Ultrasound Found Inadequate for Lymph Node Biopsy

-- Jeff Muise

Tuesday, September 29, 2009

TUESDAY, Sept. 29 (HealthDay News) -- Ultrasound scanners currently do not have sufficient resolution to biopsy sentinel lymph nodes (SLN) for evidence of cancer metastasis and cannot replace conventional SLN biopsy, according to a study published online Sept. 28 in the Journal of Clinical Oncology.

Amira Sanki, of the Royal Prince Alfred and Mater Hospitals in Sydney, Australia, and colleagues conducted ultrasound biopsies on 871 SLN fields in 716 patients with melanoma. Conventional SLN biopsy was performed within a day of the ultrasound examination. The minimum cross-sectional area of the SLN metastatic deposit for ultrasound detection was calculated.

The researchers found that ultrasound biopsy in the detection of positive SLNs had an overall sensitivity of 24.3 percent and a specificity of 96.8 percent, with sensitivity highest for SLNs in the neck (45.8 percent). The median minimum cross-section area of the SLN metastatic deposit for detection was 0.39 mm2. The authors opine that ultrasound could play an adjunct role monitoring patients who elect not to have a SLN biopsy or are contraindicated for surgery.

"However, in our patient population it is clear that the majority of metastatic deposits in SLNs are less than the resolution limits of current high-resolution ultrasound scanners. Ultrasound examination of SLNs, therefore, cannot replace SLN biopsy for the diagnosis of nodal metastases in patients with primary melanoma and clinically negative regional nodes," Sanki and colleagues conclude.

One study author reported receiving financial compensation from the Royal Prince Alfred Hospital Medical Centre.

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