Lymph node ultrasound during melanoma follow-up significantly improves metastasis detection compared with clinical examination alone

Krüger, Ullrich; Kretschmer, Lutz; Thoms, Kai‐Martin; Padeken, Michael; Bertsch, Hans Peter; Schön, Michael P.; Zutt, Markus

doi:10.1097/cmr.0b013e328348dad3

Cited by 32 publications

(56 citation statements)

References 18 publications

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“…Correct diagnosis the nature of cervical lymph nodes is extremely important from the therapeutic viewpoint. One of the major treatment choices for metastatic cervical nodes is neck dissection, which may lead to complications, whereas the treatment for tuberculosis lymphadenitis is anti-tuberculosis medication, which is far less complicated than surgery (Krüger et al, 2011). Ultrasonography (US) is noninvasive and can give useful clues in the diagnosis of cervical lymphadenopathy, however, the differential diagnosis is difficult in some situations even combined with color Doppler imaging (Khanna et al, 2011).…”

Section: Introductionmentioning

confidence: 99%

Clinical Value of Real Time Elastography in Patients with Unexplained Cervical Lymphadenopathy: Quantitative Evaluation

Fu¹,

Yun-fei²,

Yan³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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Ultrasonography is non-invasive and can give useful clues in the diagnosis of cervical lymphadenopathy, However, differential diagnosis is difficult in some situations even combined with color Doppler imaging. The present study was conducted to evaluate the clinical value of real time elastography in patients with unexplained cervical lymphadenopathy using a quantitative method. From May 2011 to February 2012, 39 enlarged lymph nodes from 39 patients with unexplained cervical lymphadenopathy were assessed. All the patients were examined by both B-mode ultrasound, color Doppler flow imaging and elastography. The method of analyzing elasto-graphic data was the calculation of the 10 parametres ("mean", "sd", "area%", "com", "kur", "ske", "con", "ent", "idm", "asm") offered by the software integrated into the Hitachi system. The findings were then correlated with the definitive tissue diagnosis obtained by lymph node dissection or biopsy. Final histology revealed 10 cases of metastatic lymph nodes, 11 cases of lymphoma, 12 cases of tuberculosis and 6 cases of nonspecific lymphadenitis. The significant distinguishing features for conventional ultrasound were the maximum short diameter (p=0.007) and absent of echogenic hilum (p=0.0293). The diagnostic accuracy was 43.6% (17/39 cases) and there were 17 patients with equivocal diagnosis. For elastography, "mean" (p=0.003), "area%" (p=0.009), "kurt" (p=0.0291), "skew" (p=0.014) and "cont" (p=0.012) demonstrated significant differences between groups. With 9 of the 17 patients with previous equivocal diagnoses (52.9%) definite and correct diagnoses could be obtained. The diagnostic accuracy for conventional ultrasound combined elastography was 69.2% (27/39 cases). There were differences in the diagnostic sensitivity of the two methods (p=0.0224). Ultrasound combined with elastography demonstrated higher rates of conclusive and accurate diagnoses in patients with unexplained cervical lymphadenopathy than conventional ultrasound. The quantitative program showed good correlation with the pathology of different lymph node diseases.

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Section: Introductionmentioning

confidence: 99%

Clinical Value of Real Time Elastography in Patients with Unexplained Cervical Lymphadenopathy: Quantitative Evaluation

Fu¹,

Yun-fei²,

Yan³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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“…Jambusaria-Pahlajani et al studied 100 17 100 99.5 44 Hinz et al 22 11.8 100 20 Stoffels et al 20 13.6 96.9 221 Kruger et al 21 93.9 98 433…”

Section: Accuracy Of Sonographic Measurementsmentioning

confidence: 97%

The Value of Sonography in the Assessment of Skin Cancers and Their Metastases

DiGiacinto

Bagley

Goldsbury

2016

Journal of Diagnostic Medical Sonography

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Skin cancer is the most common type of cancer in the United States, and it affects approximately 2.2 million people each year. 1 Melanoma is less common than nonmelanoma skin cancers (NMSC) but is more serious because it is the most likely to metastasize. 1 The histologic thickness or depth of invasion, called the Breslow index, determines prognosis and treatment options. 2 Preoperative evaluation of lesion depth could improve patient management and outcomes. Sonography has been used to assess lesion depth and margins prior to excision as well as to classify adjacent lymph nodes as metastatic. Adding sonography to a patient's protocol may improve management by clarifying lesion depth, identifying margins for excision, and determining lymph node involvement. MethodsA search of peer-reviewed journal databases, including CINAHL, MEDLINE, and OVID, was conducted with search terms such as sonography, ultrasound, skin cancer, and melanoma. Original research articles related to the detection and assessment of skin cancers and lymph nodes were evaluated for inclusion. Additionally, articles that focused on detecting, characterizing, and following up on skin cancer were analyzed and included. AbstractSkin cancer has become more prevalent in recent years, and finding ways to assess and characterize it prior to excision is important. Sonography can be an integral part of the preoperative and follow-up assessment of melanoma, metastatic lymph nodes, and nonmelanoma skin cancers. A review of the literature is reported, indicating that sonography appears to be effective at showing lesion thickness, defining lesion borders, and helping to identify whether lymph nodes are metastatic; however, it cannot differentiate among the types of skin cancer. Based on these findings, best practice scanning techniques are outlined for sonographers.

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“…For patients with thin melanoma, advances are likely to come from the development of new biomarkers to identify those patients who may forego an SLNB [46][47][48]. For patients with melanoma where the chance of a positive node is low, high-resolution ultrasound may be a viable alternative to SLNB, particularly for head and neck melanoma where technical difficulties make SLN biopsy unreliable [49][50][51].…”

Section: Alternatives To Sln Biopsymentioning

confidence: 99%