acta med nicomedia Acta Medica Nicomedia 2717-8994 2717-8994 Kocaeli Üniversitesi 10.53446/actamednicomedia.1846958 Radiology and Organ Imaging Radyoloji ve Organ Görüntüleme IN VIVO QUANTITATIVE ULTRASOUND IMAGING ON SKIN FOR NON-INVASIVE CHARACTERIZATION OF BREAST CANCER RELATED LYMPHEDEMA MEME KANSERİYLE İLİŞKİLİ LENFÖDEMİN İNVAZİV OLMAYAN KARAKTERİZASYONU İÇİN CİLTTE İN VİVO KANTİTATİF ULTRASON GÖRÜNTÜLEME https://orcid.org/0000-0003-3284-6169 Demirkan İrem BAHÇEŞEHİR ÜNİVERSİTESİ 03 10 2026 9 1 8 12 22 2025 01 20 2026 Copyright © 2020, Acta Medica Nicomedia 2020 Acta Medica Nicomedia

Objective: To study the potential of in vivo quantitative ultrasound (QUS) imaging using Rényi Entropy (RE) and attenuation coefficient measurements for non-invasive characterization of skin tissue variations in breast cancer-related lymphedema (BCRL). Methods: Ultrasound radiofrequency (RF) signals recorded from the skin tissue of the arm in five women with Stage II BCRL and five healthy individuals as controls were analyzed. RE was computed from the RF data to quantify tissue heterogeneity, while the attenuation coefficient was estimated using the spectral-log difference method. Corresponding B-mode images were used for anatomical reference, and statistical comparisons were performed between two groups. Results: Both RE and attenuation coefficient values were significantly lower in lymphedematous dermis than in healthy skin (p<0.01), showing decreased signal complexity and changed acoustic scatterer characteristics associated with lymphatic fluid accumulation. Furthermore, the attenuation coefficients from healthy skin dermis fall into the same range as previously reported values, thus confirming the measurement approach. Spatially quantitative distributions were further demonstrated by parametric mapping of entropy and attenuation, enabling robust differentiation between control subjects and patients with BCRL. Conclusion: The findings of this study showed that the joint analysis of entropy and attenuation-based quantitative ultrasound metrics is sensitive to edema-related changes in the dermal microstructure of BCRL, detecting changes that are not readily discernible in conventional qualitative B-mode imaging. QUS-derived metrics provide complementary insight into tissue heterogeneity and acoustic energy loss at the microtissue level, whereas B-mode principally offers macroscopic anatomical information.

Amaç: Meme kanseriyle ilişkili lenfödemde deri dokusu varyasyonlarını invaziv olmayan bir şekilde karakterize etmek için Rényi Entropisi (RE) ve zayıflama katsayısı ölçümlerini kullanarak in vivo kantitatif ultrason görüntülemenin potansiyelini incelemek. Yöntem: Evre II meme kanseri kaynaklı lenfödemli beş kadın ve kontrol grubu olarak beş sağlıklı bireyin kol deri dokusundan kaydedilen ultrason radyo frekansı (RF) sinyalleri analiz edildi. Doku heterojenliğini ölçmek için RF verilerinden RE hesaplandı, zayıflama katsayısı ise spektral-logaritmik fark yöntemi kullanılarak tahmin edildi. Anatomik referans için karşılık gelen B-mod görüntüleri kullanıldı ve iki grup arasında istatistiksel karşılaştırmalar yapıldı. Bulgular: Hem RE hem de zayıflama katsayısı değerleri, lenfödemli dermiste sağlıklı deriye göre anlamlı derecede daha düşüktü (p<0,01), bu da lenfatik sıvı birikimiyle ilişkili olarak sinyal karmaşıklığında azalma ve akustik saçıcı özelliklerinde değişiklik olduğunu gösterdi. Ayrıca, sağlıklı deri dermisinden elde edilen zayıflama katsayıları, daha önce bildirilen değerlerle aynı aralığa düşmektedir, bu da ölçüm yaklaşımını doğrulamaktadır. Entropi ve zayıflamanın parametrik haritalanmasıyla mekansal olarak nicel dağılımlar daha da gösterilmiş ve kontrol denekleri ile lenfödemli hastalar arasında sağlam bir ayrım yapılması sağlanmıştır. Sonuç: Bu çalışmanın bulguları, entropi ve zayıflamaya dayalı nicel ultrason metriklerinin ortak analizinin, lenfödemin dermal mikro yapısındaki ödemle ilgili değişikliklere duyarlı olduğunu ve geleneksel nitel B-mod görüntülemede kolayca ayırt edilemeyen değişiklikleri tespit ettiğini göstermiştir. Nicel ultrason kaynaklı metrikler, doku heterojenliği ve mikro doku düzeyinde akustik enerji kaybı hakkında tamamlayıcı bilgiler sağlarken, B-mod esas olarak makroskopik anatomik bilgiler sunmaktadır.

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