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. 2011:4:1-6.
doi: 10.2147/CCID.S13499. Epub 2011 Feb 8.

Imaging of melanoma: usefulness of ultrasonography before and after contrast injection for diagnosis and early evaluation of treatment

Linda Chami  1 , Nathalie Lassau, Mohamed Chebil, Caroline Robert
Affiliations

Imaging of melanoma: usefulness of ultrasonography before and after contrast injection for diagnosis and early evaluation of treatment

Linda Chami et al. Clin Cosmet Investig Dermatol. 2011.

Abstract

High-frequency ultrasound (8-14 MHz) is routinely used to display cutaneous melanomas. Maximum thickness measurement (Breslow index) has been shown to be well correlated to histologic findings for lesions of more than 0.75 mm. Some morphological criteria (strong delineation, hypoechoic texture, homogeneity) have been reported to help differentiate between malignant and benign pigmented blue lesions, but remain insufficient. Vascular ultrasound analysis using Doppler mode provides additional information and showed good specificity for malignancy (90%-100%), but variable sensitivity (34%-100%). Recent advances in ultrasound imaging allow functional evaluation. Likewise, dynamic contrast-enhanced ultrasound using contrast medium injection and specific perfusion and quantification software showed promising results in clinical and preclinical trials for early prediction of tumor response to target treatments.

Keywords: dynamic contrast-enhanced ultrasound; melanoma; ultrasound.

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Figures

Figure 1
Figure 1
In left window, dynamic contrast-enhanced ultrasound evaluation of superficial skin melanoma after injection of contrast medium (SonoVue®) and using perfusion software (Vascular Recognition Imaging, Toshiba, Japan). Quantitative perfusion software (CHI-Q Laboratory, Toshiba, Japan) provides time intensity curve of enhancement (right window). Several perfusion parameters can be extracted after modelling, ie, maximum intensity, slope, area under wash-out, area under wash-in, time to peak, mean transit time.
Figure 2
Figure 2
In transit melanoma metastasis treated by isolated limb perfusion in a good responder. Ultrasound B mode (gray scale) scanning of superficial subcutaneous hypoechoic nodule of the right limb. A) Before treatment, the lesion was 14.8 mm in size. B) At day 1 after treatment no significant morphologic change was observed (14.2 mm). C) At day 7, the lesion shows a significant decrease in size (8.3 mm). D) In the same patient, after modelling, perfusion curves expressed as linear raw data show an important increase in perfusion parameters at day 1 after treatment compared with baseline.
See this image and copyright information in PMC

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