Assessment of the optimal interval for and sensitivity of short-term sequential digital dermoscopy monitoring for the diagnosis of melanoma.
OBJECTIVE
To determine whether 6 weeks could replace 3 months for short-term sequential digital dermoscopy imaging (ST-SDDI) of suspicious melanocytic lesions and determine the proportion of melanomas missed.


METHODS
Consecutive lesions (n = 2602) undergoing ST-SDDI monitored from 1859 patients were included. Half of the patients underwent 6-week monitoring followed by 3-month monitoring (range, 2.5-4.5 months) if changes were not seen. The remainder underwent 3-month monitoring only. Any change during this time led to excision. Lesions unchanged were then followed up over time.


METHODS
A tertiary referral institution.


METHODS
The proportion of changed melanomas (sensitivity) and odds ratios (ORs) for melanoma of changed lesions.


RESULTS
Eighty-one melanomas were detected using ST-SDDI (Breslow thickness: median, in situ; maximum, 0.8 mm). Of 39 melanomas detected using ST-SDDI in the 6-week monitored lesions, 27 (69%) were detected at 6 weeks and 12 (31%) at 3 months. The OR for melanoma for a lesion changing at 6 weeks was 19 (95% confidence interval [CI], 10-35), and the overall OR for melanoma for a lesion changing during the short-term monitoring period (6 weeks to 4.5 months) was 47 (95% CI, 23-94). For lesions remaining unchanged at 3 months, 99.2% (1118 of 1127 lesions) were shown to be benign as defined by an unremarkable further follow-up. Seventy-five percent (15 of 20) of the lentigo maligna melanomas, 93% (40 of 43) of other in situ melanomas, and 96% (26 of 27) of the invasive melanomas were detected using ST-SDDI. Conclusion Three months remains the standard interval for ST-SDDI, where the sensitivity for the diagnosis of melanoma for changed (non-lentigo maligna) lesions is high but not 100%.
Altamura
Davide
D
Sydney Melanoma Diagnostic Centre, Sydney Cancer Centre, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia.
Avramidis
Michelle
M
Menzies
Scott W
SW
D001185:Artificial Intelligence; D002278:Carcinoma in Situ / Q000175:diagnosis / Q000473:pathology; D002471:Cell Transformation, Neoplastic / Q000473:pathology; D046169:Dermoscopy; D004416:Dysplastic Nevus Syndrome / Q000175:diagnosis / Q000473:pathology; D005500:Follow-Up Studies; D006801:Humans; D018327:Hutchinson's Melanotic Freckle / Q000175:diagnosis / Q000473:pathology; D007091:Image Processing, Computer-Assisted; D008545:Melanoma / Q000175:diagnosis*; D009361:Neoplasm Invasiveness; D016017:Odds Ratio; D012680:Sensitivity and Specificity; D012867:Skin / Q000473:pathology; D012878:Skin Neoplasms / Q000175:diagnosis* / Q000473:pathology; D012985:Software Design