Test Characteristics of High-Resolution Ultrasound in the Preoperative Assessment of Margins of Basal Cell and Squamous Cell Carcinoma in Patients Undergoing Mohs Micrographic Surgery

Intraoperative imaging during Mohs surgery with reflectance confocal microscopy: initial clinical experience

“…In the long term, our approach may be combined with preoperative detection of lateral margins, to provide a perioperative tool for guiding Mohs surgery. Microscopic approaches that are being investigated for preoperative imaging include RCM, optical coherence tomography, and ultrasound [31][32][33][34][35][36] Furthermore, microscopic imaging may be combined with macroscopic approaches [37][38][39][40] to enable detection over larger areas and/or increased speed. Finally, all of this work in skin and the Mohs surgery setting may serve as an excellent model for optical imaging of residual cancers in other tissues and for translation to other surgical settings.…”

Ultrasound in dermatology: Principles and applications

“…Another study, examining the role for HFUS in improving the surgical precision of Mohs micrographic surgery for NMSC (regardless of histologic subtype), found that HFUS was more sensitive in determining subclinical extension of larger ([1.74 cm 2 ) tumors but was not adequately sensitive in picking up more subtle areas of extension in smaller and more insidious tumors. 19 Similarly, other work to evaluate the role for ultrasound in examining the boundaries before Mohs micrographic surgery determined that 20-MHz ultrasound was not superior in estimating tumor size to clinical assessment alone. 21 It may be that HFUS is more suitable for application in larger excisions than in Mohs micrographic surgery at the present time.…”

“…More than distinguishing between benign and malignant lesions, however, HFUS has considerable potential to provide the dermatologist with information regarding tumor margins, although many have suggested that further refinement is needed before clinical protocols are established [16][17][18][19] (Fig 2). One recent publication correlated the ultrasonographic assessment of superficial and nodular BCCs with the histopathological measurements of the tumors postexcision (with fixed 4-mm margins), determining that HFUS was able to accurately predict which tumors had subclinical extension beyond 4-mm margins in 48 of 50 cases.…”

High Resolution Ultrasound Imaging of Melanocytic and Other Pigmented Lesions of the Skin

“…It is usually well delimited from the surrounding dermis.Ultrasound may also assist the detection of early recurrence, especially when surgical removal is incomplete or in cases treated with radiotherapy or cryosurgery. Ultrasound may also be used to help to determine the surgical margins or to delimitate the area treated with radiotherapy or cryosurgery (25,(27)(28)(29)(30)(31)(32). This may decrease the rate of relapse.…”