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A Journal on Dermatology
Esperienze Dermatologiche 2013 December;15(4):163-8
Role of high-resolution ultrasound and color-Doppler in the assessment of the grade of malignancy in the diagnosis of melanoma
Delfino M. 1, Farina D. 1, De Fata Salvatores G. 1, Mancini M. 2, Scotto Di Santolo M. 3
1 Dipartimento di Medicina Clinica e Chirurgia, Dermatologia, Università degli Studi di Napoli “Federico II”, Napoli, Italia;
2 Istituto di Biostrutture e Bioimmagini, Consiglio Nazionale delle Ricerche, Napoli, Italia;
3 Dipartimento Assistenziale Diagnostica per Immagini e Radioterapia, Università degli Studi di Napoli “Federico II”, Napoli, Italia
Aim: The aim of this study was to evaluate the possibility of integrating clinical and dermoscopic diagnosis of melanoma with high-resolution ultrasound and color-Doppler to assess the grade of malignancy, for prognostic purposes and surgical planning.
Methods: Thirty-four cutaneous lesions, clinically and dermoscopically classified as melanomas, were examined with 17-MHz ultrasound probe and color-Doppler. For each lesion sonographically thickness and vascular patterns were evaluated. Once excised, lesions were histologically evaluated in a blinded study. The resulting data were correlated with the corresponding ultrasound parameters. This comparison was statistically tested.
Results: According to ultrasound measurement of tumor thickness melanomas were assigned into three groups: group A: thin melanomas (<1 mm); group B: average melanomas (≥1 mm and <2 mm); group C: thick melanomas (≥2 mm). In the last one, a strong correlation with Breslow index was observed. Thin melanomas proved avascular pattern, the average showed a modest blood supply. Thick melanomas, however, showed intense vascular signal.
Conclusion: The study confirms that high-resolution ultrasound and analysis of intratumoral vascular pattern allow an accurate preoperative assessment of thickness lesions, tumor angiogenesis and metastatic potential of cutaneous melanom