Verification of new method for automatic thickness measurement of melanocytic skin tumours by high frequency ultrasound

Histological thickness of cutaneous melanoma (CM), known as the Breslow index (pT), represents the most important prognostic factor. The objective of this study is to evaluate the reliability of automatic algorithm based on B-scan image processing of 22 MHz ultrasound (US) for measuring the thickness of CM and melanocytic nevi (MN). The thickness of CM (n = 54) and MN (n = 91) has been measured manually (mT) and automatically (aT) using an algorithm based on B-scan image processing of 22 MHz US. All melanocytic skin tumours (MST) were surgically excised and their histological thicknesses (pT) according to Breslow were evaluated. The investigated parameters were expressed as medians with interquartile range (IQR) because of their asymmetric distribution, Spearman’s correlation coefficient was determined as well. An agreement between values of mT/aT and mT/pT was evaluated by using the Bland-Altman plots. We found a good agreement of aT and mT with the moderate bias of 0.08 mm and relatively small range (95 % CI –0.01 to 0.18) in CM, accordingly 0.03 mm (95 % CI 0.00 to 0.07 mm) regarding MN. The medians of mT/pT in cases of CM and MN were 0.96 mm (IQR: 0.65-1.52) / 0.97 (IQR: 0.66-1.62) and 0.51 mm (IQR: 0.37-0.67) / 0.69 mm (IQR: 0.46-1.01) respectively. The parameters of the thickness correlated better in CM (r = 0.86) than in MN (r = 0.64) cases. The difference between manual (mT) and automatic (aT) measurements while evaluating the thickness of MST was non-significant. Therefore, automatic algorithm based on B-scan image processing of 22 MHz US is a reliable tool for measuring the thickness of MST by less experienced operators.

[1]  C. Catricalà,et al.  High frequency ultrasound in the preoperative staging of primary melanoma: a statistical analysis , 2002, Melanoma research.

[2]  R Kazys,et al.  Principles of high‐frequency ultrasonography for investigation of skin pathology , 2011, Journal of the European Academy of Dermatology and Venereology : JEADV.

[3]  S. Koscielny,et al.  Prognostic value of angiogenesis evaluated with high-frequency and colour Doppler sonography for preoperative assessment of primary cutaneous melanomas: correlation with recurrence after a 5 year follow-up period , 2006, Cancer imaging : the official publication of the International Cancer Imaging Society.

[4]  C. Sander,et al.  Dermatoscopy and high frequency sonography: two useful non-invasive methods to increase preoperative diagnostic accuracy in pigmented skin lesions. , 1998, Pigment cell research.

[5]  Jacobo Wortsman,et al.  Clinical usefulness of variable-frequency ultrasound in localized lesions of the skin. , 2010, Journal of the American Academy of Dermatology.

[6]  Bruno Giraudeau,et al.  Preoperative measurement of thickness of cutaneous melanoma using high-resolution 20 MHz ultrasound imaging: A monocenter prospective study and systematic review of the literature. , 2009, Ultrasound in medicine & biology.

[7]  M. Hočevar,et al.  Pre‐operative ultrasound with a 12–15 MHz linear probe reliably differentiates between melanoma thicker and thinner than 1 mm , 2010, Journal of the European Academy of Dermatology and Venereology : JEADV.

[8]  M. Weichenthal,et al.  The velocity of ultrasound in human primary melanoma tissue - implications for the clinical use of high resolution sonography , 2001, BMC dermatology.

[9]  R. Scolyer,et al.  Breslow Thickness Measurements of Melanomas Around American Joint Committee on Cancer Staging Cut-Off Points: Imprecision and Terminal Digit Bias Have Important Implications for Staging and Patient Management , 2016, Annals of Surgical Oncology.

[10]  S. Koscielny,et al.  Prognostic value of high-frequency sonography and color Doppler sonography for the preoperative assessment of melanomas. , 1999, AJR. American journal of roentgenology.

[11]  S. Haeri,et al.  Intrahepatic Persistent Right Umbilical Vein and Associated Outcomes , 2016, Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine.

