Power Doppler ultrasonography for the evaluation of skin tumors other than malignant melanoma

Abstract

The purpose of this prospective study was to evaluate the value of power Doppler ultrasonography (PDUS) in assessing the vascularity of skin tumors other than malignant melanoma, and to investigate possible diagnostic criteria to help to distinguish malignant from benign tumors preoperatively. Seventy-one patients with the clinical diagnosis of a skin tumor were initially evaluated by ultrasonography. Then PDUS was performed and the presence and type of vascularity (peripheral or mixed) were investigated. Of the 19 benign and 52 malignant lesions, 3 could not be visualized with US. Forty-nine lesions were found to have vascularity (21 peripheral, 28 mixed-type) on PDUS. Of the malignant lesions, 26 showed mixed and 17 showed peripheral-type vascularity; for benign lesions these numbers were 2 and 4 respectively. The presence of vascularity correlated well with pathological behavior (malignant versus benign) (P = 0.00002), width (P = 0.0001), thickness (P = 0.001), dermal disruption (P = 0.0018), and subdermal extension (P = 0.002) of the tumor; however, the type of vascularity correlated only with thickness (P = 0.014). In relation to malignancy, the sensitivity of the presence of vascularity on PDUS was 88% and the specificity was 63%. These values were 93% and 40% respectively, for the mixed type of vascularity when it was accepted as a feature of malignancy. PDUS may help to distinguish malignant from benign skin tumors during preoperative evaluation.