High-frequency ultrasound features of basal cell carcinoma and its association with histological recurrence risk

Background: Due to advances in high-frequency ultrasound technology, it is easier to detect fine structures of skin lesions. The aim of this study was to examine the ultrasonographic features and use recurrence risk stratification to assess the diagnostic performance of pre-operative ultrasound examination of basal cell carcinoma (BCC). Methods: This was a retrospective study. Forty-six BCC lesions underwent pre-operative ultrasound examination using 50- and 20- MHz probes. Ultrasonographic shape, margin, internal echoes, hyper-echoic spots, posterior echoes, and depth of the lesion were evaluated and correlated with the risk of recurrence based on histological features. Results: Forty-two patients had 46 skin lesions in total. The high-risk (n = 6) and low-risk (n = 40) groups exhibited considerable overlap in the ultrasonographic manifestations and no significant difference in margin (χ^2 = 3.231, P = 0.072), internal echo (χ^2 = 1.592, P = 0.207), or posterior echo (P = 0.169). However, high-risk BCCs tended to be irregular in shape than low-risk lesions (χ^2 = 4.313, P = 0.038). Both types presented hyper-echoic spots (χ^2 = 1.850, P = 0.174). Additionally, 78% of low-risk lesions were confined to the dermis (31/40), and 100% of high-risk lesions infiltrated into the sub-cutaneous tissue, resulting in a significant difference between the two groups (χ^2 = 10.951, P = 0.001). Ultrasound detected sub-clinical lesions in five patients. Conclusions: High-frequency ultrasound can provide important information for pre-operative evaluation of risk in BCC foci and reveal hidden lesions. The technique may play a crucial role in guiding therapeutic options for BCC.

In vivo longitudinal and multimodal imaging of hypoxia-inducible factor 1a and angiogenesis in breast cancer

Background:Angiogenesis and hypoxia-inducible factor 1a(HIF-1a)play major roles in solid tumors.This study aimed to establish a longitudinal and multimodal imaging model for in vivo evaluation of HIF1a and angiogenesis in breast cancer.Methods:By transfection of a 5 hypoxia-responsive element(HRE)/green fluorescent protein(GFP)plasmid,the cell line Ca761-hregfp was established,which emitted green fluorescence triggered by HIF-1a under hypoxia.The cells were subjected to CoCl2-simulated hypoxia to confirm the imaging strategy.We grew Ca761-hre-gfp cells in the left rear flanks of twelve 615 mice.Experiments were conducted on days 4,9,15,and 19.For in vivo analysis,Ca761-hre-gfp subcutaneous allografted tumors were imaged in vivo using contrast-enhanced ultrasound(CEUS)and fluorescence imaging(FLI)during tumor development.The tumor size,CEUS peak intensity,and FLI photons were measured to evaluate tumor growth,angiogenesis,and HIF-1a activity,respectively.After each experiment,three mice were randomly sacrificed and tumor specimens were collected to examine HIF-1a activity and the microvessel density(MVD).Results:In vitro,both green fluorescence and HIF-1a expression were detected in Ca761-hre-gfp cells treated with CoCl2,indicating the suitability of the cells to detect HIF-1a activity.In vivo,HIF-1a activity first increased and then decreased,which was significantly correlated with angiogenic changes(r=0.803,P=0.005).These changes were confirmed by immunohistochemical staining of HIF-1a and MVD.Conclusions:The findings validated the Ca761-hre-gfp murine allograft model for reliable evaluation of HIF-1a activity and angiogenesis longitudinally using both molecular and pre-clinical non-invasive imaging modalities.The cell line may be useful for studies of anti-HIF pathway therapies.

Multi-dimensional skin imaging evaluation of eccrine hidrocystoma

Eccrine hidrocystoma(EH)is a benign tumor derived from the cystic dilatation of the eccrine sweat ducts caused by the retention of eccrine secretions.EH is rare and is found most often in middle-aged women,especially those who work or stay for a long duration in hot and humid environments.The lesions usually involve periocular and malar areas,manifesting as multiple translucent skin-colored to bluish cysts.The sizes and numbers of the lesions can fluctuate according to the season,with exacerbation in warm weather and alleviation in cold weather.EH is histopathologically characterized by unilocular dermal cysts lined by two layers of cuboidal to flattened epithelial cells.