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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

A) Histopathology (Breslow rate) vs. high frequency ultrasonography (HFUS) depth determination for the 10 patients evaluated with superficial basal cell carcinoma (BCC). B) The same but with nodular BCC
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Figure 0004: A) Histopathology (Breslow rate) vs. high frequency ultrasonography (HFUS) depth determination for the 10 patients evaluated with superficial basal cell carcinoma (BCC). B) The same but with nodular BCC

Mentions: The clinical and histological characteristics of the lesions of the 20 patients studied are presented in Table 1. There were 10 men and 10 women, with 10 superficial and 10 nodular BCCs. The mean age of the patients was 67 years (range 51-89 years). Fifteen lesions were located on the face and 5 on the trunk. Resulting lesion depths with HFUS and Breslow are presented in Figure 4 for both superficial and nodular lesions, respectively. In the superficial lesions, the Breslow rate was similar or higher than HFUS in most cases (8/10). In the nodular lesions, however, there was no clear trend. The largest difference between the two techniques was 2.7 mm.


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)

A) Histopathology (Breslow rate) vs. high frequency ultrasonography (HFUS) depth determination for the 10 patients evaluated with superficial basal cell carcinoma (BCC). B) The same but with nodular BCC
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 0004: A) Histopathology (Breslow rate) vs. high frequency ultrasonography (HFUS) depth determination for the 10 patients evaluated with superficial basal cell carcinoma (BCC). B) The same but with nodular BCC
Mentions: The clinical and histological characteristics of the lesions of the 20 patients studied are presented in Table 1. There were 10 men and 10 women, with 10 superficial and 10 nodular BCCs. The mean age of the patients was 67 years (range 51-89 years). Fifteen lesions were located on the face and 5 on the trunk. Resulting lesion depths with HFUS and Breslow are presented in Figure 4 for both superficial and nodular lesions, respectively. In the superficial lesions, the Breslow rate was similar or higher than HFUS in most cases (8/10). In the nodular lesions, however, there was no clear trend. The largest difference between the two techniques was 2.7 mm.

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