PhD Scientific Days 2023

Clinical Medicine VI.

Comparison of Optically Guided High-Frequency Ultrasound and Multispectral Imaging for the Estimation of Tumor Thickness of Malignant Melanoma

Text of the abstract

Introduction: The incidence of malignant melanoma has shown a significant increase in recent decades. Histopathological evaluation after surgical excision is the gold standard method for diagnosing melanoma. Based on the Breslow thickness, the histologically confirmed tumor depth, the clinicians define the required staging procedures and surgical safety margins. However, Breslow thickness is not available at the time of the initial melanoma diagnosis. To date, novel imaging techniques have been introduced for the assessment of Breslow thickness, but no data is available to compare their efficacy.
Aims: In this work, we aimed to evaluate and compare the efficacy of optically guided high-frequency ultrasound (HFUS) and multispectral imaging (MSI) for the estimation of Breslow tumor thickness and tumor staging before surgery.
Method: In this study, we examined 80 patients with histologically verified primary melanoma. We created 3 subgroups of the patients according to tumor thickness, which also define the required safety margins: Breslow≤1 mm, 1-2 mm and >2 mm. We used an optically guided 33 MHz HFUS device (Dermus SkinScanner) and an MSI prototype to measure tumor thickness. Image analysis was performed using SkinAid (HFUS) and ImageJ (MSI) software.
Results: The used MSI algorithm allowed us to classify melanomas into the above-mentioned three subgroups with the sensitivity of 57.70% and the specificity of 78.80%. We compared these results to the performance of HFUS, which reached a sensitivity of 93.50% and specificity of 96.75%. Both correlations were significant, however HFUS showed a closer correlation with Breslow thickness than MSI (MSI: r: -0.6788; HFUS: r: 0.9706, p: <0.0001).
Conclusion: To the best of our knowledge, we were the first to analyze tumor thickness using MSI to classify melanomas into 3 subgroups of great clinical relevance. However, our novel optically guided HFUS reached higher sensitivity and specificity. Based on our findings, these novel imaging methods may help to estimate Breslow thickness prior to surgery to guide the further management of the patients.
Funding: This work was supported by grants from the EFOP-3.6.3-VEKOP-16-2017-00009 (N.N.V.), ÚNKP-22-2-III-SE-18 (N.N.V.), ÚNKP-22-4-II-SE-13 (N.K.) and the National Research, Development and Innovation Office of Hungary – NKFIH [FK131916, Semmelweis University, M.M.].