Verification of new method for automatic thickness measurement of melanocytic skin tumours by high frequency ultrasound

Histological thickness of cutaneous melanoma (CM), known as the Breslow index (pT), represents the most important prognostic factor. The objective of this study is to evaluate the reliability of automatic algorithm based on B-scan image processing of 22 MHz ultrasound (US) for measuring the thickness of CM and melanocytic nevi (MN). The thickness of CM (n = 54) and MN (n = 91) has been measured manually (mT) and automatically (aT) using an algorithm based on B-scan image processing of 22 MHz US. All melanocytic skin tumours (MST) were surgically excised and their histological thicknesses (pT) according to Breslow were evaluated. The investigated parameters were expressed as medians with interquartile range (IQR) because of their asymmetric distribution, Spearman’s correlation coefficient was determined as well. An agreement between values of mT/aT and mT/pT was evaluated by using the Bland-Altman plots. We found a good agreement of aT and mT with the moderate bias of 0.08 mm and relatively small range (95 % CI –0.01 to 0.18) in CM, accordingly 0.03 mm (95 % CI 0.00 to 0.07 mm) regarding MN. The medians of mT/pT in cases of CM and MN were 0.96 mm (IQR: 0.65-1.52) / 0.97 (IQR: 0.66-1.62) and 0.51 mm (IQR: 0.37-0.67) / 0.69 mm (IQR: 0.46-1.01) respectively. The parameters of the thickness correlated better in CM (r = 0.86) than in MN (r = 0.64) cases. The difference between manual (mT) and automatic (aT) measurements while evaluating the thickness of MST was non-significant. Therefore, automatic algorithm based on B-scan image processing of 22 MHz US is a reliable tool for measuring the thickness of MST by less experienced operators

Verification of new method for automatic thickness measurement of melanocytic skin tumours by high frequency ultrasound

Histological thickness of cutaneous melanoma (CM), known as the Breslow index (pT), represents the most important prognostic factor. The objective of this study is to evaluate the reliability of automatic algorithm based on B-scan image processing of 22 MHz ultrasound (US) for measuring the thickness of CM and melanocytic nevi (MN). The thickness of CM (n = 54) and MN (n = 91) has been measured manually (mT) and automatically (aT) using an algorithm based on B-scan image processing of 22 MHz US. All melanocytic skin tumours (MST) were surgically excised and their histological thicknesses (pT) according to Breslow were evaluated. The investigated parameters were expressed as medians with interquartile range (IQR) because of their asymmetric distribution, Spearman’s correlation coefficient was determined as well. An agreement between values of mT/aT and mT/pT was evaluated by using the Bland-Altman plots. We found a good agreement of aT and mT with the moderate bias of 0.08 mm and relatively small range (95 % CI –0.01 to 0.18) in CM, accordingly 0.03 mm (95 % CI 0.00 to 0.07 mm) regarding MN. The medians of mT/pT in cases of CM and MN were 0.96 mm (IQR: 0.65-1.52) / 0.97 (IQR: 0.66-1.62) and 0.51 mm (IQR: 0.37-0.67) / 0.69 mm (IQR: 0.46-1.01) respectively. The parameters of the thickness correlated better in CM (r = 0.86) than in MN (r = 0.64) cases. The difference between manual (mT) and automatic (aT) measurements while evaluating the thickness of MST was non-significant. Therefore, automatic algorithm based on B-scan image processing of 22 MHz US is a reliable tool for measuring the thickness of MST by less experienced operators

Diffuse Leptomeningeal Glioneuronal Tumour with 9-Year Follow-Up: Case Report and Review of the Literature

In 2016, the World Health Organisation Classification (WHO) of Tumours was updated with diffuse leptomeningeal glioneuronal tumour (DLGNT) as a provisional unit of mixed neuronal and glial tumours. Here, we report a DLGNT that has been re-diagnosed with the updated WHO classification, with clinical features, imaging, and histopathological findings and a 9-year follow-up. A 16-year-old girl presented with headache, vomiting, and vertigo. Magnetic resonance imaging (MRI) demonstrated a hyperintense mass with heterogenous enhancement in the right cerebellopontine angle and internal auditory canal. No leptomeningeal involvement was seen. The histological examination revealed neoplastic tissue of moderate cellularity formed mostly by oligodendrocyte-like cells. Follow-up MRI scans demonstrated cystic lesions in the subarachnoid spaces in the brain with vivid leptomeningeal enhancement. Later spread of the tumour was found in the spinal canal. On demand biopsy samples were re-examined, and pathological diagnosis was identified as DLGNT. In contrast to most reported DLGNTs, the tumour described in this manuscript did not present with diffuse leptomeningeal spread, but later presented with leptomeningeal involvement in the brain and spinal cord. Our case expands the spectrum of radiological features, provides a long-term clinical and radiological follow-up, and highlights the major role of molecular genetic testing in unusual cases