Ultrasonographic staging of cutaneous malignant tumors: an ultrasonographic depth index

Abstract

The objective of this paper is to assess the role of conventional and high-frequency ultrasound in the evaluation of the depth of cutaneous skin cancer. The study was performed on 46 subjects, divided into 3 categories, according to their skin pathology [basal cell carcinoma (BCC), 18 subjects; superficial spreading melanoma (SSM), 8 subjects; nodular melanoma (NM), 20 subjects]. Conventional and high-frequency ultrasonographic measurements were performed in order to assess the thickness of the tumors and the vascularization degree. We compared the mean values of the tumoral thickness obtained by using ultrasound (ultrasonographic depth index) with the histological depth index, obtained after performing histological sections stained with hematoxylin-eosin, and specific monoclonal antibodies in case of pigmented tumors. We established a correlation index between the histological and ultrasonographic values of the tumoral thickness. We found a strong correlation between the ultrasonographic index (measured by high-frequency sonography) and the histological index for nodular BCC (correlation of 98.4 %), NM subjects (correlation of 98.4 %), and SSM subjects (correlation of 99.4 %). An increase of the blood supply was noticed in nodular lesions only. Ultrasonography allows a very accurate assessment of skin cancer. The ultrasonographic depth index can be considered an objective, non-invasive marker for cutaneous tumors, comparable to the histological one, with a very good sensitivity (98-99 %).

The value of ultrasound diagnosis in the multidisciplinary approach of cutaneous tumours. Case report

“…Reduced elasticity correlates with tumour congestion and hypervascularization [6][7][8]. This case report emphasizes the importance of US in evaluating cutaneous tumours and its impact on therapeutic approach optimisation.…”

“…Increased sonographic index values in comparison to the histological Breslow index values in our case can be explained by the presence of the peritumoral inflammatory infiltrate. In addition, according to the literature data and our experience, the high frequency ultrasound (Dermascan 20MHz) offers highly accurate depth index information in comparison to conventional US [8,12].…”

“…Qualitative elastography based on a standard colour code, revealed an increased rigidity of both tumours, suggesting malignant lesions. Inflammatory and hypervascularized lesions have increased rigidity [6,8]. The clinical and US data indicated the necessity of performing surgery and also gave the surgeon valuable information regarding the surgical approach.…”

Non-invasive diagnostic techniques in the diagnosis of squamous cell carcinoma

“…The method should be used as a complementary method in preoperative evolution of the tumor. [47][48][49] Wortsman et al, in a large retrospective study of 4338 ultrasonographic skin examinations, showed that the addition of HF ultrasonography increased the correctness of clinical diagnosis from 73% to 97%. …”

Modern non-invasive diagnostic techniques in the detection of early cutaneous melanoma

“…The highest resolution high-frequency ultrasound devices (20-100 MHz) showed a 99.4% correlation with pathology in an analysis of superficial spreading melanoma. 40 Jasaitiene et al indicate that the correlation between the thickness of melanoma assessed by ultrasound examination and histopathological examination in the case of devices with a frequency of 20, 75 and 100 MHz is from 0.895 to 0.99, whereas for the devices of 7.5 MHz the "r" value is 0.76. 38 …”