Skin fluorescent imaging showed high sensitivity and specificity for the discrimination of low- and high-risk lesions, demonstrating an alternative, noninvasive approach to melanoma biopsies, according to findings from a phase II trial published in JAAD International.
“By identifying the molecular signals that drive melanoma early on, skin fluorescent imaging has the potential to help clinicians decide which suspicious lesions to biopsy while sparing patients unnecessary biopsies,” stated lead study author Douglas Grossman, MD, PhD, Co-leader of the Melanoma Center at Huntsman Cancer Institute and Professor of Dermatology at the University of Utah. “Skin fluorescent imaging is a promising step forward in noninvasive approaches to catching melanoma early and reducing biopsies of moles.”
Background and Study Methods
Skin fluorescent imaging is a noninvasive technology for the detection of αvβ3 integrin in the tumor microenvironment. Researchers assessed the efficacy of skin fluorescent imaging to differentiate benign from malignant melanocytic lesions in a prospective, single-arm, validation trial. The study included 240 clinically suspicious cutaneous pigmented lesions from six academic and community dermatology clinics in California, Utah, and Oregon, that were not yet biopsied.
Key Findings
Forty-one percent of the lesions did not have any dysplasia, 25% had nevi with low-grade dysplasia, 21% had nevi with high-grade dysplasia, 8.3% had melanoma in situ, and 4.6% were invasive melanoma.
Skin fluorescent imaging cutoff scores of 5 showed a sensitivity of 93% and a specificity of 77%; a cutoff score of 7 showed a sensitivity of 87% and a specificity of 91% for differentiating lesions with no or low-grade dysplasia from those with high-grade dysplasia or malignant melanoma.
The area under the receiver operating characteristic curve was 0.907 (95% confidence interval = 0.864–0.951; P < .0001).
“Many early melanomas and moles can have similar features,” Dr. Grossman said. “Skin fluorescent imaging offers a more targeted approach to melanoma screening, so that the lesions most likely to be melanoma can be biopsied."
DISCLOSURE: Dr. Grossman reported being on the clinical advisory board for Orlucent, Inc., and receiving an honorarium for his work. For full disclosures of the other study authors, visit jaadinternational.org.
