Doppler ultrasound and strain elastography in the assessment of cutaneous melanoma: preliminary results

Abstract

Aim: To study the usefulness of color or power Doppler ultrasound (US) in the pre-surgical evaluation of skin melanoma, and to correlate the Doppler characteristics with the appearance on high frequency ultrasound strain elastography (SE) in the preoperative evaluation of cutaneous melanoma. Materials and method: The study included 42 cutaneous melanoma lesions in 39 adult subjects examined between September 2011 and January 2015. Doppler US features (the presence and aspect of vascularization, and the number of vascular pedicles) and elasticity by strain elastography were evaluated together with the pathological results. Results: The melanoma lesions presented hyper-vascularization, with multiple vascular pedicles and stiff appearance. Significant correlations between the thickness of the tumor, measured histopathologically by the Breslow index, and the degree of vascularization (p=0.0167), and number of vascular pedicles (p=0.0065) were identified. Strong correlations between the SE appearance and vascularization on one hand, and SE and the number of vascular pedicles were also identified (p<0.001). Conclusion: Our study demonstrates that Doppler US and SE offer useful information for THE preoperative evaluation of cutaneous melanoma and may contribute to better defining the long term prognosis.

Ultrasound and Infrared-Based Imaging Modalities for Diagnosis and Management of Cutaneous Diseases

“…The strain ratio comparing the melanomas and the hypodermis as well as the melanomas and the dermis showed a strong relationship ( 36 ). This group also previously reported thicker tumors had lower elasticity, while thinner ones were more elastic ( 37 ). A similar study used real-time elastography for superficial spreading melanoma and found predominance of dark blue regions (rigid) within the melanomas compared to green areas in benign nevi (moderate elasticity) ( 38 ).…”

Ultrasonographic Evaluation of Skin Toxicity Following Radiotherapy of Breast Cancer: A Systematic Review

“…Emerging ultrasound-based techniques, such as elastography, may provide more accurate and objective features to ultrasound B-mode by measuring skin elasticity. It has been measured in different skin diseases [ 47 , 48 ] and gives valuable addition to the US evaluation.…”

Formulas, Algorithms and Examples for Binomial Distributed Data Confidence Interval Calculation: Excess Risk, Relative Risk and Odds Ratio

“…Fisher was the first to notice that the significance level is build up from the cases where the arrangement is as extreme as the observed arrangement, or more so. Some authors suggest that, when changing from evaluation of ER to OR or RR, to also change (see §1 in [61]) the study design and its associated statistical analysis (for Fisher Exact, see [69]) while others keep the bivariate binomial assumption even when some data are missing (see §2 in [70]). It is possible to argue that changing from m and n to m + n does not change the nature of the phenomena (successions of Bernoulli trials) nor the independence between the samples; thus, Equation ( 9) is slightly changed replacing n and m with m + n everywhere, but the increase of the cases leads to the increase in density of the points inside of the domain of the evaluated function and has as effect the increase of the CIs accuracy as well (for instance, for the case depicted in Figure 11, the increase is from 2995 to 3072 cases out of 3111 falling in the [4%, 5%] range).…”