High‐frequency ultrasonography but not 930‐nm optical coherence tomography reliably evaluates melanoma thickness in vivo: a prospective validation study. (30th September 2014)

• Record Type: Journal Article
• Authors: Meyer, N.; Lauwers‐Cances, V.; Lourari, S.; Laurent, J.; Konstantinou, M.‐P.; Lagarde, J.‐M.; Krief, B.; Batatia, H.; Lamant, L.; Paul, C.
• Is Part Of: British journal of dermatology. Volume 171:Number 4(2014:Oct.)
• Page Start: 799
• Page End: 805
• Publication Date: 2014-09-30
• Subjects: Dermatology -- Periodicals; Skin -- Diseases -- Periodicals; 616.5
• DOI: 10.1111/bjd.13129
• Languages: English
• ISSNs: 0007-0963

Abstract

<abstract abstract-type="main" id="bjd13129-abs-0001"> <title>Summary</title> <sec id="bjd13129-sec-0001" sec-type="section"> <title>Background</title> <p>Early diagnosis and rapid surgical excision are essential for improving the prognosis of patients with melanoma. Reflectance confocal microscopy has been validated as a feasible procedure for <italic>in vivo</italic> diagnosis of melanoma but cannot be used to measure tumour thickness. However, ultrasonography and optical coherence tomography may allow melanoma thickness to be measured <italic>in vivo</italic>.</p> </sec> <sec id="bjd13129-sec-0002" sec-type="section"> <title>Objectives</title> <p>To validate the accuracy and reliability of high‐frequency ultrasonography (HFUS) and optical coherence tomography for assessing melanoma thickness <italic>in vivo</italic>.</p> </sec> <sec id="bjd13129-sec-0003" sec-type="section"> <title>Methods</title> <p>We conducted a prospective study on 131 patients with at least one equivocal melanocytic lesion. Each lesion underwent optical coherence tomography and HFUS assessment, followed by excision and pathological examination<bold>.</bold> Histopathology was considered to be the gold standard for assessing melanoma thickness. Repeatability, inter‐ and intrarater reproducibility and reliability were evaluated for each imaging procedure.</p> </sec> <sec id="bjd13129-sec-0004" sec-type="section"> <title>Results</title> <p>Ultrasonography showed a good level of agreement with histology [intraclass correlation coefficient (ICC) 0·807; 95% confidence interval (CI) 0·703–0·877] and excellent inter‐rater reproducibility (<italic>G </italic>=<italic> </italic>0·97), resulting in reliable <italic>in vivo</italic> assessment of melanoma thickness. The 930‐nm optical coherence tomography showed a poor level of agreement with histopathology (ICC 0·0; 95% CI −0·2–0·2) and the inter‐rater reproducibility was null (<italic>G </italic>=<italic> </italic>0·00).</p> </sec> <sec id="bjd13129-sec-0005" sec-type="section"> <title>Conclusions</title> <p>HFUS is a reliable and reproducible noninvasive method for assessing melanoma thickness. Routine use of HFUS may allow single‐step excision of equivocal melanocytic lesions, with surgical margins determined by <italic>in vivo</italic> assessment of tumour thickness.</p> </sec> </abstract>