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Soo Park, MD
Soo Park, MD
Posted: Friday, February 6, 2026
According to Szalai et al, high-frequency ultrasound may serve as a reliable preoperative tool for evaluating basal cell carcinoma (BCC) morphology and vascularity, with the ability to accurately distinguish solid from infiltrative subtypes. Their findings, which were published in the journal Cancers, appear to support its role as an adjunct to dermatoscopy.
Based on previous research, the investigators noted, “[The ability of high-frequency ultrasound] to reliably differentiate between histopathologic subtypes based on morphologic and vascular characteristics requires further validation.” In the present study of a large, well-characterized cohort, they found that “ultrasound contour and vascularity patterns demonstrated a strong and highly significant association with histopathologic subtype….”
Between January 2010 and December 2011, a total of 320 patients with 330 histologically confirmed BCC lesions underwent high-frequency ultrasound examination using a 15 to 18 MHz linear transducer. Lesions were classified by ultrasound contour (sharp vs irregular) and vascularity (hypervascular vs hypovascular) and were correlated with histopathologic subtype (solid vs infiltrative). Postoperative ultrasound follow-up was performed in a subset of patients to monitor for disease recurrence.
Solid BCCs generally exhibited sharp, well-defined margins, the investigators wrote, whereas irregular contours were more commonly seen in infiltrative tumors. This association was reported to be highly significant (odds ratio [OR] = 71.9; P < .001). Vascularity patterns were also found to significantly differ between subtypes: solid tumors were more likely to present with hypervascular features, in contrast with the hypovascular patterns frequently exhibited in infiltrative tumors (OR = 3.24; P < .001). There appeared to be no statistically significant associations between ultrasound morphology and patient sex or age. Seven histologically confirmed recurrences were detected among patients who underwent postoperative high-frequency ultrasound follow-up.
“Overall, high-frequency ultrasound serves as a powerful adjunct to dermatoscopy in the management of [BCC], contributing to improved diagnostic accuracy, optimized treatment selection, and enhanced postoperative monitoring,” the investigators concluded.
Disclosure: The study authors reported no conflicts of interest.
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