Vascularity in cutaneous melanoma detected by Doppler sonography and histology: correlation with tumour behaviour

The blood flow in 71 primary skin melanomas was investigated by a 10MHz Doppler ultrasound flowmeter and flow signals were analysed on an Angioscan-II spectrum analyser. Doppler flow signals were detected in 44 tumours, with a close relationship to Breslow's tumour thickness. No blood flow signal was detected in 27 lesions and 25 of these had a tumour thickness of 0.8 mm or less. Ninety-seven per cent of tumours of thickness greater than 0.8 mm had detectable Doppler flow signals. Histological assessment of vascularity by Ulex europaeus agglutinin 1 lectin staining showed a high vascularity at the tumour base of Doppler positive lesions. The vascularity quantified by measurement on an IBAS-2 image analyser correlated well with the blood flow demonstrated by Doppler ultrasound. This study indicates the development of a neovascular bed as the tumour thickness approaches 0.8 mm. Doppler signal analysis revealed higher peak and mean systolic frequencies over melanomas associated with regional or systemic spread than flow signals from melanomas of patients remaining disease-free for 2 years.