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Bozsányi S, Boostani M, Farkas K, Hamilton-Meikle P, Varga NN, Szabó B, Vasanits F, Kuroli E, Meznerics FA, Lőrincz K, Holló P, Bánvölgyi A, Wikonkál NM, Paragh G, Kiss N. Optically Guided High-Frequency Ultrasound to Differentiate High-Risk Basal Cell Carcinoma Subtypes: A Single-Centre Prospective Study. J Clin Med 2023; 12:6910. [PMID: 37959375 PMCID: PMC10648659 DOI: 10.3390/jcm12216910] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 10/24/2023] [Accepted: 11/01/2023] [Indexed: 11/15/2023] Open
Abstract
BACKGROUND Basal cell carcinoma (BCC) is the most common type of skin cancer in the Caucasian population. Currently, invasive biopsy is the only way of establishing the histological subtype (HST) that determines the treatment options. Our study aimed to evaluate whether optically guided high-frequency ultrasound (OG-HFUS) imaging could differentiate aggressive HST BCCs from low-risk tumors. METHODS We conducted prospective clinical and dermoscopic examinations of BCCs, followed by 33 MHz OG-HFUS imaging, surgical excision, and a histological analysis. We enrolled 75 patients with 78 BCCs. In total, 63 BCCs were utilized to establish a novel OG-HFUS risk classification algorithm, while 15 were employed for the validation of this algorithm. The mean age of the patients was 72.9 ± 11.2 years. Histology identified 16 lesions as aggressive HST (infiltrative or micronodular subtypes) and 47 as low-risk HST (superficial or nodular subtypes). To assess the data, we used a one-sided Fisher's exact test for a categorical analysis and a Receiver Operating Characteristic (ROC) curve analysis to evaluate the diagnostic accuracy. RESULTS OG-HFUS distinguished aggressive BCC HSTs by their irregular shape (p < 0.0001), ill-defined margins (p < 0.0001), and non-homogeneous internal echoes (p = 0.004). We developed a risk-categorizing algorithm that differentiated aggressive HSTs from low-risk HSTs with a higher sensitivity (82.4%) and specificity (91.3%) than a combined macroscopic and dermoscopic evaluation (sensitivity: 40.1% and specificity: 73.1%). The positive and negative predictive values (PPV and NPV, respectively) for dermoscopy were 30.2% and 76.8%, respectively. In comparison, the OG-HFUS-based algorithm demonstrated a PPV of 94.7% and an NPV of 78.6%. We verified the algorithm using an independent image set, n = 15, including 12 low-risk and 3 high-risk (high-risk) with two blinded evaluators, where we found a sensitivity of 83.33% and specificity of 91.66%. CONCLUSIONS Our study shows that OG-HFUS can identify aggressive BCC HSTs based on easily identifiable morphological parameters, supporting early therapeutic decision making.
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Affiliation(s)
- Szabolcs Bozsányi
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary; (S.B.); (M.B.); (K.F.); (P.H.-M.); (N.N.V.); (B.S.); (F.V.); (E.K.); (F.A.M.); (K.L.); (P.H.); (A.B.); (N.M.W.)
- Department of Dermatology, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14203, USA;
| | - Mehdi Boostani
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary; (S.B.); (M.B.); (K.F.); (P.H.-M.); (N.N.V.); (B.S.); (F.V.); (E.K.); (F.A.M.); (K.L.); (P.H.); (A.B.); (N.M.W.)
| | - Klára Farkas
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary; (S.B.); (M.B.); (K.F.); (P.H.-M.); (N.N.V.); (B.S.); (F.V.); (E.K.); (F.A.M.); (K.L.); (P.H.); (A.B.); (N.M.W.)
| | - Phyllida Hamilton-Meikle
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary; (S.B.); (M.B.); (K.F.); (P.H.-M.); (N.N.V.); (B.S.); (F.V.); (E.K.); (F.A.M.); (K.L.); (P.H.); (A.B.); (N.M.W.)
| | - Noémi Nóra Varga
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary; (S.B.); (M.B.); (K.F.); (P.H.-M.); (N.N.V.); (B.S.); (F.V.); (E.K.); (F.A.M.); (K.L.); (P.H.); (A.B.); (N.M.W.)
