Skin cancer: findings and role of high-resolution ultrasound

Modern advancements in technology have opened a new era of precise medical evaluation, particularly in the realm of skin tumors, which stand as the most prevalent forms of malignancies across the human body. While physical examination has historically been a primary tool, an array of innovative instruments has been designed to assess skin tumors. This arsenal includes digital photography, dermoscopy, reflectance confocal microscopy, optical coherence tomography, and the remarkable capabilities of high-frequency ultrasound (US).
For this purpose, the utilization of high-resolution transducers facilitate ultrasound evaluation of skin tumors. Notably, these transducers must possess certain technical characteristics- a minimum frequency of ≥ 15 MHz, accompanied by the broadband and linear transducers. The use of three-dimensional images emerges as a valuable addition. Moreover, in the pursuit of detecting blood flow, the color/power-Doppler mode should be activated. A generous application of gel on the lesion is customary, with the potential inclusion of gel pad spacers. It's of utmost importance to ensure that minimal hand pressure is exerted on the probe during the examination process. The US assessment allows to evaluate tumoral dimensions, encompassing critical parameters such as thickness. Beyond that, it improves the diagnostics of loco-regional staging. The preoperative assessment of tumor extent is also a valuable assistance. Conversely, the US use also allows to diagnose infiltration to underlying structures, namely fascia, muscles, cartilages, and even bone cortex. This critical information empowers the surgeon to opt for a more assertive surgical strategy, when warranted.