Diagnostic value of ultrasound examination of skin melanoma for selecting the optimal treatment tactics

Анотація

Cutaneous melanoma is a malignant tumor characterized by a high risk of both lymphatic and hematogenous metastasis, which represents a negative prognostic factor for affected patients. Although melanoma accounts for only approximately 1% of all skin cancer cases globally, it is responsible for more than 80% of skin cancer-related deaths due to delayed or inaccurate diagnosis. Given the increasing incidence of melanoma, particularly among individuals of Caucasian origin I-II, timely and accurate diagnosis is of critical importance. High-frequency ultrasound (HFUS) is a non-invasive and safe imaging modality that enables the assessment of tumor invasion depth and skin structure prior to surgical intervention. The aim of this study was to evaluate the diagnostic performance of high-frequency ultrasound using a 20-22 MHz probe for the preoperative visualization and assessment of cutaneous melanoma, through comparison with histopathological examination (HPE) data. Specifically, the study analyzed the effectiveness of a linear ultrasound probe with a frequency range of 10-22 MHz on the General Electric LOGIQ E R8 (USA) system, in comparison to the 22 MHz DUB Skinscanner (Germany), for determining tumor invasion depth. Additionally, the study established the statistical correlation between HFUS and histopathological findings, to justify the integration of HFUS into clinical diagnostic algorithms for melanoma as a non-invasive tool for preoperative assessment. A total of 90 patients with dermoscopically suspected melanoma were examined. The results of preoperative HFUS performed with two systems – GE LOGIQ E R8 (USA), using a linear transducer with a central frequency of 10-22 MHz, and the DUB Skinscanner (Germany), with a 22 MHz linear transducer were compared to histopathological data. Based on the results of the statistical analysis, the GE ultrasound system demonstrated a very high level of concordance with histopathological measurements, significantly outperforming the DUB device. These findings support the incorporation of high-frequency ultrasound into the diagnostic algorithm for patients with cutaneous melanoma as a non-invasive and informative method for preoperative evaluation.