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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