Abstract
With the increasing incidence of skin cancer, many noninvasive technologies to detect its presence have been developed. This review focuses on reflectance confocal microscopy (RCM), optical coherence tomography (OCT), high-frequency ultrasound (HFUS), electrical impedance spectroscopy (EIS), pigmented lesion assay (PLA), and Raman spectroscopy (RS) and discusses the basic principle, clinical applications, advantages, and disadvantages of each technology. RCM provides high cellular resolution and has high sensitivity and specificity for the diagnosis of skin cancer. OCT provides lower resolution than RCM, although its evaluable depth is deeper than that of RCM. RCM and OCT may be useful in reducing the number of unnecessary biopsies, evaluating the tumor margin, and monitoring treatment response. HFUS can be mainly used to delineate tumor depths or margins and monitor the treatment response. EIS provides high sensitivity but low specificity for the diagnosis of skin malignancies. PLA, which is based on the genetic information of lesions, is applicable for the detection of melanoma with high sensitivity and moderate-to-high specificity. RS showed high accuracy for the diagnosis of skin cancer, although more clinical studies are required. Advances in these technologies for the diagnosis of skin cancer can lead to the realization of optimized and individualized treatments.
Highlights
Skin cancer is by far the most common type of cancer
This study reported that reflectance confocal microscopy (RCM) could detect residual Basal cell carcinoma (BCC) with a sensitivity of 92.8% and specificity of 68.4% [20]
Another study that included eight superficial spreading melanomas and 20 nodular melanomas (NMs) found that the correlation between the tumor depth index measured using high-frequency ultrasound (HFUS) and that measured using histopathology was greater than 98%
Summary
Skin cancer is by far the most common type of cancer. Globally, its incidence has increased over the past decades, with more than 1.5 million cases, including non-melanoma skin cancers (NMSCs) and melanomas newly diagnosed in 2020 [1]. To minimize the frequency of invasive biopsy procedures and improve the diagnostic accuracy of skin cancer, many emerging noninvasive technologies have been developed as an alternative to skin biopsy. These technologies enable screening and sequential follow-up of multiple suspicious lesions without frequent biopsies, which is especially beneficial for patients with multiple atypical nevi or field cancerization. They have ushered in a new era of skin cancer diagnosis as they are combined with machine-based learning along with the development of computer science [7]. This review discusses the utility and limitations of these technologies for the detection of skin cancer, focusing on reflectance confocal microscopy (RCM), optical coherence tomography (OCT), high-frequency ultrasound (HFUS), electrical impedance spectroscopy (EIS), pigmented lesion assay (PLA), and Raman spectroscopy (RS)
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