DOES HIGH-FREQUENCY (40-60 MHZ) ULTRASOUND IMAGING PLAY A ROLE IN THECLINICAL MANAGEMENT OF CUTANEOUS MELANOMA

The assessment of cutaneous melanoma in the clinical setting is often difficult, and important features such as depth and width remain unkno wn until the pathology report is received. Access to prognostic featur es such as vertical height before excisional biopsy would offer a basi s for guidance in defining surgical margins and early planning of trea tment options. Recently developed high-frequency ultrasound imaging in the 40- to 60-MHz range is a noninvasive method that provides in vivo information about cutaneous lesions. Imaging at these frequencies pro vides high-resolution data within the range of the epidermis and dermi s (3-4 mm in depth). Ten cutaneous melanomas and seven pigmented lesio ns were assessed in this fashion. Vertical height was documented and c ompared to histopathological findings. High-frequency ultrasound imagi ng determination of vertical height correlated well with the standard measurement of Breslow's thickness on histological sections only in mi drange (1.0-3.0 mm) lesions, Inflammatory cells at the base of three m elanomas provoked an overestimation of the depth measurement with ultr asonography. Thick keratin layers such as those found on the feet acte d as a virtual block to the high-frequency scanner, The application of this new advance in noninvasive imaging technology to the clinical as sessment of cutaneous melanoma provides interesting in vivo data but i n its present state does not replace the need for the biopsy of pigmen ted lesions and histopathological diagnosis.