[12]  A. Martorell,et al.  Guidelines for Performing Dermatologic Ultrasound Examinations by the DERMUS Group , 2016, Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine.

[13]  M. Schmid-Wendtner,et al.  Ultrasound technology in dermatology. , 2008, Seminars in cutaneous medicine and surgery.

[14]  M. Elon Gale,et al.  DICOM Modality Worklist: An essential component in a PACS environment , 2000, Journal of Digital Imaging.

[15]  David H. Douglas,et al.  ALGORITHMS FOR THE REDUCTION OF THE NUMBER OF POINTS REQUIRED TO REPRESENT A DIGITIZED LINE OR ITS CARICATURE , 1973 .

[16]  D. Altman,et al.  Measuring agreement in method comparison studies , 1999, Statistical methods in medical research.

[17]  S. Seidenari,et al.  Preoperative melanoma thickness determination by 20-MHz sonography and digital videomicroscopy in combination. , 2003, Archives of dermatology.

[18]  Wilhelm Burger,et al.  Digital Image Processing - An Algorithmic Introduction using Java , 2008, Texts in Computer Science.

[19]  M. Delfino,et al.  High-resolution color-Doppler ultrasound for the study of skin growths , 2015, Archives of Dermatological Research.

[20]  V. Muse,et al.  An automated PACS workstation interface: a timesaving enhancement. , 2000, AJR. American journal of roentgenology.

[21]  Dorothee Dill-Müller,et al.  Ultrasonography in dermatology , 2007, Journal der Deutschen Dermatologischen Gesellschaft = Journal of the German Society of Dermatology : JDDG.

[22]  L. Lenghel,et al.  Assessment of Cutaneous Melanoma by Use of Very- High-Frequency Ultrasound and Real-Time Elastography. , 2016, AJR. American journal of roentgenology.

[23]  H. Koga,et al.  High-frequency 30-MHz sonography in preoperative assessment of tumor thickness of primary melanoma: usefulness in determination of surgical margin and indication for sentinel lymph node biopsy , 2009, International Journal of Clinical Oncology.

[24]  Samuel M. Nagle,et al.  Challenges and Regulatory Considerations in the Acoustic Measurement of High‐Frequency (>20 MHz) Ultrasound , 2013, Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine.

[25]  Matti Pietikäinen,et al.  Adaptive document image binarization , 2000, Pattern Recognit..

[26]  F. Amzica,et al.  Ultrasonographic staging of cutaneous malignant tumors: an ultrasonographic depth index , 2013, Archives of Dermatological Research.

[27]  J. Lagarde,et al.  High‐frequency ultrasonography but not 930‐nm optical coherence tomography reliably evaluates melanoma thickness in vivo: a prospective validation study , 2014, The British journal of dermatology.

[28]  T. de Baère,et al.  Prognostic value of angiogenesis evaluated with high-frequency and color Doppler sonography for preoperative assessment of melanomas. , 2002, AJR. American journal of roentgenology.

[29]  R. Raišutis,et al.  Automated Estimation of Melanocytic Skin Tumor Thickness by Ultrasonic Radiofrequency Data , 2016, Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine.

[30]  D. Miller,et al.  Determining skin thickness with pulsed ultra sound. , 1979, The Journal of investigative dermatology.

[31]  Michael Vogt,et al.  Preoperative Ultrasonic Assessment of Thin Melanocytic Skin Lesions Using a 100‐MHz Ultrasound Transducer: A Comparative Study , 2007, Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.].

[32]  J. Pundzius,et al.  Measurement of melanoma thickness--comparison of two methods: ultrasound versus morphology. , 2011, Journal of plastic, reconstructive & aesthetic surgery : JPRAS.

[33]  S. Menzies,et al.  Melanoma histological Breslow thickness predicted by 75‐MHz ultrasonography , 2008, The British journal of dermatology.

[34]  S. Koscielny,et al.  High-frequency sonography and color Doppler in the management of pigmented skin lesions. , 2003, Ultrasound in medicine & biology.

[35]  Ximena Wortsman,et al.  Common Applications of Dermatologic Sonography , 2012, Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine.