Assessment of the Diagnostic Performance of Clinical Examinations and High-Frequency Ultrasound in Patients With Pigmented Skin Tumors.

Autor:	Wang LF; Department of Medical Ultrasound, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China.; Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China., Ni N; Department of Dermatologic Surgery, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China., Hou JJ; School of Medicine, Tongji University, Shanghai, China., Wang S; School of Medicine, Tongji University, Shanghai, China., Wang JY; School of Medicine, Tongji University, Shanghai, China., Wang Q; Department of Medical Ultrasound, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China.; Department of Medical Ultrasound, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China.; Shanghai Engineering Research Center of Ultrasound Diagnosis and Treatment, Shanghai, China., Zhu AQ; Department of Medical Ultrasound, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China.; Department of Medical Ultrasound, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China.; Shanghai Engineering Research Center of Ultrasound Diagnosis and Treatment, Shanghai, China., Zhang YQ; Department of Medical Ultrasound, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China.; Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China., Ren WW; Department of Medical Ultrasound, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China.; Department of Medical Ultrasound, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China.; Shanghai Engineering Research Center of Ultrasound Diagnosis and Treatment, Shanghai, China., Chen ZT; Department of Medical Ultrasound, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China.; Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China., Shan DD; Department of Medical Ultrasound, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China.; Department of Medical Ultrasound, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China.; Shanghai Engineering Research Center of Ultrasound Diagnosis and Treatment, Shanghai, China., Zhao YJ; Department of Medical Imaging, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China., Guo LH; Department of Medical Ultrasound, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China.; Department of Medical Ultrasound, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China.; Shanghai Engineering Research Center of Ultrasound Diagnosis and Treatment, Shanghai, China., Xu HX; Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China.
Jazyk:	angličtina
Zdroj:	Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine [J Ultrasound Med] 2024 Jan; Vol. 43 (1), pp. 151-160. Date of Electronic Publication: 2023 Oct 09.
DOI:	10.1002/jum.16348
Abstrakt:	Objectives: To investigate whether the integration of high-frequency ultrasound (HFUS) to routine clinical examinations could improve diagnostic performance and management decision for pigmented skin tumors. Methods: Three general practitioners trained previously and a dermatologist independently assessed pigmented skin tumors and rendered management decision based on clinical examinations alone or clinical examinations integrating HFUS. Results: After integrating HFUS, the diagnostic area under the curve (AUC) (0.658-0.693 versus 0.848, all P < .05) and specificity (46.6-58.6% versus 89.7%, all P < .05) for pigmented skin malignancies were improved for general practitioners, meanwhile unnecessary biopsy rate reduced (42.9-53.6% versus 10.7%, P < .001). To the dermatologist, the diagnostic AUC (0.822 versus 0.949, P < .001), sensitivity (81.7% versus 96.7%, P = .012) and specificity (0.828 versus 0.931, P = .031) improved significantly, meanwhile both missed biopsy rate (14.5% versus 4.8%, P = .031) and unnecessary biopsy rate (19.6% versus 7.1%, P = .016) decreased. Additionally, the diagnostic performance of the general practitioner with integrating HFUS could be comparable with the dermatologist based on clinical examinations alone (all P > .05). Conclusions: As a complementary tool of clinical examinations, HFUS could help physicians differentiate pigmented skin malignancies and manage decision. (© 2023 American Institute of Ultrasound in Medicine.)
Databáze:	MEDLINE
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