{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T15:16:25Z","timestamp":1787670985894,"version":"build-2736575974"},"reference-count":34,"publisher":"MDPI AG","issue":"15","license":[{"start":{"date-parts":[[2024,7,26]],"date-time":"2024-07-26T00:00:00Z","timestamp":1721952000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"the Australasian Lymphology Association"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Lymphoedema tissue is characterised by excess free fluid and structural changes to the extracellular matrix (ECM) in the form of fibrotic and fatty deposition. These tissue characteristics are integral to the assessment of lymphoedema progression; however, clinicians and researchers often focus on changes in the free fluid, volume and function of lymphatic vasculature to inform practice. Subsequently, little is known about the effect of clinical interventions on lymphoedema tissue composition. This article presents a novel approach to classify lymphoedema tissue. The Localised Objective Characterisation Assessment of Lymphoedema (LOCAL) classification combines diagnostic and clinically meaningful objective assessment thresholds to infer lymphoedema pathophysiological changes in tissue layers. The LOCAL classification method was verified using data from fifteen women with unilateral breast cancer-related lymphoedema who were evaluated at three sites on each arm using high-frequency ultrasound (HFUS), bio-electrical impedance spectroscopy (BIS) and volume measurements. Participants exhibited an uneven distribution of volume between the proximal and distal segments of the arm (p = 0.023), with multiple tissue compositional categories observed across sites on the same limb (p &lt; 0.001). The LOCAL method demonstrated utility in categorising a diverse range of lymphoedema tissue layer changes beyond what can be ascertained from whole-limb measures.<\/jats:p>","DOI":"10.3390\/diagnostics14151616","type":"journal-article","created":{"date-parts":[[2024,7,26]],"date-time":"2024-07-26T13:04:59Z","timestamp":1721999099000},"page":"1616","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Localised Objective Characterisation Assessment of Lymphoedema (LOCAL): Using High-Frequency Ultrasound, Bioelectrical Impedance Spectroscopy and Volume to Evaluate Superficial Tissue Composition"],"prefix":"10.3390","volume":"14","author":[{"given":"Jennifer","family":"Sanderson","sequence":"first","affiliation":[{"name":"Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD 4215, Australia"},{"name":"School of Health Sciences and Social Work, Griffith University, Brisbane, QLD 4111, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neil","family":"Tuttle","sequence":"additional","affiliation":[{"name":"School of Health Sciences and Social Work, Griffith University, Brisbane, QLD 4111, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robyn","family":"Box","sequence":"additional","affiliation":[{"name":"QLD Lymphoedema and Breast Oncology Physiotherapy, Brisbane, QLD 4051, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hildegard","family":"Reul-Hirche","sequence":"additional","affiliation":[{"name":"School of Health Sciences and Social Work, Griffith University, Brisbane, QLD 4111, Australia"},{"name":"Royal Brisbane and Women\u2019s Hospital, Herston, QLD 4006, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4820-1090","authenticated-orcid":false,"given":"E-Liisa","family":"Laakso","sequence":"additional","affiliation":[{"name":"Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD 4215, Australia"},{"name":"Mater Research Institute, University of Queensland, South Brisbane, QLD 4101, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,7,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Sanderson, J., Tuttle, N., Box, R., Reul-Hirche, H., and Laakso, E.-L. 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