Abstract
Melanoma is a melanocytic tumor that is responsible for the most skin cancer-related deaths. By contrast, seborrheic keratosis (SK) is a very common benign lesion with a clinical picture that may resemble melanoma. We used a multispectral imaging device to distinguish these two entities, with the use of autofluorescence imaging with 405 nm and diffuse reflectance imaging with 525 and 660 narrow-band LED illumination. We analyzed intensity descriptors of the acquired images. These included ratios of intensity values of different channels, standard deviation and minimum/maximum values of intensity of the lesions. The pattern of the lesions was also assessed with the use of particle analysis. We found significantly higher intensity values in SKs compared with melanoma, especially with the use of the autofluorescence channel. Moreover, we found a significantly higher number of particles with high fluorescence in SKs. We created a parameter, the SK index, using these values to differentiate melanoma from SK with a sensitivity of 91.9% and specificity of 57.0%. In conclusion, this imaging technique is potentially applicable to distinguish melanoma from SK based on the analysis of various quantitative parameters. For this application, multispectral imaging could be used as a screening tool by general physicians and non-experts in the everyday practice.
Highlights
Melanoma is a melanocytic tumor that is responsible for most skin cancer-related deaths [1,2]
Intensity Values In seborrheic keratosis (SK), both the AF/G, AF/R and Min/Max ratios proved to be significantly higher compared with the melanomas (Figures 2 and 3)
Disproportions in intensity values of the SK lesions resulted in significantly higher standard deviation (SD) compared with melanomas
Summary
Melanoma (malignant melanoma, MM) is a melanocytic tumor that is responsible for most skin cancer-related deaths [1,2]. There are various further imaging modalities for the diagnosis of skin tumors, such as high-frequency ultrasound [28,29], optical coherence tomography [30], reflectance confocal microscopy (RCM) [31] and multiphoton microscopy [32,33,34] These are very expensive and their availability is generally limited to large dermatology centers [35,36]. There is a subgroup of melanomas that appear very similar to SKs and, as new entities, are recently referred to as SK-like melanomas [18] They cannot be differentiated from SKs with the naked eye or are not even discernible with a dermoscope [37].
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