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Use of High-Frequency Ultrasound in Preoperative Assessment of Melanoma

By: Victoria Kuhr, MS
Posted: Tuesday, May 14, 2024

Jennifer Powers, MD, of the University of Iowa Hospitals and Clinics, Iowa City, and colleagues found that high-frequency ultrasound (HFUS) may serve as a valuable supplementary tool for preoperatively assessing melanoma because of its increased accuracy in thicker tumors. Additionally, the researchers reported that sonographic frequencies lower than 20 MHz tended to be less reliable in assessing tumor depth, and frequencies higher than 70 MHz may have stronger correlations with histopathology. These findings were presented at the 2024 American Academy of Dermatology (AAD) Annual Meeting (Poster 50732).

The study authors conducted a systematic review of publications written in English within PubMed, CINAHL, Embase, Clarivate, and Cochrane electronic databases in March 2023. Inclusion criteria included receipt of preoperative HFUS (more than 10 MHz) melanoma measurements, performance of melanoma biopsy or an excision, and a reported tumor depth correlation coefficient between HFUS and histopathology. Of the 1,197 articles initially identified, 36 studies met the inclusion criteria and were included in the review.

Of the 2,093 melanomas imaged, most were on the trunk and head or face. The most common melanomas imaged were those with superficial spreading. The maximum ultrasound frequencies across studies ranged from 13 MHz to 100 MHz, and the number of tumors across studies ranged from 5 to 264. The correlation coefficients between HFUS and histopathology ranged from 0.417 to 0.997, with a median of 0.94, a mean of 0.89, and a standard deviation of 0.13. Overall, lower-frequency probes (< 20 MHz) seemed to be less accurate in assessing melanoma thickness when compared with higher-frequency probes (> 70 MHz), with a cumulative mean correlation coefficient of 0.828 vs 0.927 (20–25 MHz) and 0.967 (> 70 MHz). From the studies reviewed, the investigators noted higher accuracy of HFUS in preoperative staging and defining surgical margins in melanomas larger than 0.75 mm.

Disclosure: For full disclosures of the study authors, visit

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