Contrast-Enhanced Ultrasound for Characterizing Lymph Nodes With Focal Cortical Thickening in Patients With Cutaneous Melanoma

Abstract

Although our findings need to be confirmed in larger series, they indicate that contrast-enhanced ultrasound can be useful in clinical practice for characterizing focal cortical thickening in lymph nodes. The exclusion or identification of regional lymph node metastases is of fundamental importance in oncologic staging because this issue directly influences both the prognosis and the choice of therapeutic strategy.

The place of CEUS in distinguishing benign from malignant cervical lymph nodes: a prospective study

“…We found the majority of benign lymph nodes to have homogenous enhancement on CEUS, either intense or moderate (29 of 32 nodes) and only three showed inhomogeneous enhancement. According to many authors [8,9,20] normal and reactive lymph nodes have intense vascularization with cortical capillary circulation and this fact could explain the homogenous aspect. On the other hand 19 (65.5%) of malignant nodes in our study, were inhomogeneous, and one of them had no enhancement, probably due to the fact that they were less vascularized and had perfusion defects [20].…”

“…According to many authors [8,9,20] normal and reactive lymph nodes have intense vascularization with cortical capillary circulation and this fact could explain the homogenous aspect. On the other hand 19 (65.5%) of malignant nodes in our study, were inhomogeneous, and one of them had no enhancement, probably due to the fact that they were less vascularized and had perfusion defects [20]. CEUS is clinically valuable for microvascular analysis as it can deliver better data about vascular pattern and vascular defects.…”

“…Rubaltelli et al [20] investigated the lymph nodes with focal cortical thickening. They found perfusion defects of thickened cortex in nodes affected by metastasis of cutaneous melanoma.…”

“…According to some studies, TTP and AUC are considered to be lower in malignant nodes, but for DPI and RBV literature data are still contradictory [1,20,21].…”

Contrast-enhanced ultrasound findings in soft-tissue lesions: preliminary results

“…There are currently no validated DCE-US criteria for distinguishing benign and malignant soft-tissue masses (unlike those for lymphadenopathy [9]). Our objective was to identify at least one DCE-US parameter whose assessment would allow more accurate differentiation of softtissue lesions that are probably benign (and can therefore be managed with monitoring alone) from those likely to be malignant, which require additional diagnostic studies.…”