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| |  Elastography Can Help Distinguish Between Cancerous and Benign Skin Growths: Presented at RSNA By Charlene Laino CHICAGO -- December 6, 2009 -- Adding elastography to high-frequency ultrasound can help differentiate between cancerous and benign skin conditions, possibly reducing unnecessary biopsies, researchers reported here at the Radiological Society of North America (RSNA) 95th Annual Meeting. The researchers used an ultra high-frequency ultrasound system to image 40 patients with proliferative malignant neoplasms or benign skin lesions. The elastographic properties of the lesions also were assessed. To perform elastography, which uses pressure from breathing, heartbeat, or pushing on the skin to measure the stiffness of a lesion, physicians only need to add special software to the ultrasound unit and push a button during imaging, Eliot L. Siegel, MD, University of Maryland School of Medicine, Baltimore, Maryland, explained during his presentation December 1. It is entirely noninvasive. Participants suffered from a variety of malignant tumours, including squamous cell carcinoma, basal cell carcinoma, and melanoma. Benign lesions included dermatofibroma and lipoma. The researchers calculated the ratio of elasticity between normal skin and adjacent skin lesions. All diagnoses were confirmed histopathologically. The elasticity ratio of normal skin to the various skin lesions ranged from 0.04 to 0.3 for cystic skin lesions and from to 0.4 to 5.0 for benign proliferative lesions, such as intradermal nevi or benign histiocytosis. Malignant lesions typically had a ratio above 10.0. “High-frequency ultrasound with elastography successfully delineated the extent of lesions and was able to provide measurable differentiation among a variety of benign and malignant lesions,” Dr. Siegel said. Cystic lesions demonstrate high levels of elasticity and tend to be more compressible; whereas, malignant lesions are significantly stiffer and less elastic, he explained. “[Elastography] has the potential to improve the efficiency of skin cancer diagnosis, which could cut down on unnecessary biopsies,” Dr. Siegel said. RSNA spokesperson Mary C. Mahoney, MD, University of Cincinnati Medical Center, Ohio, Cincinnati, who moderated a news briefing to discuss the findings, said that elastography is increasingly being used to detect other diseases as well, including breast, liver, and thyroid malignancies. “The equipment is relatively commonly available, as is the software,” she said. [Presentation title: Elastographic Ultrasound Quantitative Analysis Combined With High Frequency Imaging for Characterization of Benign and Malignant Skin Lesions. Abstract SSJ14-04]
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