title: Depth determination of skin cancers treated with superficial brachytherapy: ultrasound vs. histopathology.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Dermatology Department, La Fe University and Polytechnic Hospital, Valencia.
authors.forename: Rosa
authors.initials: R
authors.lastname: Ballester-Sánchez
authors.affiliation: Radiotherapy Department, La Fe University and Polytechnic Hospital, Valencia.
authors.forename: Olga
authors.initials: O
authors.lastname: Pons-Llanas
authors.affiliation: Pathology Department, La Fe University and Polytechnic Hospital, Valencia.
authors.forename: Margarita
authors.initials: M
authors.lastname: Llavador-Ros
authors.affiliation: Dermatology Department, La Fe University and Polytechnic Hospital, Valencia.
authors.forename: Rafael
authors.initials: R
authors.lastname: Botella-Estrada
authors.affiliation: Radiology Department, La Fe University and Polytechnic Hospital, Valencia.
authors.forename: Antonio
authors.initials: A
authors.lastname: Ballester-Cuñat
authors.affiliation: Radiotherapy Department, La Fe University and Polytechnic Hospital, Valencia.
authors.forename: Alejandro
authors.initials: A
authors.lastname: Tormo-Micó
authors.affiliation: Radiotherapy Department, La Fe University and Polytechnic Hospital, Valencia.
authors.forename: Francisco
authors.initials: F
authors.lastname: Javier Celadá-Álvarez
authors.affiliation: Radiotherapy Department, Benidorm Hospital, Alicante.
authors.forename: Silvia
authors.initials: S
authors.lastname: Rodríguez-Villalba
authors.affiliation: Radiotherapy Department, Benidorm Hospital, Alicante.
authors.forename: Manuel
authors.initials: M
authors.lastname: Santos-Ortega
authors.affiliation: Department of Atomic, Molecular and Nuclear Physics, University of Valencia, Burjassot, Spain.
authors.forename: Facundo
authors.initials: F
authors.lastname: Ballester-Pallarés
authors.affiliation: Radiotherapy Department, La Fe University and Polytechnic Hospital, Valencia ; Radiotherapy Department, Benidorm Hospital, Alicante.
authors.forename: Jose
authors.initials: J
authors.lastname: Perez-Calatayud
keywords: basal cell carcinoma; electronic brachytherapy; punch biopsy; skin brachytherapy; skin cancer; ultrasound
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