Ballester-Sánchez Rosa, Pons-Llanas Olga, Llavador-Ros Margarita, Botella-Estrada Rafael, Ballester-Cuñat Antonio, Tormo-Micó Alejandro, Javier Celadá-Álvarez Francisco, Rodríguez-Villalba Silvia, Santos-Ortega Manuel, Ballester-Pallarés Facundo, Perez-Calatayud Jose
Dermatology Department, La Fe University and Polytechnic Hospital, Valencia.
Radiotherapy Department, La Fe University and Polytechnic Hospital, Valencia.
J Contemp Brachytherapy. 2015 Jan;6(4):356-61. doi: 10.5114/jcb.2014.47860. Epub 2014 Dec 31.
The purpose of this study is to compare high frequency ultrasonography (HFUS) and histpathologic assessment done by punch biopsy in order to determine depth of basal cell carcinoma (BCC), in both superficial and nodular BCCs prior to brachytherapy treatment.
This study includes 20 patients with 10 superficial and 10 nodular BCCs. First, punch biopsy was done to confirm the diagnosis and to measure tumour depth (Breslow rate). Subsequently, HFUS was done to measure tumour depth to search for correlation of these two techniques.
Neither clear tendency nor significance of the punch biopsy vs. HFUS depth determination is observed. Depth value differences with both modalities resulted patient dependent and then consequence of its uncertainty. Conceptually, HFUS should determine the macroscopic lesion (gross tumour volume - GTV), while punch biopsy is able to detect the microscopic extension (clinical target volume - CTV). Uncertainties of HFUS are difficult to address, while punch biopsy is done just on a small lesion section, not necessarily the deepest one.
According to the results, HFUS is less accurate at very shallow depths. Nodular cases present higher depth determination differences than superficial ones. In our clinical practice, we decided to prescribe at 3 mm depth when HFUS measurements give depth lesion values smaller than this value.
本研究旨在比较高频超声检查（HFUS）与穿刺活检的组织病理学评估，以确定在近距离放射治疗前浅表型和结节型基底细胞癌（BCC）的基底细胞癌深度。
本研究纳入20例患者，其中有10例浅表型BCC和10例结节型BCC。首先，进行穿刺活检以确诊并测量肿瘤深度（布雷斯洛率）。随后，进行HFUS以测量肿瘤深度，以探寻这两种技术的相关性。
未观察到穿刺活检与HFUS深度测定之间有明显趋势或显著意义。两种方法的深度值差异取决于患者，是其不确定性的结果。从概念上讲，HFUS应确定宏观病变（大体肿瘤体积-GTV），而穿刺活检能够检测微观扩展（临床靶体积-CTV）。HFUS的不确定性难以解决，而穿刺活检仅在小的病变切片上进行，不一定是最深的切片。
根据结果，HFUS在非常浅的深度时准确性较低。结节型病例的深度测定差异比浅表型病例更高。在我们的临床实践中，当HFUS测量得出的病变深度值小于3mm时，我们决定按3mm深度进行治疗。
