Ultrasonography, CT Outperform Physical Exam for Identifying Metastases in cSCC

WEDNESDAY, April 22, 2026 (HealthDay News) -- For detecting baseline nodal metastases in high-risk cutaneous squamous cell carcinoma (cSCC), ultrasonography and computed tomography (CT) outperform physical examination, according to a study published online April 22 in JAMA Dermatology.Carla Ferrándiz-Pulido, M.D., Ph.D., from the Hospital Universitari Vall d'Hebron in Barcelona, Spain, and colleagues compared the diagnostic performance of physical examination, ultrasonography, and contrast-enhanced CT in detecting nodal metastases at baseline staging of high-risk cSCC in a prospective, multicenter, paired diagnostic study conducted across 13 tertiary dermato-oncology centers in Spain. Participants had histologically confirmed high-risk cSCC (stage T2b/T3 or T2a with additional high-risk features).The analysis included 155 patients, 12 of whom developed nodal metastases within three months after surgery. The researchers found the highest overall sensitivity for ultrasonography results (63.6 percent) followed by CT and physical examination (54.5 and 8.3 percent, respectively). The corresponding specificities were 95.6, 95.0, and 99.3 percent. Almost perfect agreement was seen for ultrasonography and CT (κ = 0.87), while poor concordance was seen with physical examination. Disparities were seen in diagnostic performance in a subgroup analysis by immune status. Both ultrasonography and CT achieved 100 percent sensitivity in patients with immunocompetence, and the area under the receiver operating characteristic curve (AUROC) was excellent (0.98 for both). In contrast, among patients who were immunosuppressed, sensitivity declined markedly (20.0 and 16.7 percent for ultrasonography and CT, respectively), with AUROCs of 0.57 and 0.55, respectively."The findings of this diagnostic study confirm the value of performing radiologic assessments of lymphatic drainage territories during baseline staging in patients with high-risk cSCC," the authors write.Several authors disclosed ties to the biopharmaceutical industry.Abstract/Full Text (subscription or payment may be required)Editorial (subscription or payment may be required).Sign up for our weekly HealthDay newsletter

Ultrasonography, CT Outperform Physical Exam for Identifying Metastases in cSCC

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