Utility of high-resolution ultrasonography and colour Doppler in the assessment of pigmented skin lesions

Abstract

Introduction This study evaluated the role of high-resolution ultrasonography in the assessment of pigmented skin lesions in correlation with clinico-pathological findings to predict malignant potential with high sensitivity and specificity. Methods A prospective cross-sectional study was carried out in 124 cases of pigmented skin lesions by using variable frequency (6–18 MHz) high-resolution ultrasonography and colour Doppler over a period of 14 months in Central Hospital, South Central Railway, Hyderabad, India. The correlation between sonographic parameters (greyscale imaging characteristics and vascular flow on colour Doppler) and pathological parameters (malignant and benign) were statistically analysed. Results For predicting malignancy, the presence of vascular flow on colour Doppler had good overall accuracy, specificity and negative predictive value but relatively low sensitivity and positive predictive value (respectively, 91%, 94%, 94%, 81% and 78%). However, greyscale imaging characteristics to predict malignancy had low overall accuracy, specificity and positive predictive value but high sensitivity and negative predictive value (respectively, 54%, 34%, 26%, 85% and 89%). There was a significant positive association between vascular flow on Doppler and malignancy ( P = 0.0001) but the correlation between greyscale imaging findings and malignancy is not statistically significant ( P = 0.0603 ). Conclusions High-resolution sonographic imaging is useful in non-invasive monitoring of pigmented lesions at risk and screening of pigmented lesions suspected of malignancy to give relevant information about the extent and nature of the disease and to stratify the high risk cases for surveillance and planning of the treatment.