First experiences with a high-resolution ultrasonic scanner in the diagnosis of malignant melanomas

Abstract

The use of high-resolution ultrasonic instruments with transducer frequencies above 8 MHz makes it possible to visualize malignant melanomas of a thickness of more than 0.7 mm. While the sonolucent structure has not permitted the dignity of a lesion to be judged to date, it is easy to determine the maximal tumor thickness as well as infiltration of the subcutis. Thus "low-risk" and "high-risk" melanomas may be differentiated preoperatively according to these parameters. The results are of great use for the operator to plan the extent of his intervention, as well as to select patients for prophylactic regional lymphonodectomy.

Noninvasive Imaging of Skin Tumors

“…[13][14][15] The sonographic characteristics of skin tumors have been widely investigated by different research groups. 10,[16][17][18][19] By means of ultrasound, skin tumors usually appear as a homogeneously echo-poor area in comparison to the surrounding echo-rich dermis, from which it can be easily distinguished (Figure 4). Because all skin tumors appear echo poor, ultrasound is not able to make a differential diagnosis without clinical information.…”

Skin Ultrasound in Dermatologic Surgical Planning

“…High‐resolution ultrasonography was introduced 10 years ago in clinical dermatology as a simple and reliable method to study skin and soft tissue 1 . Ever since then, ultrasonography has gained widespread acceptance for the evaluation of proliferative, infiltrative, and nodular lesions of superficial soft tissues 2–5 . However, the information obtained with sonography concerns almost exclusively the morphologic aspects of the lesions; the diagnosis of the nature of the lesion is often beyond the possibilities of the technique 6 .…”

High-resolution MR imaging of the cutis and subcutis

“…contrast medium. Although high-resolution US showed promising results in determining the invasion depth of skin tumours and in basic studies of skin aging, its di-agnostic value in diseases of the dermis and subcutis is still under debate (3,8,10,11,17,18). The sonographically measured tumour thickness was generally higher than the histologically determined thickness, which may be explained by the tissue shrinking in the histological processing and/or by the granulation tissue surrounding the tumour (8,18).…”

“…To date, however, high-resolution US (with transducers of up to 100 MHz) has failed to visualize accurately the pathomorphological changes that are essential for differentiating a variety of cutaneous and subcutaneous diseases (3,(8)(9)(10)(11)(16)(17)(18). Conventional MR imaging and MR spectroscopy have concentrated on the evaluation of structural and metabolic changes in the deep structures of the head and body (1,4,7).…”