| | - Boglárka Szabó
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary; (S.B.); (M.B.); (K.F.); (P.H.-M.); (N.N.V.); (B.S.); (F.V.); (E.K.); (F.A.M.); (K.L.); (P.H.); (A.B.); (N.M.W.)
| | - Flóra Vasanits
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary; (S.B.); (M.B.); (K.F.); (P.H.-M.); (N.N.V.); (B.S.); (F.V.); (E.K.); (F.A.M.); (K.L.); (P.H.); (A.B.); (N.M.W.)
| | - Enikő Kuroli
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary; (S.B.); (M.B.); (K.F.); (P.H.-M.); (N.N.V.); (B.S.); (F.V.); (E.K.); (F.A.M.); (K.L.); (P.H.); (A.B.); (N.M.W.)
| | - Fanni Adél Meznerics
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary; (S.B.); (M.B.); (K.F.); (P.H.-M.); (N.N.V.); (B.S.); (F.V.); (E.K.); (F.A.M.); (K.L.); (P.H.); (A.B.); (N.M.W.)
| | - Kende Lőrincz
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary; (S.B.); (M.B.); (K.F.); (P.H.-M.); (N.N.V.); (B.S.); (F.V.); (E.K.); (F.A.M.); (K.L.); (P.H.); (A.B.); (N.M.W.)
| | - Péter Holló
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary; (S.B.); (M.B.); (K.F.); (P.H.-M.); (N.N.V.); (B.S.); (F.V.); (E.K.); (F.A.M.); (K.L.); (P.H.); (A.B.); (N.M.W.)
| | - András Bánvölgyi
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary; (S.B.); (M.B.); (K.F.); (P.H.-M.); (N.N.V.); (B.S.); (F.V.); (E.K.); (F.A.M.); (K.L.); (P.H.); (A.B.); (N.M.W.)
| | - Norbert M. Wikonkál
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary; (S.B.); (M.B.); (K.F.); (P.H.-M.); (N.N.V.); (B.S.); (F.V.); (E.K.); (F.A.M.); (K.L.); (P.H.); (A.B.); (N.M.W.)
| | - Gyorgy Paragh
- Department of Dermatology, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14203, USA;
| | - Norbert Kiss
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary; (S.B.); (M.B.); (K.F.); (P.H.-M.); (N.N.V.); (B.S.); (F.V.); (E.K.); (F.A.M.); (K.L.); (P.H.); (A.B.); (N.M.W.)
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Liang JF, Luo PP, Zhang Y, Zhao G, Zhou M, Wang J. Comparison of Sonographic Characteristics Between Superficial Basal Cell Carcinoma and Non-Superficial Basal Cell Carcinomas. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2023; 42:1549-1556. [PMID: 36637366 DOI: 10.1002/jum.16174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Revised: 12/22/2022] [Accepted: 12/26/2022] [Indexed: 06/17/2023]
Abstract
OBJECTIVES To compare the sonographic characteristics of superficial basal cell carcinoma (sBCC) and non-superficial basal cell carcinomas (nsBCC). METHODS The ultrasound characteristics of 73 basal cell carcinoma (BCC) confirmed by surgical pathology were retrospectively analyzed, and the cases were divided into 11 cases of sBCC and 62 cases of nsBCC according to pathological subtypes. Ultrasound characteristics between groups were compared. RESULTS Among all the ultrasound characteristics, lesion thickness (P = .000), shape (χ2 = 39.293, P = .000), basal changes (χ2 = 8.473, P = .037), infiltration level (χ2 = 46.140, P = .000), and distribution of intralesional hyperechogenic spots (χ2 = 15.699, P = .000) of the lesions had statistically significant correlation with pathological diagnosis of sBCC. While no significant differences were shown in surface morphology, keratinization, maximum diameter, intralesional echogenicity, posterior echogenic changes, and intralesional color Doppler flow of the lesions. CONCLUSIONS Small lesion thickness, oblate shape, superficial dermal local infiltration, and <3 internal hyperechogenic spots distribution of BCC determined by high frequency ultrasound may positively correlate with pathological diagnosis of sBCC. This is beneficial for treatment planning.
