[In vivo differentiation of pigmented skin tumors with laser Doppler perfusion imaging].
OBJECTIVE
Malignant melanomas show a higher heterogeneity in their architecture and a higher vessel density because of neovascularization compared to benign melanocytic skin tumours. In this study the validity of the newly developed Laser Doppler Perfusion Imager (LDPI) with a lateral resolution of 100 microns in the differential diagnosis of pigmented skin tumours was investigated.


METHODS
The perfusion of 116 pigmented skin tumours was s measured with LDPI; 44 malignant melanomas, five melanoma metastases, 59 dysplastic nevi and eight basal cell carcinomas were studied before excision for precise histological diagnosis.


RESULTS
There is a significantly higher perfusion of the malignant melanomas (3.15 +/- 1.87 AU) compared to dysplastic nevi (1.14 +/- 0.97 AU) (p < 0.01). By calculating a ratio of the mean perfusion in the tumour and the mean perfusion in adjacent healthy skin, the potential source of error because of regional differences in perfusion is eliminated. The ratio of malignant melanomas (10.78 +/- 9.18) is significantly higher than these of melanoma metastases (4.20 +/- 1.66), basal cell carcinomas (3.24 +/- 1.32) and dysplastic nevi (2.85 +/- 1.32).


CONCLUSIONS
The high resolution LDPI has the potential to be a non-invasive screening method for preoperative differential diagnosis of pigmented skin tumours. Besides the epiluminescence microscopy and sonographic determination of the tumour thickness, we have now the possibility to get preoperative information about tumour vascularization.
Stücker
M
M
Klinik für Dermatologie und Allergologie, Ruhr-Universität Bochum, Gudrunstrasse 56, 44791 Bochum. M.Stuecker@derma.de
Hoffmann
M
M
Memmel
U
U
von Bormann
C
C
Hoffmann
K
K
Altmeyer
P
P
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002280:Basal Cell Carcinoma / Q000098:blood supply / Q000175:diagnosis* / Q000473:pathology; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000295:instrumentation*; D017078:Laser-Doppler Flowmetry / Q000295:instrumentation*; D008297:Male; D008545:Melanoma / Q000098:blood supply / Q000175:diagnosis* / Q000473:pathology; D008833:Microcirculation / Q000502:physiology; D008875:Middle Aged; D009389:Neovascularization, Pathologic / Q000175:diagnosis* / Q000473:pathology; D009508:Nevus, Pigmented / Q000098:blood supply / Q000175:diagnosis* / Q000473:pathology; D012680:Sensitivity and Specificity; D012867:Skin / Q000098:blood supply / Q000473:pathology; D012878:Skin Neoplasms / Q000098:blood supply / Q000175:diagnosis* / Q000473:pathology
In-vivo-Differenzierung von pigmentierten Hauttumoren mittels Laser-Doppler-Perfusion-Imaging.