Dermoscopy guided high-frequency ultrasound features of basal cell carcinoma subtypes compared with histopathology: a multicenter study

Abstract Accurate non-invasive differentiation of basal cell carcinoma (BCC) subtypes is crucial for guiding treatment; however, current imaging tools have limitations in accessibility, depth resolution, and interpretability. To describe sonographic features of distinct BCC subtypes using dermoscopy-guided high-frequency ultrasound (DG-HFUS), and assess its potential as a non-invasive subtyping modality. In this multicenter cross-sectional study, 87 histologically confirmed BCCs (nodular, superficial, infiltrative, and micronodular) were imaged using a portable 33 MHz DG-HFUS device. Morphological features were evaluated independently by blinded observers, and statistical associations with histologic subtypes were analyzed using univariate logistic regression. Hypoechoic mass was the most common sonographic feature of BCCs, seen in 92% of cases. Distinct DG-HFUS features correlated with specific subtypes: ribbon-like shape (OR = 86.3, p < 0.0001), homogeneous internal echoes (OR = 22.5, p = 0.003), and well-defined margins (OR = 9, p = 0.04) were strongly associated with superficial BCC; oval shape (OR = 3.8, p = 0.003) and prominent hyperechoic spots (OR = 3.5, p = 0.005) with nodular BCC; and acoustic shadowing (OR = 7.5, p = 0.001) with infiltrative BCC. Micronodular BCCs were underrepresented. Mixed subtypes were excluded, and vascular patterns were not evaluated. DG-HFUS reveals subtype-specific sonographic features and offers a promising, accessible, and interpretable tool for non-invasive BCC classification in clinical settings.

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Publication Details

Journal
Scientific Reports
Published
2026-07-24
DOI
https://doi.org/10.1038/s41598-026-62657-2
Primary Topic
Cutaneous Melanoma Detection and Management
Type
article
Field-Weighted Citation Impact
0.00

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article

Dermoscopy guided high-frequency ultrasound features of basal cell carcinoma subtypes compared with histopathology: a multicenter study

Mariano Suppa, András Bánvölgyi, Priscila Giavedoni, Mehdi Boostani et al.
Scientific Reports
Cutaneous Melanoma Detection and Management
article

Dermoscopy guided high-frequency ultrasound features of basal cell carcinoma subtypes compared with histopathology: a multicenter study

Mariano Suppa, András Bánvölgyi, Priscila Giavedoni, Mehdi Boostani, Norbert Kiss, Norbert M. Wikonkal, Javiera Pérez‐Ánker, Kende Lörincz, V. del Mármol, Lucas Boussingault, Tara Kiss, Florencia Vera Morandini, Ximena Wortsman, Noah Goldfarb, György Paragh, Manu Jain, Kamran Avanaki, Cristian Navarrete-Dechent, Josep Malvehy, Philippe Bahadoran
article en

Abstract

Abstract Accurate non-invasive differentiation of basal cell carcinoma (BCC) subtypes is crucial for guiding treatment; however, current imaging tools have limitations in accessibility, depth resolution, and interpretability. To describe sonographic features of distinct BCC subtypes using dermoscopy-guided high-frequency ultrasound (DG-HFUS), and assess its potential as a non-invasive subtyping modality. In this multicenter cross-sectional study, 87 histologically confirmed BCCs (nodular, superficial, infiltrative, and micronodular) were imaged using a portable 33 MHz DG-HFUS device. Morphological features were evaluated independently by blinded observers, and statistical associations with histologic subtypes were analyzed using univariate logistic regression. Hypoechoic mass was the most common sonographic feature of BCCs, seen in 92% of cases. Distinct DG-HFUS features correlated with specific subtypes: ribbon-like shape (OR = 86.3, p < 0.0001), homogeneous internal echoes (OR = 22.5, p = 0.003), and well-defined margins (OR = 9, p = 0.04) were strongly associated with superficial BCC; oval shape (OR = 3.8, p = 0.003) and prominent hyperechoic spots (OR = 3.5, p = 0.005) with nodular BCC; and acoustic shadowing (OR = 7.5, p = 0.001) with infiltrative BCC. Micronodular BCCs were underrepresented. Mixed subtypes were excluded, and vascular patterns were not evaluated. DG-HFUS reveals subtype-specific sonographic features and offers a promising, accessible, and interpretable tool for non-invasive BCC classification in clinical settings.

Scientific Reports
Semmelweis University (HU), Roswell Park Comprehensive Cancer Center (US), University of Minnesota (US), Université Libre de Bruxelles (BE), Memorial Sloan Kettering Cancer Center (US), University of Miami (US), Pontificia Universidad Católica de Chile (CL), Military Hospital (PK), Instituto de Salud Carlos III (ES), Institut Jules Bordet (BE), Erasmus Hospital (BE), Centre Hospitalier Universitaire de Nice (FR), University of Illinois Chicago (US), Central Military Hospital (NL), Centre for Biomedical Network Research on Rare Diseases (ES), Hospital Clínic de Barcelona (ES), Minneapolis VA Health Care System (US), MNGI Digestive Health (US), Société Française de Cardiologie (FR), Consorci Institut D'Investigacions Biomediques August Pi I Sunyer (ES), Instituto de Investigación de Enfermedades Raras (ES), University of Chile (CL), Universitat de Barcelona (ES)
U.S. Department of Veterans Affairs, Semmelweis Egyetem, Galderma, Nemzeti Kutatási, Fejlesztési és Innovaciós Alap
Openalex Percentile: Top 11%
Cutaneous Melanoma Detection and Management
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