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Affiliation(s)
- Jian-Feng Liang
- Department of Ultrasound, Zhongshan Hospital of Traditional Chinese Medicine, Zhongshan, Guangdong, China
| | - Ping-Ping Luo
- Department of Ultrasound, Zhongshan Hospital of Traditional Chinese Medicine, Zhongshan, Guangdong, China
| | - Yan Zhang
- Department of Ultrasound, Zhongshan Hospital of Traditional Chinese Medicine, Zhongshan, Guangdong, China
| | - Gang Zhao
- Department of Ultrasound, Zhongshan Hospital of Traditional Chinese Medicine, Zhongshan, Guangdong, China
| | - Mei Zhou
- Department of Pathology, Zhongshan Hospital of Traditional Chinese Medicine, Zhongshan, Guangdong, China
| | - Jing Wang
- Department of Pathology, Zhongshan Hospital of Traditional Chinese Medicine, Zhongshan, Guangdong, China
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Wortsman X. Key Points to Select a Device for Dermatologic Ultrasound. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2023; 42:521-545. [PMID: 36394307 DOI: 10.1002/jum.16000] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Accepted: 04/19/2022] [Indexed: 05/26/2023]
Abstract
What points to consider when selecting a device for practicing dermatologic ultrasound is an excellent question. After we met the requisites published in the guidelines for practicing dermatologic ultrasound, it is necessary to consider the main objective of the use because it is not the same to be focused mostly on the avoidance of the puncture of important facial vessels such as the case of injectors of cosmetic fillers in comparison to the use of operators that need to deal with the diagnosis and monitoring of a wide range of dermatologic pathologies. Currently, a broad variety of ultrasound devices meets the minimum requirements for practicing these examinations in the market. Thus, small, portable, and high-end devices may present advantages and limitations that must be balanced according to the primary purposes and the budget. Moreover, the shape and footprint of the probes can make difficult or facilitate a dermatologic procedure. Other points to consider are the type of storage and the need for technical service. In summary, there are key points that we need to consider when we select a dermatologic ultrasound device in dermatology or aesthetics.
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Affiliation(s)
- Ximena Wortsman
- Institute for Diagnostic Imaging and Research of the Skin and Soft Tissues, Santiago, Chile
- Department of Dermatology, Faculty of Medicine, Universidad de Chile, Santiago, Chile
- Department of Dermatology, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile
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Laverde-Saad A, Simard A, Nassim D, Jfri A, Alajmi A, O'Brien E, Wortsman X. Performance of Ultrasound for Identifying Morphological Characteristics and Thickness of Cutaneous Basal Cell Carcinoma: A Systematic Review. Dermatology 2022; 238:692-710. [PMID: 35026769 DOI: 10.1159/000520751] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 11/02/2021] [Indexed: 11/19/2022] Open
Abstract
Advances in ultrasound technology and non-surgical treatments of basal cell carcinomas (BCCs) have raised the need to study the performance of high-frequency ultrasound (HFUS) in BCCs. We aimed to assess the performance of HFUS in the evaluation of BCCs to formulate recommendations for its uses and conducted a systematic review of the literature to do so. A search of Central, Medline, Embase, CINHAL, and Web of Science was performed using key/MESH terms "ultrasonography" and "basal cell carcinoma" (January 2005-December 2020). We included primary studies reporting biopsy-confirmed BCCs for which the target intervention was ultrasound assessment at 15 MHz or higher frequency. Thirty articles were included, studying a total of 1,203 biopsy-confirmed BCCs. HFUS provides accurate depth measurements, especially for BCCs >1 mm. The definition of lateral margins in vivo needs further studies; however, ex vivo margin assessment seems convincing. There is a diagnostic role for HFUS in identifying higher recurrence risk BCC subtypes, which can help in risk stratification. Performance of HFUS is significant in BCC management. Pre-surgical scans may support case selection for Mohs. HFUS can improve safety when used to plan brachytherapy treatments, help with case selection and adjunct treatment choice pre-photodynamic therapy. Finally, HFUS can help follow lesions after intervention, particularly non-surgical management, and support the decision to observe or re-intervene. HFUS can enhance clinical practice by providing useful information that cannot be deducted from the clinical examination. It would be recommended to evaluate the extent, mainly depth, and detect the aggressiveness of the BCCs.
