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Contrast-enhanced ultrasound using Sonazoid (Sonazoid-CEUS), which is based on a perfluorobutane microbubble contrast agent with reticuloendothelial uptake properties, was evaluated for SLN detection in patients with stage Ib\u2013II melanoma.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>In this prospective single-arm cohort study, 71 eligible subjects underwent perilesional intradermal Sonazoid-CEUS, followed by lymphoscintigraphy and SLN biopsy. The numbers of SLNs detected via CEUS and lymphoscintigraphy were compared by using non-parametric paired analysis (Wilcoxon signed-rank test). The diagnostic accuracy of CEUS for metastatic involvement was evaluated against histopathological results.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Sonazoid-CEUS achieved a 97.3% success rate in identifying SLNs, detecting 148 SLNs, with an average of 2.1\u2009\u00b1\u20091.1 SLNs per patient. Most patients (93.0%) had single-basin lymphatic drainage. For metastasis detection, CEUS demonstrated 82.1% sensitivity, 88.4% specificity, and 85.9% accuracy. Ulceration, high mitotic count, and HMB45 positivity in primary lesions were significantly associated with SLN metastasis. No contrast-related adverse events were observed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Sonazoid-CEUS is a safe and accurate non-radioactive technique for SLN identification and preoperative diagnosis in patients with cutaneous melanoma; moreover, it exhibits potential value as a complementary imaging modality within established SLNB workflows.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Key Points<\/jats:title>\n                    <jats:p>\n                      <jats:bold>\n                        <jats:italic>Question<\/jats:italic>\n                      <\/jats:bold>\n                      <jats:italic>Can a non-radioactive contrast-enhanced ultrasound technique using Sonazoid improve preoperative localization and characterization of sentinel lymph nodes in patients with cutaneous melanoma?<\/jats:italic>\n                    <\/jats:p>\n                    <jats:p>\n                      <jats:bold>\n                        <jats:italic>Findings<\/jats:italic>\n                      <\/jats:bold>\n                      <jats:italic>In this prospective study, Sonazoid-CEUS identified sentinel lymph nodes in 97.3% of patients and showed high diagnostic accuracy without contrast-related adverse events.<\/jats:italic>\n                    <\/jats:p>\n                    <jats:p>\n                      <jats:bold>\n                        <jats:italic>Clinical relevance<\/jats:italic>\n                      <\/jats:bold>\n                      <jats:italic>Sonazoid-CEUS provides a non-radioactive adjunct for preoperative sentinel lymph node mapping and characterization in cutaneous melanoma, thereby potentially improving surgical planning while offering complementary functional information alongside conventional lymphoscintigraphy.<\/jats:italic>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00330-026-12640-2","type":"journal-article","created":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T18:18:02Z","timestamp":1779733082000},"page":"7599-7608","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Sonazoid-enhanced ultrasound for preoperative localization and characterization of sentinel lymph nodes in patients with cutaneous melanoma"],"prefix":"10.1007","volume":"36","author":[{"given":"Binbin","family":"Jiang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liqi","family":"Sun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lu","family":"Si","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiayong","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chuanliang","family":"Cui","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kun","family":"Yan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9598-2075","authenticated-orcid":false,"given":"Shanshan","family":"Yin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,25]]},"reference":[{"key":"12640_CR1","doi-asserted-by":"publisher","first-page":"290","DOI":"10.6004\/jnccn.2024.0036","volume":"22","author":"SM Swetter","year":"2024","unstructured":"Swetter SM, Johnson D, Albertini MR et al (2024) NCCN Guidelines\u00ae Insights: Melanoma: Cutaneous, version 2.2024. 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