Reliability of measurement of skin ultrasonic properties in vivo: A potential technique for assessing irradiated skin

Background/aims: Quantitative and objective technique to assess radiation-induced tissue fibrosis is important for clinicians to estimate the efficiency of radiotherapeutic schemes. It has been widely reported that ultrasonic properties are sensitive to changes of acoustic scatterers in biological tissues. Therefore, measurement of ultrasonic properties may serve as a potential assessment technique for irradiated skins. The aim of the present study is to investigate the reliability of such measurement so as to evaluate its potentials for future clinical applications. Methods: Ultrasonic parameters including attenuation slope (β), integrated attenuation (IA) and integrated backscatter (IBS) were measured for the frequency range of 10-25MHz from echographic signals of the forearm and neck dermis of 20 normal subjects in vivo. The intra- and inter-rater reliability of measurement was assessed in 10 normal subjects using intra-class correlation coefficients (ICC) and Bland-Altman test. Results: The intra- and inter-rater measurement was demonstrated to be reliable as indicated by high ICC values generally larger than 0.80. In addition, the ultrasonic parameters could successfully differentiate the skins in the neck and forearm regions. Conclusion: The measurement provided reliable information on the ultrasonic properties of the skins and could be potentially applied to comparative clinical trials to assess the late effects of radiotherapy on skins.