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Affiliation(s)
- Alexandra Laverde-Saad
- Division of Dermatology, McGill University Health Centre, Montreal General Hospital, Montreal, Québec, Canada
| | - Alexe Simard
- Faculty of Medicine, McGill University, Montreal, Québec, Canada
| | - David Nassim
- Faculty of Medicine, McGill University, Montreal, Québec, Canada
| | - Abdulhadi Jfri
- Division of Dermatology, McGill University Health Centre, Montreal General Hospital, Montreal, Québec, Canada
| | - Ali Alajmi
- Division of Dermatology, McGill University Health Centre, Montreal General Hospital, Montreal, Québec, Canada
| | - Elizabeth O'Brien
- Division of Dermatology, McGill University Health Centre, Montreal General Hospital, Montreal, Québec, Canada
| | - Ximena Wortsman
- Institute for Diagnostic Imaging and Research of the Skin and Soft Tissues, Santiago, Chile.,Department of Dermatology, Faculty of Medicine, Universidad de Chile, Santiago, Chile.,Department of Dermatology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
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Băbțan AM, Vesa ȘC, Boșca BA, Crișan M, Mihu CM, Băciuț MF, Dinu C, Crișan B, Câmpian RS, Feurdean CN, Ionel A, Bezugly A, Bordea IR, Ilea A. High-Frequency Ultrasound Assessment of Skin and Oral Mucosa in Metabolic Syndrome Patients-A Cross-Sectional Study. J Clin Med 2021; 10:jcm10194461. [PMID: 34640479 PMCID: PMC8509493 DOI: 10.3390/jcm10194461] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 09/16/2021] [Accepted: 09/24/2021] [Indexed: 12/01/2022] Open
Abstract
Background: Exogenous factors (such as sun exposure, smoking habits, and diet) and endogenous (inflammatory status, general diseases) have a direct influence on skin and soft tissue characteristics. The study’s objective was to assess the impact of metabolic syndrome (MS) on characteristics of skin layers in sun-exposed and non-exposed maxillofacial tissues evaluated by high-frequency ultrasound (HFU), as a potential diagnosis and monitoring tool for the aging process. Material and methods: The present study included 102 subjects (24 with MS; 78 without MS). Anthropometric parameters and disease history were recorded, and blood samples were harvested in order to assess biochemical parameters of MS. Sun-exposed skin (zygomatic region) and non-exposed oral mucosa of the lower lip were assessed using HFU (DUB® cutis, Taberna Pro Medicum) with a 22 MHz probe. Results: Patients with cardiac disease had significantly lower values for epidermis density (p = 0.002). Gender was independently linked to the aged dermis depth (p < 0.001), aged dermis no. of px (pixels) (p < 0.001), dermis depth (p < 0.001), dermis no. of px (p < 0.001), and subcutaneous tissue density (p < 0.001). Patients with MS had thinner epidermis (p = 0.008) and thinner aged dermis (p = 0.037) when compared to non-MS subjects. Conclusion: Patients with MS had thinner epidermis and a lower epidermis number of pixels in sun-exposed skin. Women had lower epidermis density and thicker dermis in sun-exposed skin. Our study showed that HFU, as a non-invasive investigation approach, is useful to diagnose and monitor the aging process in skin and oral mucosa, correlated with skin phenotype pathological conditions.
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Affiliation(s)
- Anida Maria Băbțan
- Oral Rehabilitation Department, Faculty of Dentistry, “Iuliu Haţieganu” University of Medicine and Pharmacy Cluj-Napoca, Babeș Street No. 15, 400012 Cluj-Napoca, Cluj County, Romania; (A.M.B.); (R.S.C.); (C.N.F.); (A.I.); (A.I.)
| | - Ștefan Cristian Vesa
- Pharmacology, Toxicology and Clinical Pharmacology Department, Faculty of Medicine, “Iuliu Haţieganu” University of Medicine and Pharmacy Cluj-Napoca, Marinescu Street No. 23, 400337 Cluj-Napoca, Cluj County, Romania
- Correspondence: ; Tel.: +40-740125980
| | - Bianca Adina Boșca
- Histology Department, Faculty of Medicine, “Iuliu Haţieganu” University of Medicine and Pharmacy Cluj-Napoca, Pasteur Street No. 4, 400349 Cluj-Napoca, Cluj County, Romania; (B.A.B.); (M.C.); (C.M.M.)
