Potential Use of Contrast-Enhanced Ultrasound (CEUS) in the Detection of Metastatic Superficial Lymph Nodes in Melanoma Patients

Rubaltelli, Léopoldo; Beltrame, Valeria; Scagliori, Elena; Bezzon, Elisabetta; Frigo, Annachiara; Rastrelli, Marco; Stramare, Roberto

doi:10.1055/s-0033-1335857

Cited by 26 publications

(19 citation statements)

References 13 publications

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“…Non‐invasive techniques such as MR‐spectroscopy, PET/MRI, high‐frequency ultrasound, ultrasound‐based elastography, contrast‐enhanced US, power and colour Doppler US, perfusion US, multimodality imaging systems, and photoacoustic imaging have been used for detection and management of various cancers, including skin cancer. Ultrasound modalities are a particularly attractive option because they are widely available, quick, relatively inexpensive, easy to use, and have the potential to guide pretreatment planning, and provide real‐time imaging during biopsy and surgery .…”

Section: Resultsmentioning

confidence: 99%

A review of non‐invasive imaging in extramammary Paget's disease

Bayan

Khanna

Rotemberg

et al. 2018

Acad Dermatol Venereol

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Extramammary Paget's Disease (EMPD) is a rare intraepithelial adenocarcinoma that classically manifests with pruritic, erythematous and scaling plaques. The clinical picture frequently mimics inflammatory or infectious conditions and is thus commonly misdiagnosed. The assessment of tumour margins is equally challenging as tumours have a propensity to spread beyond clinically visible boundaries. Appropriate non-invasive diagnostic tools can assist in the early detection, diagnosis and management of EMPD. This paper will review the literature on non-invasive imaging modalities used in EMPD. Articles from the PubMed database were selected based on relevance to the topic of this review. Articles that were not specific to EMPD and non-invasive imaging were excluded. Search strategy is further described in the methods section below. Eighteen articles were selected for this review: six PET/CT, five reflectance confocal microscopy (RCM), two photodynamic diagnosis (PDD), two dermoscopy, two MRI and one optical coherence tomography (OCT) paper(s). Dermoscopy, PDD, RCM and OCT can help to distinguish malignant conditions, including EMPD, from benign conditions. RCM and OCT can identify atypical cells in real-time, and have the potential to improve the accuracy of surgical margins intraoperatively and overall management. Distinctive confocal characteristics of EMPD have been described using RCM. The sensitivity and specificity of these findings require additional validation. Radiographic techniques also play a central role in the diagnosis of EMPD and assessment of disease spread. PET/CT and MRI can detect primary disease, nodal and distant metastases, with superior delineation of disease spread on MRI. Limitations of PET/CT are mainly related to primary tumour thickness, and size and FDG-avidity of nodal and distant metastases. Limitations of MRI include the fact that few studies have examined its use in EMPD; additional research is warranted. Randomized controlled trials and large prospective studies evaluating the use of non-invasive imaging in EMPD are needed.

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Section: Resultsmentioning

confidence: 99%

A review of non‐invasive imaging in extramammary Paget's disease

Bayan

Khanna

Rotemberg

et al. 2018

Acad Dermatol Venereol

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“…36 A large study on 540 patients with melanoma implementing CEUS for superficial lymph node metastases was conducted by Rubaltelli et al in 2014. 37 The authors concluded that after i.v. delivery of microbubbles, the node enhancement pattern interpretation increases the diagnostic accuracy of ultrasound in the differential diagnosis of benign and malignant lymph nodes by up to 0.99 and helps avoid unnecessary fine needle biopsy.…”

Section: Resultsmentioning

confidence: 99%

Contrast-enhanced ultrasound mapping of sentinel lymph nodes in oral tongue cancer—a pilot study

