Paired comparison of the sensitivity and specificity of multispectral digital skin lesion analysis and reflectance confocal microscopy in the detection of melanoma in vivo: A cross-sectional study.
BACKGROUND
Several technologies have been developed to aid dermatologists in the detection of melanoma in vivo including dermoscopy, multispectral digital skin lesion analysis (MDSLA), and reflectance confocal microscopy (RCM). To our knowledge, there have been no studies directly comparing MDSLA and RCM.


OBJECTIVE
We conducted a repeated measures analysis comparing the sensitivity and specificity of MDSLA and RCM in the detection of melanoma (n = 55 lesions from 36 patients).


METHODS
Study patients (n = 36) with atypical-appearing pigmented lesions (n = 55) underwent imaging by both RCM and MDSLA. Lesions were biopsied and analyzed by histopathology.


RESULTS
RCM exhibited superior test metrics (P = .001, McNemar test) compared with MDSLA. Respectively, sensitivity measures were 85.7% and 71.4%, and specificity rates were 66.7% and 25.0%.


CONCLUSIONS
The sample size was relatively small and was collected from only one dermatologist's patient base; there was some degree of dermatopathologist interobserver variability; and only one confocalist performed the RCM image evaluations.


CONCLUSIONS
RCM is a useful adjunct during clinical assessment of in vivo lesions suspicious for melanoma or those requiring re-excision because of high level of dysplasia or having features consistent with an atypical melanocytic nevus with severe cytologic atypia.
University of Connecticut School of Medicine, Farmington, Connecticut.
Eunice
E
Song
Department of Dermatology, University of Connecticut Health Center, Farmington, Connecticut. Electronic address: grant@uchc.edu.
Jane M
JM
Grant-Kels
Department of Community Medicine and Health Care, University of Connecticut Health Center, Farmington, Connecticut; University of Connecticut School of Medicine, Farmington, Connecticut.
Helen
H
Swede
Department of Dermatology, University of Connecticut Health Center, Farmington, Connecticut.
Jody L
JL
D'Antonio
Department of Dermatology, Harvard Medical School, Boston, Massachusetts.
Avery
A
Lachance
Department of Dermatology, University of Connecticut Health Center, Farmington, Connecticut.
Soheil S
SS
Dadras
Department of Dermatology, University of Connecticut Health Center, Farmington, Connecticut.
Arni K
AK
Kristjansson
Department of Dermatology, University of Connecticut Health Center, Farmington, Connecticut.
Katalin
K
Ferenczi
Department of Dermatology, University of Connecticut Health Center, Farmington, Connecticut.
Hanspaul S
HS
Makkar
Department of Dermatology, University of Connecticut Health Center, Farmington, Connecticut.
Marti J
MJ
Rothe
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005188:False Negative Reactions; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D008297:Male; D008545:Melanoma / Q000000981:diagnostic imaging* / Q000473:pathology*; D018613:Microscopy, Confocal; D008875:Middle Aged; D012680:Sensitivity and Specificity; D012878:Skin Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D055815:Young Adult
dermoscopy; melanoma; multispectral digital skin lesion analysis; noninvasive imaging; reflectance confocal microscopy