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Title: High frequency ultrasound assessment of skin fibrosis : clinical results
Authors: Huang, YP 
Zheng, YP 
Leung, SF
Choi, PC
Issue Date: Aug-2007
Source: Ultrasound in medicine and biology, Aug. 2007, v. 33, no. 8, p. 1191-1198
Abstract: Fibrosis is a common late effect of radiotherapy treatment for cancer patients. Current clinical assessment of radiation-induced fibrosis is generally limited to clinician-based rating scales, which are usually not sufficient for quantitative and objective evaluations. Ultrasonic propagation properties of tissues are widely reported to be sensitive to the alterations of tissue compositions and structures. Based on our previous feasibility study, we used four parameters including skin thickness and three ultrasonic parameters of dermal tissues (attenuation slope [β], integrated attenuation [IA] and integrated backscatter [IBS]) in the frequency range of 10 to 25 MHz for the assessment of skin fibrosis. Experiments were conducted on the forearm and neck skin in patients with postirradiation fibrosis in the neck region. The palpation score and stiffness of the neck soft tissue were also measured as an indication of fibrotic severity. Comparisons of the results between 38 patients and 20 control subjects showed a significantly smaller β (p = 0.005) and a significantly larger skin thickness (p < 0.004) and IA (p = 0.04) in the neck skins of the patients. However, age-matched comparisons showed there were neither significant differences among patient subgroups with different fibrotic levels assessed using manual palpation or significant correlations between the four parameters and the overall stiffness of the neck soft tissues (p > 0.05). In conclusion, ultrasound tissue characterization may provide additional information for the assessment of postirradiation skin fibrosis in the neck region. Further studies are necessary to investigate the feasibility of applying the current measurement for differentiating the severity of skin fibrosis.
Keywords: Radiotherapy
Fibrosis
Skin
Soft tissue
Nasopharyngeal carcinoma (NPC)
Attenuation
Backscatter
Hand palpation
Ultrasound indentation
Ultrasound
Publisher: Elsevier
Journal: Ultrasound in medicine and biology 
ISSN: 0301-5629
EISSN: 1879-291X
DOI: 10.1016/j.ultrasmedbio.2007.02.009
Rights: Ultrasound in Medicine and Biology © 2007 World Federation for Ultrasound in Medicine & Biology. The journal web site is located at http://www.sciencedirect.com.
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