Prognostic value of high-frequency sonography and color Doppler sonography for the preoperative assessment of melanomas

OBJECTIVE. The purposes of this study were to determine the efficacy of high-frequency sonography for the preoperative assessment of melanomas and to determine the prognostic value of tumor vascularity measured by color Doppler sonography. SUBJECTS AND METHODS. Twenty-seven patients with melanomas were prospectively examined using high-frequency sonography before they underwent surgery. For each tumor, morphologic evaluation (20-MHz probe), including the measurement of maximum tumor thickness, and color Doppler sonography analysis (13-MHz probe), including the measurement of intratumor vascularity, were performed. Diagnosis was confirmed by histologic findings, tumor thickness was measured using the Breslow index, and vascularity was assessed by immunochemical findings. RESULTS. Each of the 27 melanomas was depicted on high-frequency sonography as a homogeneous hypoechoic structure with well- defined margins. Tumor thickness was measured using high-frequency sonography as ranging from 0.3 to 8.0 mm, whereas it was measured using the Breslow index as ranging from 0.26 to 8.0 mm. Sonography measurements and Breslow index values were strongly correlated (r > .95). In the cases in which the Breslow index value exceeded 1 mm (n = 11), surgical reexcision was necessary but could have been avoided if surgery had been planned on the basis of high- frequency sonography measurements. Intratumor vessels were depicted on color Doppler sonography (n = 10). Color Doppler sonography data and histologic findings were significantly correlated. CONCLUSION. High-frequency sonography is a simple, reliable, noninvasive, and accurate method for the preoperative measurement of melanoma thickness. In fact, surgical planning could be adapted according to this measurement. The prognostic value of vascularization evaluated with color Doppler sonography is comparable with that determined by the Breslow index.