Abstract
Until quite recently, ultrasound has not enjoyed widespread utilization in the clinical evaluation of lymphedema. 1 Nevertheless, ultrasound can be used to evaluate the dermal thickening and hypoechogenicity that is characteristic of lymphedema, and, in addition, ultrasound may be useful to differentiate lymphedema from lipedema. 2 High-frequency ultrasonography has quite recently been demonstrated to be useful in the surgical evaluation of the lymphatic channels themselves. 3
In the current issue of Lymphatic Research and Biology, two original publications highlight the expanding potential utility of ultrasound in the clinical evaluation of lymphedema patients.
Citing the cost and lack of general availability of radionuclide and near infrared imaging modalities, Hara and Mihara report their observations regarding lymphedema diagnosis by ultrasound. Their study includes evaluation of 28 limbs assessed preoperatively before lymphaticovenous anastomosis. Indocyanine green lymphography was utilized to validate the ultrasonographic findings. The authors observed that the sensitivity and specificity for the diagnosis of lymphedema based on echography of the medial leg were 95.0% and 100.0%, respectively. The accuracy rate was 94.6%. These data appear to confirm the potential utility of ultrasonography for the diagnostic evaluation of potential lymphedema.
In a parallel article published in this issue, Kim and colleagues have investigated a newly proposed technique to measure soft tissue cross-sectional area of lymphedema-affected limbs. In their hands, ultrasonographic examination was performed on 69 female breast cancer patients. The authors evaluated both soft tissue thickness and subcutaneous tissue stiffness. Their findings suggest a strong correlation with limb circumference and tissue compliance was significantly reduced, as measured with this technique, when compared with the unaffected limbs.
In summary, the results of both of these investigations suggest wonderful promise for the utilization of diagnostic ultrasonography in the evaluation of lymphedema, suggesting that we can look forward to wider application and evolving techniques to broaden our diagnostic armamentarium.