| | - Maria Crișan
- Histology Department, Faculty of Medicine, “Iuliu Haţieganu” University of Medicine and Pharmacy Cluj-Napoca, Pasteur Street No. 4, 400349 Cluj-Napoca, Cluj County, Romania; (B.A.B.); (M.C.); (C.M.M.)
| | - Carmen Mihaela Mihu
- Histology Department, Faculty of Medicine, “Iuliu Haţieganu” University of Medicine and Pharmacy Cluj-Napoca, Pasteur Street No. 4, 400349 Cluj-Napoca, Cluj County, Romania; (B.A.B.); (M.C.); (C.M.M.)
| | - Mihaela Felicia Băciuț
- Maxillofacial Surgery and Implantology Department, Faculty of Dentistry, “Iuliu Haţieganu” University of Medicine and Pharmacy Cluj-Napoca, Cardinal Iuliu Hossu Street No. 37, 400029 Cluj-Napoca, Cluj County, Romania; (M.F.B.); (C.D.); (B.C.)
| | - Cristian Dinu
- Maxillofacial Surgery and Implantology Department, Faculty of Dentistry, “Iuliu Haţieganu” University of Medicine and Pharmacy Cluj-Napoca, Cardinal Iuliu Hossu Street No. 37, 400029 Cluj-Napoca, Cluj County, Romania; (M.F.B.); (C.D.); (B.C.)
| | - Bogdan Crișan
- Maxillofacial Surgery and Implantology Department, Faculty of Dentistry, “Iuliu Haţieganu” University of Medicine and Pharmacy Cluj-Napoca, Cardinal Iuliu Hossu Street No. 37, 400029 Cluj-Napoca, Cluj County, Romania; (M.F.B.); (C.D.); (B.C.)
| | - Radu Septimiu Câmpian
- Oral Rehabilitation Department, Faculty of Dentistry, “Iuliu Haţieganu” University of Medicine and Pharmacy Cluj-Napoca, Babeș Street No. 15, 400012 Cluj-Napoca, Cluj County, Romania; (A.M.B.); (R.S.C.); (C.N.F.); (A.I.); (A.I.)
| | - Claudia Nicoleta Feurdean
- Oral Rehabilitation Department, Faculty of Dentistry, “Iuliu Haţieganu” University of Medicine and Pharmacy Cluj-Napoca, Babeș Street No. 15, 400012 Cluj-Napoca, Cluj County, Romania; (A.M.B.); (R.S.C.); (C.N.F.); (A.I.); (A.I.)
| | - Anca Ionel
- Oral Rehabilitation Department, Faculty of Dentistry, “Iuliu Haţieganu” University of Medicine and Pharmacy Cluj-Napoca, Babeș Street No. 15, 400012 Cluj-Napoca, Cluj County, Romania; (A.M.B.); (R.S.C.); (C.N.F.); (A.I.); (A.I.)
| | - Artur Bezugly
- Dermatology and Cosmetology Department, Academy of Postgraduate Education of the Russian Federal Medical-Biological Agency, 123098 Moscow, Russia;
| | - Ioana Roxana Bordea
- Oral Health Department, Faculty of Dentistry, “Iuliu Haţieganu” University of Medicine and Pharmacy Cluj-Napoca, Babeș Street No. 15, 400012 Cluj-Napoca, Cluj County, Romania;
| | - Aranka Ilea
- Oral Rehabilitation Department, Faculty of Dentistry, “Iuliu Haţieganu” University of Medicine and Pharmacy Cluj-Napoca, Babeș Street No. 15, 400012 Cluj-Napoca, Cluj County, Romania; (A.M.B.); (R.S.C.); (C.N.F.); (A.I.); (A.I.)
