Quantitative assessment of treatment efficacy in keloids using high-frequency ultrasound and shear wave elastography: a preliminary study

Abstract

The purpose of this study was to investigate the performance of high-frequency ultrasound (HFUS) and shear wave elastography (SWE) in the quantitative evaluation of therapeutic responses of keloids. 43 patients with 76 keloids were recruited into this study. In keloids and symmetrical sites, the skin thickness was measured using HFUS and skin stiffness expressed as elastic moduli (Young’s modulus and shear wave velocity) was measured using SWE. The coefficient of variation values were calculated by using difference values of skin elastic moduli and skin thickness. A significant increase of both skin stiffness and thickness appeared in pre-treated keloids compared with post-treated keloids (P < 0.001) and normal controls (P < 0.001), respectively. Stiffness in post-treated keloids and normal skins was significantly different (P < 0.001), while the difference in thickness measurements showed no significance (P = 0.56, >0.05). The coefficient of variation of Young’s modulus was the highest when compared between (i) pre-treated keloids and theirs site-matched areas; (ii) pre-treated and post-treated keloids. SWE, which showed greater ability in determining the extent of keloids recovery, may provide an ideal tool to assess the stiffness of keloids and theirs therapeutic response.

Comparison of different MyotonPRO probes for skin stiffness evaluation in young women

“…Ultrasound Elastography has been originally used in breast cancer diagnostic 38‐41 and to assess the progression of chronic liver diseases that lead to fibrosis 42‐45 . Only recently, many research is being conducted into usefulness of Ultrasound Elastography in assessing other tissues, including skin 4,5,8,28,29 or scars 10 . It is known that Ultrasound Elastography collects information about skin stiffness and also provides a B mode ultrasound image that is useful for measuring skin thickness or monitoring/assessing changes in scars undergoing various treatments.…”

“…It is known that Ultrasound Elastography collects information about skin stiffness and also provides a B mode ultrasound image that is useful for measuring skin thickness or monitoring/assessing changes in scars undergoing various treatments. Although in order to evaluate changes occurring within dermis, it is recommended to use high‐frequency ultrasound 10,29 . However, despite the advantages, Ultrasound Elastography is neither a device easily accessible nor portable; thus, it is not widely used in clinical practice.…”

“…This parameter is especially useful in assessing skin condition. It has been extensively used in the medical research performed for estimation of progression of the skin diseases such as scleroderma, 2,3 systematic sclerosis 4,5 ichthyosis, 6 Werner Syndrome, 7 scars 8,9 or in order to show improvement after treatment 10 . Moreover, skin stiffness is also a good indicator to evaluate age‐related changes of skin often used in the cosmetic industry, 11 and frequently applied to estimate influence of cosmetics on state of skin 12,13 …”

“…Unfortunately, this method has considerable limitations—that is it is not completely objective, even if the examination is performed by an investigator with a long experience. Therefore, in order to obtain more reliable skin biomechanical properties measurements, some devices have been already tested—for example Durometer, 2,3,14‐17 SkinFibroMeter, 9,14,18‐20 Khelometer, 12,14 Reviscometer, 12,14,21,22 Frictiometer, 14,21,23 Ballistometer, 24‐27 Ultrasound Elastography 4,5,8,10,14,28,29 and the most commonly used Cutometer 6,7,11,13,14,18,21,24,30 …”

Non‐invasive evaluation of elasticity of skin with the processing of ultrasound images during ultraviolet radiation: An animal photoaging model

“…For evaluating the in vivo skin biomechanics by the shear wave velocity from intrinsic deformation induced by arterial pulsation, high‐frequency ultrasound elastography has been created which estimates the mechanical properties of the tissue. It also provides high‐resolution measurements, permitting the in vivo assessment of adaptability and retractability, which results from a combination of viscoelasticity and microstructures unevenly distributed within the dermis 27 …”