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High-Frequency Ultrasound: Can It Differentiate Between Basal Cell Carcinoma Subtypes?

By: Joshua D. Madera, MD
Posted: Monday, February 5, 2024

Investigative efforts to develop a noninvasive modality to determine the histologic subtype of basal cell carcinoma to discern aggressive from low-risk tumors may have identified a novel strategy, according to a study published in the Journal of Clinical Medicine. Through the use of optically guided high-frequency ultrasound (OG-HFUS), aggressive basal cell carcinomas may be more easily identified, thus improving therapeutic decision-making for this patient population, suggested Norbert Kiss, MD, PhD, of Semmelweis University, Budapest, and colleagues. Additional studies are warranted to quantify the full beneficial extent of this novel risk-calculating modality.

A total of 75 patients with basal cell carcinoma were enrolled in the study. All patients underwent initial clinical and dermoscopic examinations of their basal cell carcinoma followed by OG-FHUS. To further confirm their diagnosis through histologic analysis, tissue samples from the basal cell carcinomas were surgically excised.

The study authors reported 16 aggressive and 47 low-risk basal cell carcinomas based on histologic analysis. OG-HFUS was employed to create a risk-categorizing algorithm that successfully differentiated low-risk from aggressive basal cell carcinomas, with a specificity of 91.3% and a sensitivity of 82.4%. In addition, the positive and negative predictive values for the OG-HFUS–based algorithm were 94.7% and 78.6%, respectively. Aggressive basal cell carcinomas were identified by their ill-defined margins, irregular shape, and nonhomogeneous internal echoes. The validity of the risk-categorizing algorithm was verified and found to have a specificity of 91.6% and a sensitivity of 83.3%.

Disclosure: The study authors reported no conflicts of interest.

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