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The use of high frequency skin ultrasound in non-melanoma skin cancer. J Contemp Brachytherapy 2021; 13:483-491. [PMID: 34484364 PMCID: PMC8407264 DOI: 10.5114/jcb.2021.108603] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Accepted: 05/24/2021] [Indexed: 12/23/2022] Open
Abstract
Ultrasound (US) or sonography is the most common diagnostic non-invasive imaging method, which is estimated to account for more than a third of all diagnostic procedures used in medical practice. Traditionally, US frequencies used in diagnostic radiology range from 1 MHz to approximately 16 MHz. Visualization of skin morphology requires US frequencies from 20 to 100 MHz, and is called a "high frequency ultrasound" (HFUS). HFUS has been explored in normal skin and in various skin pathologies. It has been found useful in differentiation diagnosis of infiltrative (perivascular) and exudative inflammation, hypertrophic or normotrophic scars, keloids, and in skin atrophy. Moreover, it has been used to support diagnosis and management of skin tumors. In skin oncology, HFUS can provide essential information on tumors' size and margins, particularly the depth of invasion. Such information are crucial in deciding on the form of treatment (e.g., photodynamic therapy, radiotherapy, brachytherapy), computed tomography (CT)-based planning treatment (e.g., superficial brachytherapy), and in skin monitoring after treatment, in addition to clinical examination.
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Qin J, Wang J, Zhu Q, Liu J, Gao Y, Wang Y, Jin H. Usefulness of high-frequency ultrasound in differentiating basal cell carcinoma from common benign pigmented skin tumors. Skin Res Technol 2021; 27:766-773. [PMID: 33638227 DOI: 10.1111/srt.13012] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Revised: 01/12/2021] [Accepted: 01/25/2021] [Indexed: 01/10/2023]
Abstract
BACKGROUND Basal cell carcinoma (BCC) is the most common cutaneous malignancy. Occasionally, it may have an appearance similar to that of some benign pigmented skin lesions. Therefore, additional information is needed to differentiate these lesions. MATERIALS AND METHODS A diagnostic accuracy study was performed from February 2018 to April 2019. All lesions underwent ultrasound examination with 50 and 20 MHz probes. The high-frequency ultrasound (HFUS) images were evaluated independently by 2 experienced doctors for the presence of predefined features, including the depth, shape, margin, anechoic area, hyperechoic spots, epidermal interrupted echo, mushroom sign, flat-bottom sign, and superficial hyperechoic focus (SHEF). RESULTS A total of 54 BCCs, 51 melanocytic nevi and 55 seborrheic keratoses (SK), were included. BCCs often involved the subcutaneous tissue (11/54, 20.4%; P < .001) and had an irregular shape (26/54, 48.1%; P < .001) and ill-defined borders (26/54, 48.1%; P < .001), while most benign pigmented lesions had a regular shape (101/106, 95.3%; P < .001) and well-defined borders (95/106, 89.6%; P < .001). BCCs occasionally showed anechoic areas (10/54, 18.5%; P < .001) and epidermal interrupted echo (18/54, 33.3%; P < .001). Moreover, hyperechoic spots could be found in BCCs (43/54, 79.6%), nevi (27/51, 52.9%), and SK (30, 54.5%) (P = .001), with mean number of 7.3, 5.5, and 8.0, respectively. The mushroom signs were all present in melanocytic nevi (18/51, 35.3%), while the flat-bottom sign (43/55, 78.2%; P < .001) and SHEF (40/55, 72.7%; P < .001) presented mainly in SKs. CONCLUSIONS Based on the typical features, HFUS could improve the accuracy of BCC identification and should be considered when dermatologists are unsure about the lesion type.
