title: Sensitivity and specificity of multiphoton laser tomography for in vivo and ex vivo diagnosis of malignant melanoma.
abstract: The incidence of malignant melanoma has shown a dramatic increase over the past three decades. Patient outcome and curability depend on early diagnosis. In vivo multiphoton laser tomography represents a recently developed diagnostic tool that allows non-invasive tissue imaging. We aim to demonstrate the application of multiphoton laser tomography for the in vivo differentiation and diagnosis of melanoma. Laser radiation in the near infrared spectrum was used to image endogenous fluorophores by multiphoton excitation. Eighty-three melanocytic skin lesions have been investigated. The results showed distinct morphological differences in melanoma compared with melanocytic nevi. In particular, six characteristic features of malignant melanoma were specified and statistically evaluated. Sensitivity values up to 95% (range: 71-95%) and specificity values up to 97% (range: 69-97%) were achieved for diagnostic classification. Logistic regression analysis was performed to identify the most significant diagnostic criteria. We found that architectural disarray of the epidermis, poorly defined keratinocyte cell borders as well as the presence of pleomorphic or dendritic cells were of prime importance. By means of this procedure accuracy values up to 97% were reached. These findings underline the potential applicability of multiphoton laser tomography in melanoma diagnosis of melanocytic skin lesions.
authors.affiliation: Department of Dermatology and Allergology, University of Jena, Jena, Germany.
authors.forename: Enrico
authors.initials: E
authors.lastname: Dimitrow
authors.forename: Mirjana
authors.initials: M
authors.lastname: Ziemer
authors.forename: Martin Johannes
authors.initials: MJ
authors.lastname: Koehler
authors.forename: Johannes
authors.initials: J
authors.lastname: Norgauer
authors.forename: Karsten
authors.initials: K
authors.lastname: König
authors.forename: Peter
authors.initials: P
authors.lastname: Elsner
authors.forename: Martin
authors.initials: M
authors.lastname: Kaatz
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D002648:Child; D002675:Child, Preschool; D003713:Dendritic Cells / Q000473:pathology; D005260:Female; D006801:Humans; D007834:Lasers; D016015:Logistic Models; D008297:Male; D008544:Melanocytes / Q000473:pathology; D008545:Melanoma / Q000175:diagnosis*; D036641:Microscopy, Fluorescence, Multiphoton / Q000592:standards* / Q000706:statistics & numerical data; D008875:Middle Aged; D009508:Nevus, Pigmented / Q000175:diagnosis; D015588:Observer Variation; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012878:Skin Neoplasms / Q000175:diagnosis*; D014054:Tomography / Q000592:standards* / Q000706:statistics & numerical data; D055815:Young Adult