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. 2025 Jul 1;15(7):6372-6385.
doi: 10.21037/qims-24-1753. Epub 2025 Jun 30.

High-frequency quantitative ultrasound in characterizing human skin aging: an exploration of the non-modeling and modeling approaches

Yuzhen Li  1   2 , Bingbing He  1   2   3 , Xun Lang  1   2 , Guang Shi  1 , Ningtao Zhang  3 , Zhenyu Guo  3 , Yufeng Zhang  1   3
Affiliations

High-frequency quantitative ultrasound in characterizing human skin aging: an exploration of the non-modeling and modeling approaches

Yuzhen Li et al. Quant Imaging Med Surg. .

Abstract

Background: High-frequency quantitative ultrasound (HQUS) technology, with its non-invasiveness, high-resolution, objectivity, and reproducibility, holds significant potential for characterizing skin aging through the analysis of the internal structure of tissues. This study aims to explore a framework for characterizing skin aging assessment through HQUS technology to facilitate the subsequent analysis of skin aging-related studies.

Methods: In this study, an exploration of non-modeling and modeling HQUS techniques in characterizing skin aging was conducted. In particular, we tested the conventional approach using the envelope amplitude, the non-modeling approach based on the small-window entropy and the modeling approach with the Nakagami parameters (m and Ω) at scanning depths of 1 and 1.5 mm, respectively, and discovered that such a characterization framework is well-suitable for quantifying skin aging. These parameters were calculated based on ultrasound backscattered signals at a high frequency of 42 MHz from the facial skin (from the epidermis to the dermis) of 70 female participants aged 24-57 years and then analyzed using the linear fitting and receiver operating characteristic (ROC) curves.

Results: The results show that there exists a linear correlation between all parameters and participant ages at scanning depths of 1 and 1.5 mm, respectively. Among them, the correlation coefficients for parameter m are r2=0.84 (P<0.0001) and r2=0.65 (P<0.0001), which are higher than those for the relative envelope amplitude, small-window entropy, and parameter Ω. Moreover, the parameter m also has the highest area under the curve among the ROC curves, regardless of the scanning depth.

Conclusions: This characterization framework, especially the modeling of the Nakagami parameter m, has great feasibility for the characterization of human skin aging. The proposed framework holds significant potential for assessing the efficacy of facial rejuvenation products, photofacials, and similar treatments.

Keywords: Nakagami parameter; Skin aging; envelope amplitude; high-frequency ultrasound; small-window entropy.

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Conflict of interest statement

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://qims.amegroups.com/article/view/10.21037/qims-24-1753/coif). Y.L. reports the funding from the Yunnan University Professional Degree Graduate Practical Innovation Fund Project (No. ZC-23233850). B.H. reports the funding from the National Natural Science Foundation of China (Nos. 62003298, 62201495, and 62261057) and is an employee of Yunnan Betani Biotechnology Group Co., Ltd. X.L. reports the funding from Yunnan Province “Foster Yunnan Talent Support Program” Youth Talent Special Project (No. C6213001204). N.Z., Z.G, and Y.Z. are employees of Yunnan Betani Biotechnology Group Co., Ltd. The other author has no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Algorithmic flowchart of the different parameter values for characterization of human skin aging. RF, radiofrequency.
Figure 2
Figure 2
Typical images of ultrasound parametric imaging for each age group. Four columns of imaging results from left to right are B-mode images, the small-window entropy imaging, the Nakagami parameters (m) imaging, and the Nakagami parameters (Ω) imaging, respectively. The seven rows of imaging results from top to bottom are from seven age groups of 25–55 years, respectively.
Figure 3
Figure 3
Box plots corresponding to different age groups. (A) Differences in the age-group distribution of relative envelope amplitude. (B) Differences in the age-group distribution of small-window entropy. (C) Differences in the age-group distribution of Nakagami parameter (m). (D) Differences in the age-group distribution of Nakagami parameter (Ω). Data are expressed through box plots, and the scanning depth is 1 mm.
Figure 4
Figure 4
Box plots corresponding to different age groups. (A) Differences in the age-group distribution of relative envelope amplitude. (B) Differences in the age-group distribution of small-window entropy. (C) Differences in the age-group distribution of Nakagami parameter (m). (D) Differences in the age-group distribution of Nakagami parameter (Ω). Data are expressed through box plots, and the scanning depth is 1.5 mm.
Figure 5
Figure 5
Linear relationship between different ages and parameters. (A) Linear fitting curves of relative envelope amplitude in all age groups. (B) Linear fitting curves of small-window entropy in all age groups. (C) Linear fitting curves of Nakagami parameter (m) in all age groups. (D) Linear fitting curves of Nakagami parameter (Ω) in all age groups. The scanning depth is 1 mm.
Figure 6
Figure 6
Linear relationship between different ages and parameters. (A) Linear fitting curves of relative envelope amplitude in all age groups. (B) Linear fitting curves of small-window entropy in all age groups. (C) Linear fitting curves of Nakagami parameter (m) in all age groups. (D) Linear fitting curves of Nakagami parameter (Ω) in all age groups. The scanning depth is 1.5 mm.
Figure 7
Figure 7
The ROC curves obtained from the ultrasound envelope amplitude, Nakagami parameters (m and Ω), and small-window entropy parameters at intervals of 5, 10, 15, 20, 25, and 30 years, respectively. The scanning depth was set at 1 mm. AUROC, area under the receiver operating characteristic curve; ROC, receiver operating characteristic.
Figure 8
Figure 8
The ROC curves obtained from the ultrasound envelope amplitude, Nakagami parameters (m and Ω), and small-window entropy parameters at intervals of 5, 10, 15, 20, 25, and 30 years, respectively. The scanning depth was set at 1.5 mm. AUROC, area under the receiver operating characteristic curve; ROC, receiver operating characteristic.
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