Gvetadze

Xiong

et al. 2017

Dentomaxillofacial Radiology

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Objectives: To assess the usefulness of contrast-enhanced ultrasound (CEUS) with peritumoral injection of microbubble contrast agent for detecting the sentinel lymph nodes for oral tongue carcinoma. Methods: The study was carried out on 12 patients with T1-2cN0 oral tongue cancer. A radical resection of the primary disease was planned; a modified radical supraomohyoid neck dissection was reserved for patients with larger lesions (T2, n 5 8). The treatment plan and execution were not influenced by sentinel node mapping outcome. The SonovueÔ contrast agent (Bracco Imaging, Milan, Italy) was utilized. After detection, the position and radiologic features of the sentinel nodes were recorded. Results: The identification rate of the sentinel nodes was 91.7%; one patient failed to demonstrate any enhanced areas. A total of 15 sentinel nodes were found in the rest of the 11 cases, with a mean of 1.4 nodes for each patient. The sentinel nodes were localized in: Level IA-1 (6.7%) node; Level IB-11 (73.3%) nodes; Level IIA-3 (20.0%) nodes. No contrastrelated adverse effects were observed. Conclusions: For oral tongue tumours, CEUS is a feasible and potentially widely available approach of sentinel node mapping. Further clinical research is required to establish the position of CEUS detection of the sentinel nodes in oral cavity cancers. Dentomaxillofacial Radiology (2017Radiology ( ) 46, 20160345. doi: 10.1259 Cite this article as: Gvetadze SR, Xiong P, Lv M, Li J, Hu J, Ilkaev KD, et al. Contrastenhanced ultrasound mapping of sentinel lymph nodes in oral tongue cancer-a pilot study.

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“…Initial evidence for a potential benefi t of contrast-enhanced ultrasound was reported by Rubaltelli and coworkers in a population of 540 patients with malignant melanoma. Compared to fi ne needle aspiration as the standard of reference, the authors observed a sensitivity of 100 % and a specifi city of 99.5 % for contrast-enhanced ultrasound in the detection of lymph node metastases [ 65 ].…”

Section: Ultrasound Assessment Of Lymph Nodesmentioning

confidence: 98%

The Radiologist’s Approach to CUP

Kazmierczak

Rominger

Cyran

2016

Cancer of Unknown Primary

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In 2-4 % of patients with histologically proven cancer, the primary tumor cannot be localized, even by use of modern diagnostic methods. This situation is clinically described as cancer of unknown primary (CUP) [ 1 , 2 ] and has a frequency similar to pancreatic cancer, renal cell carcinoma, or leukemia [ 3 ]. Even after extensive diagnostic workup using state-of-the-art methods, less than 20 % of primary tumors are localized antemortem, compared to almost 80 % of primary tumors identifi ed in postmortem autopsy series [ 4 ].CUP tumors are adenocarcinomas in 40-60 %, undifferentiated carcinomas in 15-20 %, squamous cell carcinomas in 5-8 %, and neuroendocrine tumors in 3-5 %; 1-3 % of all CUP belong to other entities [ 5 ]. Most frequently, primary tumors are localized in the lung (20-35 %) and the pancreas (15-20 %), followed by other gastrointestinal and gynecological malignancies. Median survival in this heterogenic group of cancer patients is only 3-11 months [ 6 ]. Imaging is essential in all four steps of the diagnostic and therapeutic management of CUP patients [ 7 ]: localization of the primary tumor, identifi cation of all manifestations, identifi cation of potentially treatable tumors (i.e., breast cancer, prostate carcinoma, lymphoma, etc.), and characterization of the clinicopathological entity and stratifi cation into subsets with favorable prognosis (approximately 20 %) with differentiated and/or chemosensitive tumors for which specifi c treatment options are available and, on

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Potential Use of Contrast-Enhanced Ultrasound (CEUS) in the Detection of Metastatic Superficial Lymph Nodes in Melanoma Patients

Cited by 26 publications

References 13 publications

A review of non‐invasive imaging in extramammary Paget's disease

A review of non‐invasive imaging in extramammary Paget's disease

Contrast-enhanced ultrasound mapping of sentinel lymph nodes in oral tongue cancer—a pilot study

The Radiologist’s Approach to CUP

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