Diagnostics
Beyond Breslow Thickness: Reproducibility and Histopathologic Concordance of Ultra-High-Frequency Ultrasound in Primary Cutaneous Melanoma
By Anna Russo, Vittorio Patanè, Annalisa Di Maio and 5 others.
Abstract
Background
Ultra-high-frequency ultrasound (UHFUS) provides high-resolution assessment of superficial skin lesions, but evidence in melanoma has largely focused on preoperative thickness estimation. We evaluated the reproducibility of a structured UHFUS assessment and its histopathologic concordance in primary cutaneous melanoma.
Methods
This single-center retrospective study included 320 treatment-naïve, histologically confirmed primary cutaneous melanomas examined with UHFUS (48–70 MHz) before excision. Two experienced radiologists independently assessed tumor thickness, horizontal diameter, surface discontinuity, deepest involved compartment, boundary definition, morphology, echostructure, and separate perilesional hypoechoic foci. Histopathology served as the reference standard. Reproducibility was assessed using ICC and κ statistics; UHFUS–Breslow agreement was evaluated using Lin’s concordance correlation coefficient (CCC) and Bland–Altman analysis.