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Contrast-Enhanced Ultrasound and Shear Wave Elastography for the Treatment of Lymphedema

Phase 1
Completed
Conditions
Lymphedema Arm
Interventions
Registration Number
NCT05613946
Lead Sponsor
Mayo Clinic
Brief Summary

The purpose of this research is to determine the preferred microbubble agent (Lumason®, Optison®, and Definity®) for lymphatic channel visualization by ultrasound. This research will also evaluate the utility of preoperative high-frequency B-mode ultrasound with contrast-enhanced ultrasound for presurgical planning, and ultrasound shear wave elastography for assessing treatment response at 6-month follow up.

Detailed Description

Part 1 - Evaluate the uptake of microbubble agent (Lumason®, Optison®, and Definity®) for lymphatic visualization by ultrasound.

Part 2 - Combine preoperative high-frequency B-mode ultrasound with contrast-enhanced ultrasound to identify patent lymphatic channels for lymphaticovenous anastomosis presurgical planning. Evaluate the utility of ultrasound shear wave elastography for assessing treatment response at 6-month follow up.

Recruitment & Eligibility

Status
COMPLETED
Sex
Female
Target Recruitment
10
Inclusion Criteria
  • Unilateral lymphedema in the upper extremity (ISL stage 2 or 3) secondary to breast cancer or breast cancer treatment.
  • Patient qualifies for LVA surgery as determined by the plastic surgeons performing the surgery (Dr. Bill Tran or Dr. Vahe Fahradyan), and the patient consents to surgery.
  • Patient must be able to come to the 6-month clinical follow-up appointment (Part 2 only).
  • Patients must be able to understand the study procedures and comply with them for the entire length of the study.
  • No contraception is necessary or required.
Exclusion Criteria
  • Pregnant or nursing women.
  • Known or suspected hypersensitivity to microbubble contrast agent, perflutren, blood products, albumin, polyethylene glycol (PEG), or egg.31.
  • Known or suspected cardiac shunts.
  • Prior lymphedema surgery in the upper extremity.
  • Tattoo or scar on either upper extremity.
  • Current drug or alcohol use or dependence that, in the opinion of the investigator, would interfere with adherence to study requirements.
  • Inability or unwillingness of individual or legal guardian/representative to give written informed consent..
  • Current or past participation within a specified timeframe in another clinical trial, as warranted by the administration of this intervention.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Microbubble contrast agent OptisonOptisonWhile subjects are undergoing standard of operation for arm with lymphedema, the healthy arm will receive intradermal injection of microbubbles and imaged immediately by ultrasound.
Microbubble contrast agent DefinityDefinityWhile subjects are undergoing standard of operation for arm with lymphedema, the healthy arm will receive intradermal injection of microbubbles and imaged immediately by ultrasound.
Microbubble contrast agent LumasonLumasonWhile subjects are undergoing standard of operation for arm with lymphedema, the healthy arm will receive intradermal injection of microbubbles and imaged immediately by ultrasound.
Primary Outcome Measures
NameTimeMethod
Lymphatic vessel visualization5 minutes after injection

The time from injection to lymphatic visualization, the duration of contrast visualization, and the longest length of lymphatic channel visualized for each injection site will be determined

High-frequency ultrasound and shear-wave elastography1.5 hours for intraoperative CEUS and out-patient SWE both at baseline and 6-month follow-up

Identify any patent lymphatic channels on CEUS or high-frequency ultrasound that were not detected by the reference standard ICG lymphography. We will additionally measure dermal thickness on B-mode ultrasound and perform SWE at levels comparable to the lymphedema grading metrics routinely collected at surgical visits.

Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (1)

Mayo Clinic in Rochester

🇺🇸

Rochester, Minnesota, United States

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