Measurement of melanoma thickness – comparison of two methods: Ultrasound versus morphology

• Published in: Journal of plastic, reconstructive & aesthetic surgery Vol. 64; no. 6; pp. 796 - 802
• Main Authors: Kaikaris, Vygintas, Samsanavičius, Donatas, Kęstutis Maslauskas, Rimdeika, Rytis, Valiukevičienė, Skaidra, Makštienė, Jurgita, Pundzius, Juozas
• Format: Journal Article
• Language: English
• Published: Kidlington Elsevier Ltd 01.06.2011; Elsevier
• Subjects: Adult; Aged; Aged, 80 and over; Biological and medical sciences; Biopsy; Breslow thickness; Dermatology; Female; Follow-Up Studies; Humans; Male; Medical sciences; Melanoma; Melanoma - diagnostic imaging; Melanoma - pathology; Melanoma thickness; Middle Aged; Neoplasm Staging; Plastic Surgery; Prospective Studies; Reproducibility of Results; Skin - diagnostic imaging; Skin - pathology; Skin Neoplasms - diagnostic imaging; Skin Neoplasms - pathology; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Tumors of the skin and soft tissue. Premalignant lesions; Ultrasonography; Ultrasound; Melanoma thickness; Breslow thickness; Ultrasound; Melanoma; Measurement; Malignant tumor; Method; Thickness; Treatment; Surgery; Morphology; Malignant melanoma; Comparative study; Cancer
• ISSN: 1748-6815; 1878-0539
• DOI: 10.1016/j.bjps.2010.10.008

Summary Objective The aim of our study was to investigate the association between non-invasive ultrasound examination and morphologic test results in the measurement of cutaneous melanoma thickness influencing surgical treatment strategy. Methods Our prospective clinical study has been conducted in the Clinic of Plastic and Reconstructive Surgery of Kaunas University of Medicine Hospital (KUMH) since January 2004 until October 2008. A total of 100 patients with a clear clinical diagnosis of stage I–II cutaneous melanoma were enrolled in this study. Melanoma depth was measured using a linear 14-MHz frequency ultrasound sensor (Toshiba Xario XG). Surgically removed fragments of skin-subcutaneous tissue were fixated using 10% formalin solution in the operating theatre, and sent to KUMH Clinic of Pathological Anatomy. The most informative sections were analysed for tumour thickness, according to Breslow, as well as tumour type, vascular and lymphatic invasion and dissemination. A comparative data analysis of melanoma thickness measured by ultrasound (T) preoperatively and histologically estimated cutaneous melanoma (CM) thickness according to Breslow (pT) using the Bland–Altman method was performed. Results Higher mean difference of melanoma thickness (60 μm) between T and pT measurements was found when tumour thickness matched pT1 and pT2 categories. In cases of CM depth exceeding 2 mm, mean difference of measurements between CM thickness determined by ultrasound and histological examination was lower (30 μm). Data regression analysis showed that correlation between T and pT measurements was lower when CM was thinner (1–2 mm) (Pearson’s correlation coefficient, r : 0.283). In cases of thicker melanoma (>2 mm), strong and statistically significant ( p < 0.0001) correlation ( r : 0.869) was observed. Conclusions Correlation between melanoma thickness measured using a linear 14-MHz frequency ultrasound sensor and histologically estimated melanoma thickness according to Breslow was lower if melanoma was thinner (1–2 mm). However, in cases of thicker melanoma (>2 mm), very strong correlation between measurements was observed.