Reflectance Confocal Microscopy and Electrical Impedance Spectroscopy in the Early Detection of Melanoma in Changing Lesions during Long-term Follow-up of Very High-risk Patients

Abstract

Electrical impedance spectroscopy has clinical relevance in diagnosing malignancy in melanocytic lesions. Sixty-eight lesions with changes during digital follow-up of patients at very high risk of developing melanoma were prospectively included in this study from February to December 2016. Electrical impedance spectroscopy and reflectance confocal microscopy were performed to evaluate their performance in this subset of difficult lesions. Forty-six lesions were considered suspicious on reflectance confocal microscopy and were excised, 19 were diagnosed as melanoma. Fifteen melanomas were detected by electrical impedance spectroscopy, while 4 received a score lower than 4, which suggested no malignancy. The addition of reflectance confocal microscopy improves accuracy while maintaining the same sensitivity. In the case of electrical impedance spectroscopy scores <4, lesions exhibiting changes in follow-up may need short-term monitoring or excision if dermoscopy shows criteria for melanoma. Results of electrical impedance spectroscopy in this subset of very early lesions should be carefully considered due to the risk of false negatives.

Diagnostics Using Non-Invasive Technologies in Dermatological Oncology

“…The results were compared to dermoscopy in a reader study, showing the superiority of Nevisense for medium level experienced dermatologists and similar for experts. Rocha et al showed that Nevisense could reduce the need for follow-up of suspicious lesions due to its good negative predictive values [ 111 ] However, in a recent study of atypical melanocytic lesions under digital follow-up of high-risk patients for melanoma, Chavez-Bourgeois et al showed that Nevisense may have lower sensitivity in early small melanomas which were undetectable on clinical and dermoscopic examination in this group of patients [ 112 ] The conclusion of these results is that although Nevisense showed high sensitivity in early melanoma in the pivotal study, the clinical context and population of patients may impact the outcome, as with every diagnostic method. In the future, the algorithms used in nevisense will need to consider patient’s risk factors and clinical situations ( Figure 13 ).…”