ArticleAnnals of surgical oncology2012
Preoperative ultrasound is not useful for identifying nodal metastasis in melanoma patients undergoing sentinel node biopsy: preoperative ultrasound in clinically node-negative melanoma.
Article in Annals of surgical oncology, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.
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5 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Ultrasound, CT, MRI, or PET-CT for staging and re-staging of adults with cutaneous melanoma.The Cochrane database of systematic reviews · 2019Pooled it
- Missed Opportunities for Neoadjuvant Immunotherapy in Melanoma: Is it Time to Consider Ultrasound Staging for Newly Diagnosed Patients?Annals of surgical oncology · 2026Article
- Preoperative ultrasound before sentinel lymph node biopsy in melanoma in the era of neoadjuvant treatment: a systematic review and meta-analysis of diagnostic performance and cost analysis.EClinicalMedicine · 2026Article
- Observational
- Accuracy of real-time ultrasound elastography in the differential diagnosis of lymph nodes in cutaneous malignant melanoma (CMM): a pilot study.International journal of clinical oncology · 2014Article
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Funding
Abstract
backgroundSentinel lymph node biopsy (SLNB) is widely used in melanoma. Identifying nodal involvement preoperatively by high-resolution ultrasound may offer less invasive staging. This study assessed feasibility and staging results of clinically targeted ultrasound (before lymphoscintigraphy) compared to SLNB.
methodsFrom 2005 to 2009, a total of 325 patients with melanoma underwent ultrasound before SLNB. We reviewed demographics and histopathologic characteristics, then compared ultrasound and SLNB results. Sensitivity, specificity, and positive and negative predictive value were determined.
resultsA total of 325 patients were included, 58% men and 42% women with a median age of 58 (range 18-86) years. A total of 471 basins were examined with ultrasound. Only six patients (1.8%) avoided SLNB by undergoing ultrasound-guided fine-needle aspiration of involved nodes, then therapeutic lymphadenectomy. Sixty-five patients (20.4%) had 69 SLNB positive nodal basins; 17 nodal basins from 15 patients with positive ultrasounds were considered truly positive. Forty-five SLNB positive basins had negative ultrasounds (falsely negative). Seven node-positive basins did not undergo ultrasound because of unpredicted drainage. A total of 253 patients with negative SLNBs had negative ultrasounds in 240 nodal basins (truly negative) but falsely positive ultrasounds occurred in 40 basins. Overall, sensitivity of ultrasound was 33.8%, specificity 85.7%, positive predictive value 36.5%, and negative predictive value 84.2%. Sensitivity and specificity improved somewhat with increasing Breslow depth. Sensitivity was highest for the neck, but specificity was highest for the groin.
conclusionsRoutine preoperative ultrasound in clinically node-negative melanoma is impractical because of its low sensitivity. Selected patients with thick or ulcerated lesions may benefit. Because of variable lymphatic drainage patterns, preoperative ultrasound without lymphoscintigraphic localization will provide incomplete evaluation in many cases.
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