{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T23:46:57Z","timestamp":1783036017829,"version":"3.54.6"},"reference-count":38,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2019,11,12]],"date-time":"2019-11-12T00:00:00Z","timestamp":1573516800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acad Dermatol Venereol"],"published-print":{"date-parts":[[2020,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The metastatic involvement of regional lymph nodes is the most important prognostic factor for overall survival of skin cancer patients. The sonographic technique of freehand real\u2010time tissue elastography (<jats:styled-content style=\"fixed-case\">RTE<\/jats:styled-content>), which displays tissue rigidity as a colour overlay of the tissue image, was developed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>Our purpose was to evaluate the benefit of <jats:styled-content style=\"fixed-case\">RTE<\/jats:styled-content> for detecting lymph node metastases of skin cancer non\u2010invasively before operation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We first selected lymph nodes of skin cancer patients which had already been diagnosed by biopsy as being reactive or metastatic, and then retrospectively collected images of <jats:styled-content style=\"fixed-case\">RTE<\/jats:styled-content> and B\u2010mode and colour Doppler ultrasound on those lymph nodes performed preoperatively. Twenty\u2010one lymph nodes from 12 patients with squamous cell carcinoma (<jats:styled-content style=\"fixed-case\">SCC<\/jats:styled-content>), 23 lymph nodes from 14 patients with malignant melanoma (<jats:styled-content style=\"fixed-case\">MM<\/jats:styled-content>) and 14 lymph nodes from six patients with extramammary Paget disease (Paget) were investigated. Elastographic images were assessed on a scale of one to four according to the percentage of high elasticity (hard) area (<jats:styled-content style=\"fixed-case\">HEA<\/jats:styled-content>) in the lymph node.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In all three skin cancers, lymph nodes evaluated as grade 3 or 4 by <jats:styled-content style=\"fixed-case\">RTE<\/jats:styled-content> were metastatic. All lymph nodes evaluated as grade 1 or 2 by <jats:styled-content style=\"fixed-case\">RTE<\/jats:styled-content> were reactive in <jats:styled-content style=\"fixed-case\">SCC<\/jats:styled-content>, whereas some lymph nodes evaluated as grade 1 or 2 were metastatic in <jats:styled-content style=\"fixed-case\">MM<\/jats:styled-content> and Paget.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Real\u2010time tissue elastography may aid in distinguishing reactive lymph nodes from metastatic ones especially in <jats:styled-content style=\"fixed-case\">SCC<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jdv.15955","type":"journal-article","created":{"date-parts":[[2019,9,14]],"date-time":"2019-09-14T14:39:07Z","timestamp":1568471947000},"page":"754-761","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Usefulness of real\u2010time elastography for diagnosing lymph node metastasis of skin cancer: does elastography potentially eliminate the need for sentinel lymph node biopsy in squamous cell carcinoma?"],"prefix":"10.1111","volume":"34","author":[{"given":"T.","family":"Tanaka","sequence":"first","affiliation":[{"name":"Department of Dermatology Teikyo University School of Medicine Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0976-4982","authenticated-orcid":false,"given":"M.","family":"Kamata","sequence":"additional","affiliation":[{"name":"Department of Dermatology Teikyo University School of Medicine Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Fukaya","sequence":"additional","affiliation":[{"name":"Department of Dermatology Teikyo University School of Medicine Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.","family":"Hayashi","sequence":"additional","affiliation":[{"name":"Department of Dermatology Teikyo 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