Contrast-Enhanced Ultrasound Evaluation of Lymphatic Function in Breast Cancer-Related Lymphedema: A Comparative...

Area of Science:

• Medical Imaging
• Vascular Ultrasound
• Lymphedema Diagnostics

Background:

• Breast cancer-related lymphedema (BCRL) affects numerous patients post-treatment.
• Accurate assessment of lymphatic function is crucial for managing BCRL.
• Current diagnostic methods may lack sensitivity for early-stage lymphatic abnormalities.

Purpose of the Study:

• To compare contrast-enhanced ultrasound (CEUS) parameters of lymphatic vessels in BCRL patients versus healthy controls.
• To introduce and evaluate subcutaneous lymphatic capillary backflow (SLCBF) as a novel CEUS parameter for assessing lymphatic function.
• To determine CEUS's ability to differentiate abnormal from normal lymphatic function.

Main Methods:

• Prospective collection of CEUS data from 50 participants (38 BCRL patients, 12 healthy controls).
• Comparison of lymphatic CEUS parameters between the BCRL and control groups.
• Analysis of the correlation between SLCBF and the International Society of Lymphology (ISL) clinical stage.

Main Results:

• BCRL patients showed significantly more visualized collecting lymphatic vessels (CLVs) and larger CLV diameters compared to controls (p < 0.05).
• Subcutaneous lymphatic capillary backflow (SLCBF) was present in all BCRL patients but absent in controls.
• SLCBF grade strongly correlated with ISL clinical stage (r=0.64) and CLV diameters (r=0.65-0.67, p < 0.05).

Conclusions:

• Subcutaneous lymphatic capillary backflow (SLCBF) is a characteristic CEUS finding in BCRL patients.
• CEUS effectively visualizes the spectrum of lymphedema pathology, from early signs to structural damage.
• CEUS serves as a valuable tool for early diagnosis and precise assessment of lymphedema.