NASHVILLE, TN — High-frequency ultrasound (HFUS) can safely and efficiently visualize cutaneous tumor characteristics including depth, but how accurate is it?
That was the question raised in an article in the Journal of the European Academy of Dermatology and Venereology. Researchers from Vanderbilt University Medical School and the VA Tennessee Valley Health Care System sought to evaluate the accuracy of HFUS in measuring melanoma depth against the gold standard, histopathology for treatment planning.1
The study team conducted a review of publications in March 2023 through five electronic databases, including 36 articles that studied patients who received HFUS (≥10 MHz) measurements, melanoma biopsy or excision and reported a tumor depth correlation coefficient between HFUS and histopathology.
The results indicated that the most common tumor undergoing imaging was superficial spreading melanoma on the trunk and extremities, followed by head/face. The study found that maximum ultrasound frequencies ranged from 13 MHz to 100 MHz with participants ranging from 5 to 264, and that histopathology and HFUS correlation coefficients ranged from 0.417 to 0.997 (median: 0.94, mean: 0.89 and SD: 0.13).
“Lower frequency probes (10-20 MHz) were less accurate in assessing melanoma thickness, with a cumulative mean correlation coefficient of 0.87 compared to 0.94 (20-25 MHz) and 0.98 (≥70 MHz),” the authors pointed out. “Studies demonstrated higher sonographic accuracy in melanomas >0.75 mm. Additionally, ultrasound may report increased melanoma depth compared to histopathology for reasons including lymphocytic infiltration, presence of a nevus and shrinkage during specimen processing.”
They said a gap also was found in the reporting of details such as fundamental characteristics of lesion populations. “Specifically, 86% (31 out of 36) of the studies failed to report one or more critical metrics, such as mean, median or range of lesion depths,” the researchers wrote.
The study concluded that HFUS might serve as a supplementary tool for preoperative melanoma assessment, with increased accuracy in thicker tumors. “Frequencies <20 MHz are less reliable in assessing depth. Frequencies ≥70 MHz demonstrate stronger correlations to histopathology,” the study team wrote. “Higher ultrasound accuracy was seen for melanomas with Breslow depth >0.75 mm.”
- Sellyn GE, Lopez AA, Ghosh S, Topf MC, Chen H, Tkaczyk E, Powers JG. High-frequency ultrasound accuracy in preoperative cutaneous melanoma assessment: A meta-analysis. J Eur Acad Dermatol Venereol. 2024 Jul 5. doi: 10.1111/jdv.20179. Epub ahead of print. PMID: 38967397.