Skin melanoma imaging using ultrasonography: a literature review

Abstract

Melanoma is one of the most unpredictable tumours, as regards both morphology and the course of disease. It may have different clinical forms making it very difficult to diagnose. Therefore, it often surprises even the most experienced dermatologists. Despite numerous attempts, no efficient treatment of advanced stages have been elaborated, and early detection and removal of a skin lesion currently constitutes the most efficient treatment method. Diagnostics uses different types of dermoscopic techniques characterised by considerable sensitivity and specificity in detecting melanoma at an early developmental stage. A continuous development of medical technologies leads to improving many methods of skin lesion imaging. Ultrasonography is one of these methods, enabling evaluation of the thickness of melanoma in vivo with high precision. Change thickness is the decisive factor influencing 5-year survival. The paper evaluates the usefulness of high-frequency ultrasonography (HFUS) in pre-operative melanoma imaging on the basis of literature review. Additionally, the use, role and placement of HFUS in skin melanoma diagnostics is determined.

Usefulness of High-Frequency Ultrasonography in the Diagnosis of Melanoma: Mini Review

“…The image quality is influenced by the resolution, the key element in measuring the thickness and depth of skin changes (30). The typical ultrasound image of healthy skin is composed of three elements: epidermis, also known as epidermal echo, dermis and subcutaneous tissue (30).…”

“…Many literature studies provide US information on primary skin melanoma lesions (30)(31)(32). The first US evaluations were performed with 14 MHz probes.…”

High-frequency ultrasound in clinical dermatology: a review

“…This correlation with histologic thickness, the current gold standard on which melanoma staging and surgical planning rests, is predicted to be over 92% [ 57 ]. When compared to other techniques like OCT, ultrasound has superior correlation with histology, repeatability and inter-rater reliability [ 58 ]. Where OCT tends to underestimate Breslow thickness, ultrasound has been shown to modestly overestimate tumor thickness [ 58 ].…”

“…When compared to other techniques like OCT, ultrasound has superior correlation with histology, repeatability and inter-rater reliability [ 58 ]. Where OCT tends to underestimate Breslow thickness, ultrasound has been shown to modestly overestimate tumor thickness [ 58 ]. The cause of this overestimation is thought to result from the technology’s inability to distinguish an inflammatory infiltrate from melanocytic proliferation and neovascularization.…”

“…4 Nodular basal cell carcinoma measuring 5 mm by 7 mm on the left lower cheek of a 66-year-old man. Note the pearly borders and central ulceration in the gross photograph (a), the polymorphous vessels and ulceration in the dermatoscopic photo (b), and the 5 mm hypoechoic lesion in the superficial dermis across the short axis of this biopsy-supported nodular basal cell carcinoma using a 50-MHz UHFUS probe (Longport, Inc. EPISCAN) thickness, ultrasound has been shown to modestly overestimate tumor thickness [58]. The cause of this overestimation is thought to result from the technology's inability to distinguish an inflammatory infiltrate from melanocytic proliferation and neovascularization.…”