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Affiliation(s)
- Jing Qin
- Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Juncheng Wang
- Department of Dermatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Qingli Zhu
- Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jie Liu
- Department of Dermatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yuanjing Gao
- Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yukun Wang
- Department of Dermatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Hongzhong Jin
- Department of Dermatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Migda M, Migda MS, Migda B, Maleńczyk M. The usefulness of high-frequency ultrasonography in the preoperative evaluation of vulvar cancer - a case series. J Ultrason 2020; 19:305-310. [PMID: 32021713 PMCID: PMC6988570 DOI: 10.15557/jou.2019.0046] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Accepted: 11/20/2019] [Indexed: 11/22/2022] Open
Abstract
Vulvar cancer is a malignancy of female lower genital tract with incidence of 1:100,000 in Poland. The most common types of vulvar cancers are squamous cell carcinoma and basal cell carcinoma. This study was approved by the board of the Clinical Unit of Obstetrics, Women’s Disease and Gynecological Oncology, United District Hospital, Collegium Medicum University of Nicolaus Copernicus in Toruń, Poland. This is a tertiary reference center. We analyzed cases of postmenopausal women diagnosed with vulvar cancer referred to our clinic for surgery. The aim of the study was to compare 48 MHz ultrasound images of vulvar cancer with histological images and assess the utility of high-frequency ultrasonography images in preoperative assessment. We examined 3 cases of squamous cell carcinoma and 1 case of basal cell carcinoma using 48 MHz DermaView high-frequency mechanical probe. We described typical ultrasonographic features of vulvar carcinoma, such as echogenicity, depth of infiltration, as well as we discussed limitations of this transducer. The 48 MHz frequency exhibits a promising value for the preoperative assessment of vulvar carcinoma. High-frequency ultrasonography can provide some important information, such as morphology, boundary, internal echo, and thus help choose adequate surgical approach.
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Affiliation(s)
- Michał Migda
- Clinical Unit of Obstetrics, Women's Disease and Gynecological Oncology, United District Hospital, Collegium Medicum University of Nicolaus Copernicus in Toruń, Torun, Poland.,Civis Vita Medical Center Torun, Poland
| | | | - Bartosz Migda
- Department of Diagnostic Imaging, Second Faculty of Medicine with the English Division and the Physiotherapy Division, Medical University of Warsaw, Warsaw, Poland
| | - Marek Maleńczyk
- Clinical Unit of Obstetrics, Women's Disease and Gynecological Oncology, United District Hospital, Collegium Medicum University of Nicolaus Copernicus in Toruń, Torun, Poland
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Veness MJ, Delishaj D, Barnes EA, Bezugly A, Rembielak A. Current Role of Radiotherapy in Non-melanoma Skin Cancer. Clin Oncol (R Coll Radiol) 2019; 31:749-758. [PMID: 31447088 DOI: 10.1016/j.clon.2019.08.004] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2019] [Revised: 07/07/2019] [Accepted: 08/07/2019] [Indexed: 12/11/2022]
Abstract
Non-melanoma skin cancer (NMSC) represents the most frequently diagnosed malignancy worldwide, most being cutaneous basal cell and squamous cell carcinoma. The global incidence of NMSC continues to increase as the global population ages. Numerous treatment options are available for NMSC patients, with radiotherapy an efficacious and tissue-preserving non-surgical option. External beam radiotherapy and brachytherapy are modalities with specific indications and advantages in treating NMSC. Where excision is not an option (medically/technically inoperable) or considered less ideal (e.g. cosmetic or functional outcome), radiotherapy offers an excellent alternative. Inoperable elderly and/or co-morbid patients of poor performance status can benefit from short-course hypofractionated radiotherapy, with very acceptable toxicity. Adjuvant radiotherapy in patients with unfavourable pathology can decrease the risk of local and regional recurrence and associated morbidity and mortality. Radiotherapy has advantages and disadvantages and it is important for clinicians to understand these. Managing patients with NMSC is carried out by clinicians from multiple disciplines but it is imperative that they are all aware of the role of radiotherapy in their patients in various clinical settings. Here we aim to discuss the role and indications for recommending radiotherapy in patients with NMSC.
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Affiliation(s)
- M J Veness
- Department of Radiation Oncology, Crown Princess Mary Cancer Centre, Westmead Hospital, Sydney, New South Wales, Australia; University of Sydney, Sydney, New South Wales, Australia.
| | - D Delishaj
- Department of Translational Medicine, Division of Radiation Oncology - University of Pisa, Pisa, Italy
| | - E A Barnes
- Department of Radiation Oncology, University of Toronto, Odette Cancer Centre, Toronto, Canada
| | - A Bezugly
- Academy of Postgraduate Education of the Russian Federal Medical-Biological Agency, Moscow, Russia
| | - A Rembielak
- Department of Clinical Oncology, The Christie NHS Foundation Trust, Manchester, UK; University of Manchester, Manchester, UK
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