Impact of electrical impedance spectroscopy on dermatologists' number needed to biopsy metric and biopsy decisions for pigmented skin lesions

Litchman, Graham; Teplitz, Rebeca W.; Marson, Justin W.; Rigel, Darrell S.

doi:10.1016/j.jaad.2020.09.011

Cited by 7 publications

(7 citation statements)

References 5 publications

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“…EIS scores elevated the biopsy sensitivity of students close to that of dermatologists with images alone, suggesting particular value of EIS for novice diagnosticians. Moreover, this improvement in diagnostic accuracy among medical students is consistent with recent studies where the addition of EIS scores to clinical images alone increased diagnostic accuracy for novice diagnosticians, including trainees and midlevel practitioners [14][15][16] . Among the pigmented lesions specialists, the addition of an EIS score resulted in a trend toward improved accuracy of diagnosis, but it did not reach statistical significance.…”

Section: Resultssupporting

confidence: 88%

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Impact of Electrical Impedance Spectroscopy on Clinician Confidence and Diagnostic Accuracy in Evaluating Melanocytic Skin Lesions Suspicious for Melanoma: A Pilot Study

et al. 2022

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Introduction: Nevisense is a non-invasive device that measures electrical impedance spectroscopy (EIS) of individual skin lesions to aid in the diagnosis of melanoma. While EIS has demonstrated high sensitivity in diagnosing melanoma, its impact on a clinician’s diagnostic confidence remains unknown. Objective: To conduct a pilot study to evaluate whether clinician diagnostic confidence, sensitivity, specificity and accuracy can be increased by adding EIS measurement scores to clinical and dermoscopic images of lesions clinically suspicious for melanoma. Methods: Three pigmented lesions specialists and three 4th year medical students completed an online survey to evaluate 34 melanocytic lesions suspicious for melanoma. For each lesion, participants provided their diagnosis, biopsy recommendation, and confidence in diagnosing a lesion as benign or malignant based on history and clinical and dermoscopic images, and again after receiving an EIS score. Results: Addition of EIS scores increased mean biopsy sensitivity for melanoma/severely dysplastic nevi from 70% to 84% (p = .014) and mean diagnostic accuracy from 74% to 86% (p = .005). Mean diagnostic confidence increased for all histopathologic categories for both students and dermatologists (all p < .05). Conclusions: In this pilot study, EIS increased novice and expert diagnosticians’ confidence regarding dermoscopically equivocal melanocytic lesions. Further studies are needed to explore how EIS can help clinicians reassure patients regarding the management of clinically dysplastic melanocytic nevi.

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Section: Resultssupporting

confidence: 88%

“…The addition of EIS scores to clinical images resulted in more accurate biopsy decisionmaking by clinicians in survey studies. [14][15][16] . To date, however, the impact of EIS scores on clinician confidence in diagnosing lesions as benign or malignant remains unknown.…”

mentioning

confidence: 99%

Impact of Electrical Impedance Spectroscopy on Clinician Confidence and Diagnostic Accuracy in Evaluating Melanocytic Skin Lesions Suspicious for Melanoma: A Pilot Study

et al. 2022

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“…In addition, the diagnostic accuracy improved with the additional EIS examination, which resulted in a reduction in the number of biopsies of benign lesions [96]. Similarly, including EIS examination in the clinical decision-making process significantly decreased the number needed to biopsy from 6.3 to 5.3 in another recent study [97]. Melanomas present in the extremities and trunk were better detected using EIS (sensitivity of 91% and specificity of 64%) than those located at the head and neck region [95].…”

Section: Melanomamentioning

confidence: 92%

Emerging Minimally Invasive Technologies for the Detection of Skin Cancer

Jung

Cho

Lee

et al. 2021

JPM

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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.

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“…These devices (Nevisense, MarginProbe, ZedScan) can discriminate healthy tissues from cancerous tissues (respectively, skin, breast and cervical) with high sensitivity and specificity. [71][72][73] The EIS-based devices use multiple sensors which are in direct contact with the tissue to be probed, avoiding electrical noise coming from other biological components interposed between the electrodes and the tissue itself. This enhances the capability of detecting the electrical properties of the tissues that reflect its morphological and pathological structure.…”

Section: Bioimpedance: Basicsmentioning

confidence: 99%

“…SciBase, Dilon Technologies, Zilico, are some of the companies that developed medical devices with CE and/or FDA (US Food and Drug Administration) approval. These devices (Nevisense, MarginProbe, ZedScan) can discriminate healthy tissues from cancerous tissues (respectively, skin, breast and cervical) with high sensitivity and specificity 71–73. The EIS-based devices use multiple sensors which are in direct contact with the tissue to be probed, avoiding electrical noise coming from other biological components interposed between the electrodes and the tissue itself.…”

Section: Introductionmentioning

confidence: 99%

Characterising acute ischaemic stroke thrombi: insights from histology, imaging and emerging impedance-based technologies

et al. 2022

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Treatment of acute ischaemic stroke (AIS) focuses on rapid recanalisation of the occluded artery. In recent years, advent of mechanical thrombectomy devices and new procedures have accelerated the analysis of thrombi retrieved during the endovascular thrombectomy procedure. Despite ongoing developments and progress in AIS imaging techniques, it is not yet possible to conclude definitively regarding thrombus characteristics that could advise on the probable efficacy of thrombolysis or thrombectomy in advance of treatment. Intraprocedural devices with dignostic capabilities or new clinical imaging approaches are needed for better treatment of AIS patients. In this review, what is known about the composition of the thrombi that cause strokes and the evidence that thrombus composition has an impact on success of acute stroke treatment has been examined. This review also discusses the evidence that AIS thrombus composition varies with aetiology, questioning if suspected aetiology could be a useful indicator to stroke physicians to help decide the best acute course of treatment. Furthermore, this review discusses the evidence that current widely used radiological imaging tools can predict thrombus composition. Further use of new emerging technologies based on bioimpedance, as imaging modalities for diagnosing AIS and new medical device tools for detecting thrombus composition in situ has been introduced. Whether bioimpedance would be beneficial for gaining new insights into in situ thrombus composition that could guide choice of optimum treatment approach is also reviewed.

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Impact of electrical impedance spectroscopy on dermatologists' number needed to biopsy metric and biopsy decisions for pigmented skin lesions

Cited by 7 publications

References 5 publications

Impact of Electrical Impedance Spectroscopy on Clinician Confidence and Diagnostic Accuracy in Evaluating Melanocytic Skin Lesions Suspicious for Melanoma: A Pilot Study

Impact of Electrical Impedance Spectroscopy on Clinician Confidence and Diagnostic Accuracy in Evaluating Melanocytic Skin Lesions Suspicious for Melanoma: A Pilot Study

Emerging Minimally Invasive Technologies for the Detection of Skin Cancer

Characterising acute ischaemic stroke thrombi: insights from histology, imaging and emerging impedance-based technologies

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