The vascular morphology of melanoma is related to Breslow index: An in vivo study with dynamic optical coherence tomography

BackgroundMalignant melanoma is an aggressive skin cancer, which can lead to metastasis development. Vascularization enhancement is fundamental for tumor growth, worsening the prognosis. Dynamic optical coherence tomography (D-OCT) enables the in vivo evaluation of vascular patterns in skin lesions.ObjectiveMethodsIn vivo evaluation of the melanoma vessel morphology by means of D-OCT and correlation with Breslow index.Retrospective analysis of histologically proven melanomas, evaluated by D-OCT at three different depths (150, 300 and 500m), was performed. Vessels were classified according to morphology (dots, blobs, coiled, line, curved, serpiginous), distribution (regular, irregular) and the presence/type of branches. The data were correlated with Breslow thickness.ResultsLimitationsA total of 127 melanomas were evaluated. Dotted vessels were recorded at all depths, and their irregular distribution was associated with lesions thicker than 1.0mm (from 75% to 91%), compared with thin ones (42%) at 150m (P=0.031), and from 33% to 57% vs 18% at 300m (P=0.021). Serpiginous and branching vessels with bulges were predominantly seen in melanomas thicker than 2mm at 150m (from 14% to 27%, P<0.001) and 300m of depth (from 36% to 54%, P<0.001).Background noise hampered vessel detection at 500m. No correlation with dermoscopy/histology.ConclusionVascular pattern evaluation at 150 and 300m provided data on tumor microvascular asset and its pattern of progression in accordance with Breslow thickness. Since vascular progression is theoretically linked with tumor aggressiveness, the study of vascular pattern related with melanoma metastatization capability is warranted.