Vascularization of malignant and benign skin tumours measured by D-galactose-based signal-enhanced colour Doppler sonography

Purpose: Evaluation of colour Doppler criteria to differentiate between mal ignant and benign skin tumours on the basis of the degree of vascularizatio n. Material and Methods: The B-mode sonomorphology and the degree of vasculari zation in colour Doppler of 81 clinically potentially malignant tumours of cutaneous and subcutaneous structures were analyzed and quantified by numbe r of intratumoral vessels per sonographic slice and percentage vessel area. Results: Of all criteria employed, counting the intratumoral vessels visibl e on one ultrasound slice after application of a signal-enhancing agent led to highest sensitivity (94%) of all used criteria but the specificity was poor (64%). The highest specificity (88%) and greatest diagnostic accuracy (86%) discriminating benign and malignant lesions were found using the crit erion "percentage vessel area >5.0%" after all inflamed lesions had been ex cluded on the basis of clinical criteria. Plain colour Doppler increased th e specificity up to 97%, although the sensitivity decreased simultaneously to max. 75%. Analysis of the B-mode morphology and spectral Doppler paramet er of intratumoral vessels did not contribute to the differential diagnosis . Conclusion: Signal-enhanced colour Doppler sonography is a valuable tool in the pretherapeutic assessment of cutaneous lesions. This method may be rel evant for therapy and prognosis.