Abstract
Spectrophotometric intracutaneous analysis (SIAscopy) is an imaging technique developed for diagnostics of pigmented skin lesions. By image analysis, the displayed images indicate the potential distribution and position of melanin, blood, and collagen within the lesion. A topographic comparison was performed between SIAscopic findings and histopathology. In total, 60 patients with suspicious pigmented skin lesions were included. The lesions were SIAscopically imaged and documented before excision and histopathological preparation. Topographical comparisons between SIAscopy findings and histopathology were made. A sensitivity and specificity of 24% and 84%, respectively, were obtained for invasive melanomas. The positive and negative predicted values were 58% and 54%, respectively. The features indicating dermal melanin, blood displacement and collagen holes did only show "no" to "slight" agreement with histopathology, i.e., κ ≤ 0.21. It was concluded that (i) SIAscopy-based diagnosis has low diagnostic accuracy for melanoma, (ii) single SIAscopic features do not provide reliable diagnostic information relating to the lesions internal structure on histopathology examination and (iii) SIAscopy cannot be used as a guide for localizing the maximum tumor thickness when performing the histopathological examination. The importance of validating new optical tools for tumor diagnostics with histopathological findings was demonstrated.
Highlights
Clinical diagnosis of melanoma is difficult and there is a need for techniques that allow for noninvasive investigation of tumors, to facilitate early diagnosis
SIAscopy has been presented as a noninvasive tool to facilitate in vivo diagnosis of melanoma and significant findings were the presence of blood displacement with erythematous blush, collagen holes and presence of dermal melanin within the lesion
Topographical comparison between the individual SIAscopic features and histopathology reveals that the SIAscopic signals of melanin in the dermis, especially as a sign of tumor cells in the dermis, as well as blood displacement and collagen holes, often prove incorrect
Summary
Clinical diagnosis of melanoma is difficult and there is a need for techniques that allow for noninvasive investigation of tumors, to facilitate early diagnosis. Spectrophotometric intracutaneous analysis (SIAscopy), is a digital computerized colorimetric analysis technique developed for assisting diagnosis of pigmented skin lesions.. The technique is based on imaging the lesion in the visible and near-infrared wavelength region (400 to 1000 nm). Based on fitting the data into a mathematical model, the technique produces images indicating the distribution, location and quantity of melanin, blood and collagen within the tissue. SIAscopy has been presented as a noninvasive tool to facilitate in vivo diagnosis of melanoma and significant findings were the presence of blood displacement with erythematous blush, collagen holes and presence of dermal melanin within the lesion.
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