Use of 22 MHz High-Frequency Ultrasound in the Management of Skin Cancer

Pasquali, Paola; Camacho, Elia; Fortuño-Mar, Angeles

doi:10.1007/978-1-4614-7357-2_15

Cited by 7 publications

(3 citation statements)

References 6 publications

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“…Fractionation schedule consisted of 10 fractions, 4 Gy each, and lesions were treated 2-3 times a week. No extra margin was added to depth based on US measurements and Mohs pathology data showing that US may overcompensate for depth by about 27% [ 19 ], and there was no expected setup error in the vertical dimension.…”

Section: Methodsmentioning

confidence: 99%

The feasibility of using ultrasound during follow-up for superficial non-melanoma skin cancers after electronic brachytherapy

Goyal

Suszko

Stea

2017

jcb

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PurposeNon-melanoma skin cancers (NMSCs) can be treated with a number of modalities including surgery, topical chemotherapy, or radiotherapy. Amongst the radiotherapeutic options, electronic brachytherapy (eBT) is an appealing treatment as it is usually given in a few fractions, it leads to good outcomes, and is increasingly being used. However, currently no follow-up imaging is routinely used or recommended to evaluate treatment response of NMSC. We aimed to use ultrasound (US) in follow-up after eBT for superficial NMSC to assess its feasibility in detecting possible tumor response.Material and methodsFourteen patients were treated between 2013-2015 for a NMSC using eBT. US guidance was used for treatment planning prior to eBT initiation. After completion of eBT, patients were seen in follow-up for both clinical exam and a repeat US at 1 month to evaluate if tumor response was detectable.ResultsOf the 14 patients, 6 were male and 8 were female. The mean age was 71 years. With a median follow-up of 20.5 months, all patients had a complete response based on physical exam. Eleven patients appeared to have a complete response based on US obtained > 1 month after completing eBT. To date, there have been no local recurrences or progression, and all patients are alive.ConclusionsUS is an objective imaging modality that may be able to assess NMSC response after eBT. Based on follow-up imaging, further treatment or observation may be recommended. Although this study is hypothesis generating, larger studies with pathologic confirmation of recurrences would be needed to validate US use for follow-up, avoiding possible painful and scarring biopsies in case of low suspicion of recurrence.

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Section: Methodsmentioning

confidence: 99%

The feasibility of using ultrasound during follow-up for superficial non-melanoma skin cancers after electronic brachytherapy

Goyal

Suszko

Stea

2017

jcb

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“…In order to cover potential subclinical disease, a margin of 5 mm was added radially to the gross tumor volume (GTV) diameter measurements to create the clinical target volume (CTV), even though dermato-pathologic data has shown that the lateral extent estimate derived from US measurements tends to overestimate the extent of the lesion [ 28 ]. Since eBT is a contact therapy with the applicator applied directly and firmly to the skin, there was no expected movement during treatment but an inter-fractional error in positioning the applicator was possible.…”

Section: Methodsmentioning

confidence: 99%

“…No extra margin was added to depth based on US measurements and Mohs pathology data showing that US may overcompensate for depth by about 27% [ 28 ], and there was no expected setup error in the vertical dimension.…”

Section: Methodsmentioning

confidence: 99%

A pilot study of ultrasound-guided electronic brachytherapy for skin cancer

Goyal¹,

Kim²,

Tiwari³

et al. 2015

jcb

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PurposeElectronic brachytherapy (eBT) has gained acceptance over the past 5 years for the treatment of non-melanomatous skin cancer (NMSC). Although the prescription depth and radial margins can be chosen using clinical judgment based on visual and biopsy-derived information, we sought a more objective modality of measurement for eBT planning by using ultrasound (US) to measure superficial (< 5 mm depth) lesions.Material and methodsFrom December 2013 to April 2015, 19 patients with 23 pathologically proven NMSCs underwent a clinical examination and US evaluation of the lesions prior to initiating a course of eBT. Twenty lesions were basal cell carcinoma and 3 lesions were squamous cell carcinoma. The most common location was the nose (10 lesions). A 14 or 18 MHz US unit was used by an experienced radiologist to determine depth and lateral extension of lesions. The US-measured depth was then used to define prescription depth for eBT planning without an added margin. A margin of 7 mm was added radially to the US lateral extent measurements, and an appropriate cone applicator size was chosen to cover the target volume.ResultsThe mean depth of the lesions was 2.1 mm with a range of 1-3.4 mm, and the mean largest diameter of the lesions was 8 mm with a range of 2.6-20 mm. Dose ranged from 32-50 Gy in 8-20 fractions with a median dose of 40 Gy in 10 fractions. All patients had a complete response and no failures have occurred with a median follow-up of 12 months (range of 6-22 months). Also, no prolonged skin toxicities have occurred.ConclusionsA routinely available radiological US unit can objectively determine depth and lateral extension of NMSC lesions for more accurate eBT treatment planning, and should be considered in future eBT treatment guidelines.

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Ex Vivo High-Frequency Ultrasound Imaging of the Skin

Pasquali¹

2015

Measuring the Skin

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Use of 22 MHz High-Frequency Ultrasound in the Management of Skin Cancer

Cited by 7 publications

References 6 publications

The feasibility of using ultrasound during follow-up for superficial non-melanoma skin cancers after electronic brachytherapy

The feasibility of using ultrasound during follow-up for superficial non-melanoma skin cancers after electronic brachytherapy

A pilot study of ultrasound-guided electronic brachytherapy for skin cancer

Ex Vivo High-Frequency Ultrasound Imaging of the Skin

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