Plast Reconstr Surg. 2025 Nov 11. doi: 10.1097/PRS.0000000000012609. Online ahead of print.
ABSTRACT
INTRODUCTION: Evaluation of the severity and progression of lymphedema is challenging and there is no universal, simple and accurate established method. We propose the use of ultra-high frequency ultrasound (UHFUS) to measure skin thickness to assess lymphedema.
METHODS: Skin thickness was measured twice at 8 points in the upper limbs of 40 women using UHFUS (20 with unilateral lymphedema secondary to breast cancer and 20 healthy volunteers). Measurements were statistically compared with limb circumferences. A ROC curve analysis and a multivariable linear model were also performed.
RESULTS: Differences were found in the skin thickness between the two limbs of lymphedema patients (p <0.001), but not in healthy volunteers. Mean UHFUS examination time per patient was 8 minutes (16 measurements twice). Mean intra-rater differences was 0.09mm. The most useful point for identifying lymphedema cases was the proximal volar forearm (point 7): a cut-off value of 1.46mm in skin thickness was established for identifying lymphedema (sensitivity 70%, specificity 100%). Differences in skin thickness between the two limbs above 0.28 mm at point 7 identified all included cases of lymphedema (sensitivity 100%, specificity 100%).
CONCLUSIONS: measuring skin thickness using UHFUS is a reproducible, reliable, objective and fast method to assess lymphedema, even in initial stages, and to identify the most affected areas in upper limbs. In addition, it gives more information than limb circumferences, especially at the hand, and it would be potentially useful for the follow-up.
PMID:41218167 | DOI:10.1097/PRS.0000000000012609
