Ultra-high-frequency ultrasound monitoring of melanomas arising in congenital melanocytic nevi: a case series

Abstract

The aims of our study were to evaluate with ultra-highfrequency ultrasound (UHFUS) the ultrasound features of congenital melanocytic nevi (CMNs) and malignant melanomas (MMs) arising in CMNs and the correlation between ultrasonographic thickness and histological thickness in MMs. We evaluated 10 patients with smallmedium CMNs and 10 patients with MMs arising in small-medium CMNs. We collected patient's data, clinical and dermoscopic features. The UHFUS was performed using a 70 MHz frequency probe to study the ecostructure, shape and vascularization. Breslow thickness was compared with ultrasonographic thickness. In the MMs group the following dermoscopic features were described: hyperpigmentation (n = 9), regression area (n = 6), whitish-blue veil (n = 5), thickened network (n = 5), irregular globules (n = 3), inverse network (n = 2) and striae (n = 1). Hyperpigmentation (n = n = 9), thickened network (n = 7), irregular globules (n = 5), regression area (n = 5), striae (n = 1) and whitish-blue veil (n = 1) were found in the CMNs group. The multicomponent pattern was present in both MMs (n = 4) and in CMNs (n = 5). Moreover, the parameters indicative of suspected malignancy were variously combined in the two groups, without showing significant differences in the statistical analysis; with the exception of the blue veil that correlated with the diagnosis of MM. Ultrasonoghaphic vascularization was an ever-present parameter in MMs (100%), with high intensity of intratumoral signal, as opposed to CMNs. We also found a statistically significant correlation between ultrasound thickness and Breslow thickness. In the future, this technique could implement the diagnostic preoperative phase of MMs arising in CMNs in combination with standard clinical-dermatoscopic evaluation. Melanoma Res 31: 561

Clinical application of ultra‐high frequency ultrasound: Discovering a new imaging frontier

“…Faita et al 15 used a machine learning approach to process the UHFUS images of melanocytic lesions for the differential diagnosis of melanoma. Janowska et al 16 analyzed, with 70 MHz‐UHFUS, the features of congenital melanocytic nevi and malignant melanomas and the correlation between ultrasonographic and histological thickness. Moreover, in basal and squamous cell carcinoma or cutaneous angiosarcoma, was reported a good correlation between presurgical UHFUS evaluation and histology 17–20 .…”

“…Faita et al 15 used a machine learning approach to process the UHFUS images of melanocytic lesions for the differential diagnosis of melanoma. Janowska et al 16 12 Evaluate granuloma burden in cutaneous sarcoidosis Reginelli et al 13 ; Varkentin et al 14 ; Faita et al 15 ; Janowska et al 16 ; Nassiri-Kashani et al 17 ; Rohrbach et al 18 ; Hayashi et al 19 ; Oranges et al 20 Evaluate the characteristics of malignant cutaneous lesions, such as melanoma Hayashi et al 21 Evaluate the hair disorders Izzetti et al 22 ; Ferro et al 23 Intraoral Evaluate the salivary gland in Sjogren syndrome Izzetti et al 24 ; Izzetti et al 25 ; Izzetti et al 26 Evaluate the oral bullous lesions Hayashi et al 27 ; Bianchi et al 28 ; Visconti et al 29 Lymphovascular Evaluate lymphatic vessels in the preoperative planning of lymphovascular anastomosis…”

Ultra‐High Frequency Ultrasound in Melanoma Management

“…38 Moreover, Janowska et al described the potential role of ultrasonographic hypervascularity also in identifying melanoma arising in congenital melanocytic nevus. 39 The detection of sublesional vessels is also possible in B-mode evaluation and they appear as hypoechoic tortuous structures (Figure 5B).…”

Ultra‐high frequency ultrasound detection of the dermo‐epidermal junction: Its potential role in dermatology

“…Since the axial resolution achievable increases with the frequency, high frequencies can be used to investigate superficial structures. Ultra‐high frequency ultrasound (UHFUS) up to 100 MHz, on the contrary, allows a much more detailed view of the epidermis, also obtaining a sub‐millimetric resolution of the skin structures 5,9–12 …”

“…Ultra-high frequency ultrasound (UHFUS) up to 100 MHz, on the contrary, allows a much more detailed view of the epidermis, also obtaining a sub-millimetric resolution of the skin structures. 5,[9][10][11][12] Ultra-high frequency ultrasound has been proven to show correlations between ultrasound images and histology with high specific values, as it is able to differentiate between healthy and pathological tissues, with a comparable accuracy to biopsy. 13,14 UHFUS can detect even microscopic structures such as hair follicles and tracts, sebaceous glands, montgomery glands, apocrine glands and arrector pili muscles.…”