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Prognostic Value of Angiogenesis Evaluated with High-Frequency and Color Doppler Sonography for Preoperative Assessment of Melanomas

Nathalie Lassau1, Serge Koscielny2, Marie-Françoise Avril3, Alvaro Margulis4, Pierre Duvillard5, Thierry de Baere1, Alain Roche1 and Jérome Leclère1

1 Department of Medical Imaging, Ultrasonography Unit, Institut Gustave Roussy, 39 rue Camille Desmoulins, 94805 Villejuif, France.
2 Department of Biostatistics, Institut Gustave Roussy, 94805 Villejuif, France.
3 Department of Medicine, Institut Gustave Roussy, 94805 Villejuif, France.
4 Department of Surgery, Institut Gustave Roussy, 94805 Villejuif, France.
5 Department of Pathology, Institut Gustave Roussy, 94805 Villejuif, France.



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  		Fig. 1. —67-year-old man with melanoma. High-frequency sonogram shows tumor measuring 2.55 mm in thickness (2.2 mm on Breslow index [1]).

 


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  		Fig. 2. —Graph shows correlation between sonographic and histologic measurements of tumor thickness in 69 melanomas.

 


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  		Fig. 3. —43-year-old woman with poorly vascularized melanoma. Color Doppler sonograms reveals poor vascularization (only one vessel). Tumor measured 2.51 mm in thickness on high-frequency sonographic scan (2.1 mm on Breslow index [1]).

 


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  		Fig. 4. —43-year-old man with vascularized melanoma who subsequently developed metastases. Color Doppler sonogram reveals abundant vascularization (> one vessel). Tumor measured 3.85 mm in thickness on Breslow index [1].

 


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  		Fig. 5. —Graph of Kaplan-Meier curves indicates occurrence of metastases as function of vascularization depicted in melanomas at color Doppler sonography (p<0.001). Solid line (proportion = 1.0) represents melanomas with no vessels present, line with short dashes represents presence of one vessel, and line with long dashes represents presence of more than one vessel.

 


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  		Fig. 6. —Graph of Kaplan-Meier curves indicates occurrence of metastases as function of Breslow melanoma index [1] (p<0.001). Solid line (proportion = 1.0) represents lesions thinner than 1 mm, line with short dashes represents lesions 1-4 mm in thickness, and line with long dashes represents lesions thicker than 4 mm.

 

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