Three-dimensional laser scanning as a reliable and reproducible diagnostic tool in breast cancer related lymphedema rehabilitation: a proof-of-principle study

OBJECTIVE

In this study, we aimed to assess the reproducibility and reliability of a three-dimensional laser scanner (3DLS) in measuring the upper limb volume of BRCL women undergoing a 2-week complete decongestive therapy (CDT).

PATIENTS AND METHODS

3DLS and CM were used to measure the upper limb volume in a cohort of BCRL women before (T0) and after (T1) a 2-week CDT. We evaluated: a) correlation between 3DLS and CM at both time points; b) level of agreement and the consistency of the different measurements at both time points; c) correlation between the inter-rater operator analysis in terms of total limb volume differences before and after rehabilitative treatment of both circumferential method and laser scanning 3D in breast cancer related lymphedema patients.

RESULTS

Taken together, 43 BCRL women (age 51.1 ± 5.4 years) were included. Both 3DLS and CM showed a significant inter and intra-operator correlation in the arm volume measurement at both time-points (T0: r2=0.99, p<0.0001; T1: r2=0.99, p<0.0001). 3DLS showed a strong correlation with CM (r2=0.99, p<0.0001) in terms of volume measurement and provided greater intra-operator correlation (r2=0.92 vs. 0.62) in detecting volume variations after the treatment (T1-T0).

CONCLUSIONS

3DLS confirmed to be highly sensitive, cheap and easy-to-use in the evaluation of the upper limb volume in BCRL women before and after a rehabilitative treatment. These findings suggest that augmented reality technologies might be very useful in oncological rehabilitation.

Early Glottic Cancer: Surgery or Radiation Therapy?

From 1970 to 1979 at the University Otorhinolaryngological Clinic, at the Radiology Institute of the University and at the Radiation Therapy Department of the Hospital of Florence, 385 early glottic cancers were treated: 300 by surgery and 85 with radiation therapy as the primary therapy. The policy of treatment in this period was in most cases surgery; those patients who could not be operated were treated with radiation therapy. The local control actuarial rates at 5 years were 85 %, 70 % and 65 % for the T1a, T1b and T2 patients treated by surgery, and 86 %, 83 % and 57 % for those treated with radiation therapy. Considering the surgical salvage, the actuarial results at 5 years were 95 %, 86 % and 71 % for the group treated by surgery, and 86 %, 90 % and 69 % for the one treated with radiotherapy. The crude results at 3 and 5 years with an analysis of failures according to treatment modalities are also reported. In our experience, cordectomy can be the treatment of choice in T1a glottic cancer, whereas radiation therapy offers better results in the T1b forms. Tratment policy is more questionable in the T2 cases.

[Bilateral chronic luxation of the mandible. Clinical case]

The pathogenesis and treatment of the long standing dislocation of the mandible is showed by the Authors. A case of four months duration in a young man is presented. The reduction was accomplished manually under intravenous anaesthesia and relaxant drug. By the means of a digital electromyography a survey of the masticatory muscle before and after reduction was done. The normalisation of masticatory function was closed followed by improvement of electromyographic results.

Malignant Parotid Tumors Diagnostic Considerations and Therapeutic Suggestions

This paper presents our experience of the problem of diagnosis and surgical treatment of malignant parotid tumors, based on a retrospective evaluation of a series of 478 parotid tumors, of which 100 were malignant. Out of 75 primaris malignant tumors of epithelial origin, 35 belonged to the « epidermoid » group (adenocarcinomas, undifferentiated carcinomas, malignant mixed tumors, squamous cell carcinoma), 20 were muco-epidermoid carcinomas, 15 adenoid cystic carcinomas and 5 were acinic cell carcinoma. Altogether, 58.7% of the treated patients do not at the moment present evidence of disease; 33.3% are dead from the disease or are alive with active disease; 5.3% are dead from other causes and 2.7% are lost to follow-up. Underlining the importance of histologic examination of the swelling by intraoperative biopsy, the authors propose a diagnostic and therapeutic protocol.

Adenoid cystic carcinoma of the head and neck: a clinical study of 37 cases

Thirty-seven cases of adenoid cystic carcinoma treated at the Otolaryngologic Clinic of the University of Florence between 1962 and 1979 were studied. The patients were treated with radical surgical excision (20), non-radical surgery associated with radiotherapy (13), or with palliative treatment (4). The aim of this study is to evaluate the course of the disease according to the site and type of operation. Our results show that non-radical surgical treatment associated with radiotherapy seems to give results comparable to those obtained with radical surgery alone.