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

Chami L, Lassau N, Chebil M, Robert C - Clin Cosmet Investig Dermatol (2011)

Bottom Line: 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.

View Article: PubMed Central - PubMed

Affiliation: Imaging Department Institut Gustave Roussy, Villejuif, France;

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.

No MeSH data available.


Related in: MedlinePlus

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.
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f1-ccid-4-001: 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.

Mentions: Levovist, which in the early 2000s was the first ultrasound contrast medium used in France, displayed destructive imaging. This method requires significant acoustic power which leads to the destruction of microbubbles. Since 2003, the arrival of second-generation contrast media, eg, SonoVue® enables a new approach to imaging which is no longer a destructive mode but a real-time mode using a low mechanical index while preserving microbubbles. This approach has been made possible as a result of recent technologic developments that combine the advantages of harmonic imaging (in terms of resolution) with those of specific software (specific processing of microbubble signals). This new software can recover the high amplitude signal emitted by microbubbles in spite of nonvascular signals. The duration of the signal depends on the half-life of the microbubbles in the circulation. Real-time imaging allows accurate assessment of tumor enhancement with excellent spatial and temporal resolution, and provides time intensity curves (Figure 1).


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

Chami L, Lassau N, Chebil M, Robert C - Clin Cosmet Investig Dermatol (2011)

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.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3108283&req=5

f1-ccid-4-001: 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.
Mentions: Levovist, which in the early 2000s was the first ultrasound contrast medium used in France, displayed destructive imaging. This method requires significant acoustic power which leads to the destruction of microbubbles. Since 2003, the arrival of second-generation contrast media, eg, SonoVue® enables a new approach to imaging which is no longer a destructive mode but a real-time mode using a low mechanical index while preserving microbubbles. This approach has been made possible as a result of recent technologic developments that combine the advantages of harmonic imaging (in terms of resolution) with those of specific software (specific processing of microbubble signals). This new software can recover the high amplitude signal emitted by microbubbles in spite of nonvascular signals. The duration of the signal depends on the half-life of the microbubbles in the circulation. Real-time imaging allows accurate assessment of tumor enhancement with excellent spatial and temporal resolution, and provides time intensity curves (Figure 1).

Bottom Line: 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.

View Article: PubMed Central - PubMed

Affiliation: Imaging Department Institut Gustave Roussy, Villejuif, France;

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.

No MeSH data available.


Related in: MedlinePlus