Sellyn Georgina E, Lopez Andrea A, Ghosh Shramana, Topf Michael C, Chen Heidi, Tkaczyk Eric, Powers Jennifer G
Vanderbilt University School of Medicine, Nashville, Tennessee, USA.
Department of Veterans Affairs, Tennessee Valley Health Care System and Department of Statistics, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
J Eur Acad Dermatol Venereol. 2025 Jan;39(1):86-96. doi: 10.1111/jdv.20179. Epub 2024 Jul 5.
High-frequency ultrasound (HFUS) can safely and efficiently visualize cutaneous tumour characteristics including depth.
We aimed to evaluate its accuracy in measuring melanoma depth against the gold standard, histopathology, for treatment planning.
A review of publications was conducted in March 2023 through five electronic databases. Thirty-six included articles studied patients who received HFUS (≥10 MHz) measurements, melanoma biopsy or excision, and reported a tumour depth correlation coefficient between HFUS and histopathology. We analysed correlation coefficients between HFUS and histopathology, measured tumour depths and shed light on reasons for mismeasurements. Additionally, we identified the reporting of critical metrics including, lesion characteristics, melanoma subtype, type of correlation coefficient, 95% confidence intervals for Pearson coefficients and sample size.
The most common tumour imaged was superficial spreading melanoma on the trunk and extremities, followed by head/face. Maximum ultrasound frequencies ranged from 13 MHz to 100 MHz with participants ranging from 5 to 264. 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). 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. Furthermore, we found a gap 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.
HFUS may serve as a supplementary tool for preoperative melanoma assessment, with increased accuracy in thicker tumours. Frequencies <20 MHz are less reliable in assessing depth. Frequencies ≥70 MHz demonstrate stronger correlations to histopathology. Higher ultrasound accuracy was seen for melanomas with Breslow depth >0.75 mm.
高频超声（HFUS）能够安全有效地显示皮肤肿瘤特征，包括深度。
我们旨在评估其在测量黑色素瘤深度方面相对于治疗计划的金标准——组织病理学的准确性。
2023年3月通过五个电子数据库对相关出版物进行了综述。36篇纳入文章研究了接受HFUS（≥10MHz）测量、黑色素瘤活检或切除的患者，并报告了HFUS与组织病理学之间的肿瘤深度相关系数。我们分析了HFUS与组织病理学之间的相关系数、测量的肿瘤深度，并阐明了测量误差的原因。此外，我们确定了关键指标的报告情况，包括病变特征、黑色素瘤亚型、相关系数类型、Pearson系数的95%置信区间和样本量。
最常成像的肿瘤是躯干和四肢的浅表扩散型黑色素瘤，其次是头面部。超声的最大频率范围为13MHz至100MHz，参与者人数为5至264人。组织病理学与HFUS的相关系数范围为0.417至0.997（中位数：0.94，均值：0.89，标准差：0.13）。低频探头（10 - 20MHz）在评估黑色素瘤厚度方面准确性较低，累积平均相关系数为0.87，而20 - 25MHz为0.94，≥70MHz为0.98。研究表明，在厚度>0.75mm的黑色素瘤中，超声检查准确性更高。此外，由于淋巴细胞浸润、痣的存在以及标本处理过程中的收缩等原因，超声报告的黑色素瘤深度可能比组织病理学报告的更深。此外，我们发现病变群体基本特征等细节报告存在差距。具体而言，86%（36篇中的31篇）的研究未报告一个或多个关键指标，如病变深度的均值、中位数或范围。
HFUS可作为术前黑色素瘤评估的辅助工具，在较厚肿瘤中准确性更高。<20MHz的频率在评估深度方面可靠性较低。≥70MHz的频率与组织病理学的相关性更强。Breslow深度>0.75mm的黑色素瘤超声检查准确性更高。
