title: Comparison between high-frequency ultrasonography and histological assessment reveals weak correlation for measurements of scar tissue thickness.
abstract: OBJECTIVE
  Current methods for evaluating scar tissue volume following burns have shortcomings. The Vancouver Burn Scar scale is subjective, leading to a high variability in assessment. Although histological assessment via punch biopsy can discriminate between the different layers of skin, such an approach is invasive, inefficient, and detrimental to patient experience and wound healing. This study investigates the accuracy of high-frequency ultrasonography, a non-invasive alternative to histology, for measuring dermal and epidermal thickness in scar tissue.
  
  
  METHODS
  Scar thicknesses of 10 patients following burns were assessed using a 2-D high-frequency ultrasound probe. The scars were then biopsied using a circular 4mm punch biopsy for histological assessment. Dermal, epidermal, and total thickness of the scar tissue was measured using ultrasound and histology, and correlations between the two measurements were calculated.
  
  
  RESULTS
  There was not a strong correlation between ultrasound measurement and histological analysis for epidermal, dermal, and total thickness (Spearman's rank correlation of -0.1223, -0.6242, and -0.6242) of scar tissue.
  
  
  CONCLUSIONS
  Measurements of scar thickness using high-frequency ultrasonography did not recapitulate the in vivo dermal, epidermal and total thickness. Based on these findings, strategies for further optimization of 2-D ultrasonography is discussed before clinical and research use.
authors.affiliation: Department of Comparative Biology and Experimental Medicine, Faculty of Veterinary Medicine, University of Calgary, 3330 Hospital Dr. NW, Calgary, AB T2N 4N1, Canada. Electronic address: natacha.agabalyan@gmail.com.
authors.forename: Natacha A
authors.initials: NA
authors.lastname: Agabalyan
authors.affiliation: Department of Comparative Biology and Experimental Medicine, Faculty of Veterinary Medicine, University of Calgary, 3330 Hospital Dr. NW, Calgary, AB T2N 4N1, Canada. Electronic address: sdsu@ucalgary.ca.
authors.forename: Samuel
authors.initials: S
authors.lastname: Su
authors.affiliation: Department of Comparative Biology and Experimental Medicine, Faculty of Veterinary Medicine, University of Calgary, 3330 Hospital Dr. NW, Calgary, AB T2N 4N1, Canada. Electronic address: sarthak.chinoo@gmail.com.
authors.forename: Sarthak
authors.initials: S
authors.lastname: Sinha
authors.affiliation: Department of Comparative Biology and Experimental Medicine, Faculty of Veterinary Medicine, University of Calgary, 3330 Hospital Dr. NW, Calgary, AB T2N 4N1, Canada; Division of Physical Medicine and Rehabilitation, Departments of Clinical Neurosciences, Surgery and Pediatrics, Alberta Children's Hospital Research Institute, Firefighters' Burn Treatment Centre, University of Calgary, Canada. Electronic address: vince.gabriel@albertahealthservices.ca.
authors.forename: Vincent
authors.initials: V
authors.lastname: Gabriel
mesh_terms: D000328:Adult; D002056:Burns / Q000150:complications / Q000601:surgery*; D002921:Cicatrix / Q000000981:diagnostic imaging* / Q000209:etiology / Q000473:pathology; D017439:Cicatrix, Hypertrophic / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D012867:Skin / Q000000981:diagnostic imaging* / Q000473:pathology; D016038:Skin Transplantation; D014463:Ultrasonography; D055815:Young Adult
keywords: 2-D ultrasound; High frequency ultrasonography; Non-invasive; Scar measurement; Skin thickness imaging