Novel quantitative parameters of lymphatic contrast-enhanced ultrasound for breast cancer-related lymphoedema: Correlating with clinical staging.

INTRODUCTION

This study aimed to investigate the correlation between contrast-enhanced ultrasound (CEUS) characteristics of lymphatic vessels in affected limbs and International Society of Lymphology (ISL) clinical staging in patients with breast cancer-related lymphoedema (BCRL). Additionally, we sought to evaluate the validity of CEUS parameters in assessing lymphatic function.

METHODS

Clinical and lymphatic CEUS data of 42 patients with BCRL were collected prospectively. The morphology of collecting lymphatic vessels (CLVs) was classified into five types: beaded, linear, tortuous-and-dilated, unevenly dilated, and blind-ended. The correlations between ISL clinical stages in BCRL patients and the following parameters were recorded: internal diameter of CLVs, the number of visualised CLVs, and the number of CLVs reaching above the elbow (CLV-RAE). Additionally, differences in these lymphatic parameters with different ISL stages were compared.

RESULTS

A total of 346 CLVs were visualised in 42 BCRL patients, of which 246 CLVs were visualised above the elbow joint. The percentage of visualised CLV-RAE showed a stronger association with disease progression (r = -0.74, p < 0.05). The internal diameter of the thickest visualised CLVs demonstrated a more pronounced correlation (r = 0.69, p < 0.05). Morphological features of the CLVs showed significant staging correlations.

CONCLUSION

CEUS could accurately assess the structural and functional status of lymphatic vessels by quantitatively analysing critical parameters, including the number of CLVs, internal diameter, and imaging pattern.

IMPLICATIONS FOR PRACTICE: This study confirms the validity of CEUS parameters in assessing lymphatic vessel function and is expected to construct a quantitative assessment system for BCRL lymphatic function with the support of CEUS.