Background: Measurement of limb circumference is critical in lymphedema management, aiding in treatment evaluation and early detection. Manual tape measurements are simple and cost-effective but lack precision and reproducibility. Advanced modalities like computed tomography (CT) and magnetic resonance imaging (MRI) offer high accuracy but are costly and impractical for routine use. Objective: To address these limitations, we developed a novel system combining a bodysuit (ZOZOSUIT2; ZOZO Inc., Japan) and smartphone technology for accurate, cost-effective, and user-friendly measurements. Methods: This prospective study included patients with upper and lower limb lymphedema. The ZOZOSUIT2, embedded with 20,000 dot markers, captured 12 photographs with a smartphone camera, creating 3D models from which limb circumferences were extracted at ten upper limb and nine lower limb points. Measurements were repeated three times to evaluate reproducibility. Manual measurements served as the reference standard. Accuracy and measurement time were compared between methods. Results: A total of 26 patients (10 with upper limb and 16 with lower limb lymphedema) participated, yielding 78 measurement sets. The mean absolute error of all measurement points was less than 10 mm. At the thigh root and wrist, errors exceeded 20 mm, while they remained below 20 mm at other points. Measurement times were significantly shorter with the bodysuit system (88.2 seconds vs. 293.8 seconds, p < 0.001). Conclusions: The bodysuit and smartphone system demonstrated high accuracy, reproducibility, and time efficiency, offering a promising alternative for routine and home-based lymphedema management.
Karakawa et al. (2025) studied this question.