an impressive average cross-validation accuracy of 93.75%, with sensitivity at 95.65% and specificity at 91.03%. Machine learning and imaging can be integrated into clinical practice to enhance diagnostic accuracy and accessibility.