To the Editor:
I read with great interest the study by Liu et al demonstrating the diagnostic performance of contrast‐enhanced ultrasound (CEUS) in assessing lymphatic dysfunction in breast cancer‐related lymphedema (BCRL). 1 The identification of subcutaneous lymphatic capillary backflow as a functional imaging marker represents an important step toward improving noninvasive evaluation of lymphatic impairment.
Beyond its diagnostic capability, CEUS may have broader clinical implications in contemporary survivorship care. Functional imaging parameters could enable earlier recognition of subclinical lymphatic deterioration and support risk‐adapted follow‐up strategies after axillary interventions. In addition, incorporation of CEUS into multimodal imaging frameworks may enhance patient selection and procedural planning for physiologic surgical approaches. Established modalities such as indocyanine green lymphography and lymphoscintigraphy provide complementary insights into lymphatic transport dynamics and regional drainage patterns. 2 , 3
Future prospective studies integrating CEUS findings with symptom burden, functional outcomes, and response to complex decongestive therapy may help define clinically meaningful imaging thresholds and facilitate more personalized management pathways for patients with BCRL.
Declaration of AI‐Generated Content
Portions of the text in this correspondence were drafted and refined with the assistance of ChatGPT (OpenAI, GPT‐5 model). The author reviewed, edited, and takes full responsibility for the content and its accuracy. The use of this tool was limited to language editing and formatting; no data analysis, interpretation, or original scientific content was generated by artificial intelligence.
The author declares that there are no conflicts of interest. No funding was received for this work.
Data Availability Statement
Data sharing not applicable to this article as no datasets were generated or analyzed during the current study.
References
- 1. Liu Z, Zeng Z, Liang S, et al. Contrast‐enhanced ultrasound evaluation of lymphatic function in breast cancer‐related lymphedema: a comparative study with Normal controls. J Ultrasound Med 2026; 45:1749–1757. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 2. Yamamoto T, Yamamoto N, Doi K, et al. Indocyanine green‐enhanced lymphography for upper extremity lymphedema: a novel severity staging system using dermal backflow patterns. Plast Reconstr Surg 2011; 128:941–947. [DOI] [PubMed] [Google Scholar]
- 3. Pappalardo M, Cheng MH. Lymphoscintigraphy for the diagnosis of extremity lymphedema: current controversies regarding protocol, interpretation, and clinical application. J Surg Oncol 2020; 121:37–47. [DOI] [PubMed] [Google Scholar]
Associated Data
This section collects any data citations, data availability statements, or supplementary materials included in this article.
Data Availability Statement
Data sharing not applicable to this article as no datasets were generated or analyzed during the current study.