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The Use of High-Resolution Ultrasonography for Preoperative Detection of Metastases in Sentinel Lymph Nodes of Patients with Cutaneous Melanoma

Authors


Address correspondence and reprint requests to: Monika-H. Schmid-Wendtner, MD, Department of Dermatology and Allergology, University of Bonn, Sigmund-Freud-Str. 25, D-53127 Bonn, Germany, or e-mail: Monika-Hildegard.Schmid-Wendtner@ukb.uni-bonn.de

Abstract

BACKGROUND Sentinel lymph node biopsy (SLNB) reliably assesses the status of the regional lymph node basins and provides prognostic information in patients with cutaneous melanoma, but is logistically demanding and expensive.

OBJECTIVE The aim of this study was to evaluate the ability of high resolution B-mode ultrasonography (US) for pre-operative identification and characterization of sentinel lymph nodes (SLN) in patients with cutaneous melanoma.

PATIENTS AND METHODS In a prospective trial, the use of high resolution US was assessed in 25 consecutive patients with cutaneous melanoma identified for SLNB, first, for its value in primary detection of SLN, and, second, for its value in the correct assessment of SLN after lymphoscintigraphic mapping.

RESULTS High resolution B-mode US correctly identified two of 6 positive SLN. The sensitivity, specificity, positive predictive value, and negative predictive value of US were 33.3% (95% CI 43.3–77.7), 100.0% (95% CI 88.1–100.0), 100.0% (95%CI 15.8–100.0) and 87.9% (95% CI 71.8–96.6), respectively.

CONCLUSION High resolution B-mode US cannot replace SLNB, especially in the detection of micrometastases, but it remains the most important method to assess the lymph node status for macrometastases presurgically.

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