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Depth determination of skin cancers treated with superficial brachytherapy: ultrasound vs. histopathology.

Ballester-Sánchez R, Pons-Llanas O, Llavador-Ros M, Botella-Estrada R, Ballester-Cuñat A, Tormo-Micó A, Javier Celadá-Álvarez F, Rodríguez-Villalba S, Santos-Ortega M, Ballester-Pallarés F, Perez-Calatayud J - J Contemp Brachytherapy (2014)

Bottom Line: Depth value differences with both modalities resulted patient dependent and then consequence of its uncertainty.According to the results, HFUS is less accurate at very shallow depths.In our clinical practice, we decided to prescribe at 3 mm depth when HFUS measurements give depth lesion values smaller than this value.

View Article: PubMed Central - PubMed

Affiliation: Dermatology Department, La Fe University and Polytechnic Hospital, Valencia.

ABSTRACT

Purpose: The purpose of this study is to compare high frequency ultrasonography (HFUS) and histpathologic assessment done by punch biopsy in order to determine depth of basal cell carcinoma (BCC), in both superficial and nodular BCCs prior to brachytherapy treatment.

Material and methods: This study includes 20 patients with 10 superficial and 10 nodular BCCs. First, punch biopsy was done to confirm the diagnosis and to measure tumour depth (Breslow rate). Subsequently, HFUS was done to measure tumour depth to search for correlation of these two techniques.

Results: Neither clear tendency nor significance of the punch biopsy vs. HFUS depth determination is observed. Depth value differences with both modalities resulted patient dependent and then consequence of its uncertainty. Conceptually, HFUS should determine the macroscopic lesion (gross tumour volume - GTV), while punch biopsy is able to detect the microscopic extension (clinical target volume - CTV). Uncertainties of HFUS are difficult to address, while punch biopsy is done just on a small lesion section, not necessarily the deepest one.

Conclusions: According to the results, HFUS is less accurate at very shallow depths. Nodular cases present higher depth determination differences than superficial ones. In our clinical practice, we decided to prescribe at 3 mm depth when HFUS measurements give depth lesion values smaller than this value.

No MeSH data available.


Related in: MedlinePlus

Example of depth histopathologic assessment (Breslow rate) using a Leica DMD108 digital microimaging network
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Figure 0001: Example of depth histopathologic assessment (Breslow rate) using a Leica DMD108 digital microimaging network

Mentions: A 3 mm diameter punch biopsy, including the whole dermis, was performed in all lesions. The deepest site estimated clinically was the site chosen for the biopsy; this is the usual method practised by dermatologists. The more nodular part usually corresponds to the deepest part of the tumour. An intralesional injection of mepivacaine was administered prior to the biopsy and a silk suture was used to close the wound. Histopathologic assessment of depth was done with the Leica DMD108 digital microimaging network (Leica Microsystems SLU, Barcelona, Spain). Tumour thickness was measured from the granular layer to the deepest portion of the tumour, as shown in Figure 1.


Depth determination of skin cancers treated with superficial brachytherapy: ultrasound vs. histopathology.

Ballester-Sánchez R, Pons-Llanas O, Llavador-Ros M, Botella-Estrada R, Ballester-Cuñat A, Tormo-Micó A, Javier Celadá-Álvarez F, Rodríguez-Villalba S, Santos-Ortega M, Ballester-Pallarés F, Perez-Calatayud J - J Contemp Brachytherapy (2014)

Example of depth histopathologic assessment (Breslow rate) using a Leica DMD108 digital microimaging network
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4300362&req=5

Figure 0001: Example of depth histopathologic assessment (Breslow rate) using a Leica DMD108 digital microimaging network
Mentions: A 3 mm diameter punch biopsy, including the whole dermis, was performed in all lesions. The deepest site estimated clinically was the site chosen for the biopsy; this is the usual method practised by dermatologists. The more nodular part usually corresponds to the deepest part of the tumour. An intralesional injection of mepivacaine was administered prior to the biopsy and a silk suture was used to close the wound. Histopathologic assessment of depth was done with the Leica DMD108 digital microimaging network (Leica Microsystems SLU, Barcelona, Spain). Tumour thickness was measured from the granular layer to the deepest portion of the tumour, as shown in Figure 1.

Bottom Line: Depth value differences with both modalities resulted patient dependent and then consequence of its uncertainty.According to the results, HFUS is less accurate at very shallow depths.In our clinical practice, we decided to prescribe at 3 mm depth when HFUS measurements give depth lesion values smaller than this value.

View Article: PubMed Central - PubMed

Affiliation: Dermatology Department, La Fe University and Polytechnic Hospital, Valencia.

ABSTRACT

Purpose: The purpose of this study is to compare high frequency ultrasonography (HFUS) and histpathologic assessment done by punch biopsy in order to determine depth of basal cell carcinoma (BCC), in both superficial and nodular BCCs prior to brachytherapy treatment.

Material and methods: This study includes 20 patients with 10 superficial and 10 nodular BCCs. First, punch biopsy was done to confirm the diagnosis and to measure tumour depth (Breslow rate). Subsequently, HFUS was done to measure tumour depth to search for correlation of these two techniques.

Results: Neither clear tendency nor significance of the punch biopsy vs. HFUS depth determination is observed. Depth value differences with both modalities resulted patient dependent and then consequence of its uncertainty. Conceptually, HFUS should determine the macroscopic lesion (gross tumour volume - GTV), while punch biopsy is able to detect the microscopic extension (clinical target volume - CTV). Uncertainties of HFUS are difficult to address, while punch biopsy is done just on a small lesion section, not necessarily the deepest one.

Conclusions: According to the results, HFUS is less accurate at very shallow depths. Nodular cases present higher depth determination differences than superficial ones. In our clinical practice, we decided to prescribe at 3 mm depth when HFUS measurements give depth lesion values smaller than this value.

No MeSH data available.


Related in: MedlinePlus