Usefulness of Shear Wave Elastography in Determining the Tumor Extent of Basal Cell Carcinomas

Liang, Jian-Feng; Feng, Ming-Chu; Wang, Jing; Chen, Dong-Xiang; Guan, Jian-Ying; Luo, Ping-Ping

doi:10.1002/jum.16104

Cited by 2 publications

(2 citation statements)

References 20 publications

(30 reference statements)

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“…Skin ultrasound, which is an interdisciplinary integration of ultrasonography and dermatology, can non‐invasively provide information about internal echogenic structural features, depth of infiltration, internal blood flow distribution, and skin tumor stiffness 7 . Recent studies indicate that ultrasound technology is useful in distinguishing high‐risk BCCs from low‐risk ones and can aid in determining the ideal surgical margins 8,9 . Furthermore, ultrasound features are effective in differentiating superficial BCCs, which are the most suitable for non‐surgical treatments, from non‐superficial BCCs 10 .…”

Section: Introductionmentioning

confidence: 99%

“…7 Recent studies indicate that ultrasound technology is useful in distinguishing high-risk BCCs from low-risk ones and can aid in determining the ideal surgical margins. 8,9 Furthermore, ultrasound features are effective in differentiating superficial BCCs, which are the most suitable for non-surgical treatments, from non-superficial BCCs. 10 The aim of this study is to investigate the relationship between ultrasound features and Bcl-2 expression in BCCs, so as to provide a reference for developing pharmacological treatment plans.…”

Section: Introductionmentioning

confidence: 99%

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Correlation of ultrasound features with Bcl‐2 protein expression in basal cell carcinomas (BCCs)

Luo,

Chen,

Zhong

et al. 2023

J of Clinical Ultrasound

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BackgroundThe expression of the Bcl‐2 protein is frequently observed in basal cell carcinomas (BCCs), making it a significant biological marker and potential therapeutic target. Skin ultrasonography offers a noninvasive means of obtaining anatomical information about cutaneous tumors.ObjectivesThe purpose of this study was to investigate the correlation between ultrasound features and Bcl‐2 expression in BCCs, to provide a reference for developing pharmacological treatment plans.MethodsAccording to the Bcl‐2 protein expression, 74 BCCs confirmed by surgical pathology were divided into high Bcl‐2 expression BCCs (HB‐BCCs) and low Bcl‐2 expression BCCs (LB‐BCCs). Preoperative lesion ultrasound features were analyzed retrospectively based on Liang's criteria, which included the following features: shape, surface, keratinization, base, infiltration level, internal echogenicity, distribution of hyperechoic spots, posterior echogenic changes, internal Doppler signal, and lesion size (maximum diameter and infiltration depth). The differences of two groups were compared using a chi‐square test or a paired t‐test.ResultsBased on ultrasound features, cystic areas were more frequent in LB‐BCCs (χ2 = 7.015, P = .008). Furthermore, LB‐BCCs exhibited greater infiltration depth than HB‐BCCs (4.86 ± 2.12 mm vs. 2.72 ± 1.40 mm, P = .000), had a higher propensity to infiltrate the subcutaneous tissue (χ2 = 12.422, P = .002), and displayed a more abundant internal Doppler signal within the lesions (χ2 = 24.696, P = .000). Conversely, maximum diameter of the lesions, shape, surface, keratinization, base, hyperechoic spots distribution, and posterior echogenic changes of the lesions did not differ significantly between the two groups.ConclusionsUltrasound features are correlated with Bcl‐2 protein expression level in BCCs. LB‐BCCs show greater infiltration depth, subcutaneous infiltration, more cystic changes and more abundant internal Doppler signal than HB‐BCCs, which may suggest a potential basis for drug selection in BCC chemotherapy.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Correlation of ultrasound features with Bcl‐2 protein expression in basal cell carcinomas (BCCs)

Luo,

Chen,

Zhong

et al. 2023

J of Clinical Ultrasound

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Letter to the Editor on “Shear Wave Elastography in the Diagnosis of Tumor Extent of Basal Cell Carcinomas”

Ishida

Naganuma

2023

J of Ultrasound Medicine

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Dear EditorBasal cell carcinoma (BCC) is the most common cutaneous tumor, mostly involving the head and neck. 1 It is absolutely necessary to preserve as much surrounding normal skin as possible as well as remove the tumor without leaving tumor tissue. Generally speaking, surgical tumor resection is performed by determining the resection margin 4-10 mm outwards based on visual observation boundaries (VOB), because it is extremely challenging to determine accurately the tumor extent before histological examination. High-frequency ultrasound (HFUS) is thought to be the ideal diagnostic tool for evaluating the tumor extent.A large number of case reports and articles have been published in order to share knowledge and experiences in this field. Recently, Journal of Ultrasound in Medicine published an article entitled "Usefulness of shear wave elastography in determining the tumor extent of basal cell carcinomas (2023;42:971-976)" 2 in which the authors concluded that shear wave elastography (SWE) was helpful in determining the tumor extent of BCC. We commend the authors for providing such a meticulous data of cutaneous US. In their study, SWE parameters (E av and E sd ) were measured 1-mm intervals in four clock directions, and then the E ratio of region of interest (ROI) at a distance of 1, 2, 3, and 4 mm was calculated. The authors should be congratulated, since many of these suggestions are widely shareable. However, we think some results should be interpreted very cautiously; 1) the E ratio between real tumor boundaries and optimal surgical margins was statically significant, shown by their SW value measurements. However, this SW measurement is problematic. Current SWE measures SW propagation velocity based on the assumption that the medium has a homogeneous structure, uniform density, and purely elastic. 3 In reality, however, like conventional US beams, SWs refract at the tumor-surrounding tissue boundary according to Snell's law, and the abovementioned measurement of SW values under SWE image is largely compromised by US refraction. Additionally, SWs reflect at the boundary. Thus, a discrete attitude is always necessary when evaluating tumor boundaries by SWE (Figure 1). This idea is certainly very discouraging for SWE in clinical practice to diagnose cutaneous tumors. Nevertheless, we propose that 2DSWE may be useful for observing intratumor heterogeneity. 2) There was no comparison between B-mode US and SWE in terms of tumor boundary

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Usefulness of Shear Wave Elastography in Determining the Tumor Extent of Basal Cell Carcinomas

Cited by 2 publications

References 20 publications

Correlation of ultrasound features with Bcl‐2 protein expression in basal cell carcinomas (BCCs)

Correlation of ultrasound features with Bcl‐2 protein expression in basal cell carcinomas (BCCs)

Letter to the Editor on “Shear Wave Elastography in the Diagnosis of Tumor Extent of Basal Cell Carcinomas”

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