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Dynamic markers based on blood perfusion fluctuations for selecting skin melanocytic lesions for biopsy.

Lancaster G, Stefanovska A, Pesce M, Marco Vezzoni G, Loggini B, Pingitore R, Ghiara F, Barachini P, Cervadoro G, Romanelli M, Rossi M - Sci Rep (2015)

Bottom Line: We consider a wide frequency range from 0.005-2 Hz associated with both local vascular regulation and effects of cardiac pulsation.Combining uniquely the power of oscillations associated with individual physiological processes we obtain a marker which distinguishes between melanoma and atypical nevi with sensitivity of 100% and specificity of 90.9%.It also provides the means for simple, accurate, in vivo distinction between malignant melanoma and atypical nevi, and may lead to a substantial reduction in the number of biopsies currently undertaken.

View Article: PubMed Central - PubMed

Affiliation: Department of Clinical and Experimental Medicine, University of Pisa, Italy.

ABSTRACT
Skin malignant melanoma is a highly angiogenic cancer, necessitating early diagnosis for positive prognosis. The current diagnostic standard of biopsy and histological examination inevitably leads to many unnecessary invasive excisions. Here, we propose a non-invasive method of identification of melanoma based on blood flow dynamics. We consider a wide frequency range from 0.005-2 Hz associated with both local vascular regulation and effects of cardiac pulsation. Combining uniquely the power of oscillations associated with individual physiological processes we obtain a marker which distinguishes between melanoma and atypical nevi with sensitivity of 100% and specificity of 90.9%. The method reveals valuable functional information about the melanoma microenvironment. It also provides the means for simple, accurate, in vivo distinction between malignant melanoma and atypical nevi, and may lead to a substantial reduction in the number of biopsies currently undertaken.

No MeSH data available.


Related in: MedlinePlus

(a–c) Normalized median spectral power values obtained by wavelet analysis of laser Doppler tracings recorded for 30 minutes in SMM lesions (red line), atypical nevi (dark grey line), benign nevi (light grey line) and psoriasis (black line) in lesions centers (a), margins (b) and in contralateral healthy skin (c). Significant differences are highlighted in yellow (p < 0.05) as determined by the Kruskal Wallis test. (d–f) Normalized spectral power values within the six frequency intervals considered (see text) in SMM (red), atypical nevi (dark grey), benign nevi (light grey) and psoriasis (black) in lesion centers (d), margins (e) and healthy contralateral skin (f). *p < 0.05; **p < 0.01; ***p < 0.001.
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f2: (a–c) Normalized median spectral power values obtained by wavelet analysis of laser Doppler tracings recorded for 30 minutes in SMM lesions (red line), atypical nevi (dark grey line), benign nevi (light grey line) and psoriasis (black line) in lesions centers (a), margins (b) and in contralateral healthy skin (c). Significant differences are highlighted in yellow (p < 0.05) as determined by the Kruskal Wallis test. (d–f) Normalized spectral power values within the six frequency intervals considered (see text) in SMM (red), atypical nevi (dark grey), benign nevi (light grey) and psoriasis (black) in lesion centers (d), margins (e) and healthy contralateral skin (f). *p < 0.05; **p < 0.01; ***p < 0.001.

Mentions: Quantitative analysis of blood perfusion fluctuations are summarised in Table 4 and Fig. 2. A significantly lower normalized spectral power in the frequency intervals associated with myogenic (III) and neurogenic (IV) activity (p = 0.0006 and p = 0.0005, respectively) was observed at the lesion center of SMMs [1.7 (0.9–2.7) and 1.0 (0.6–1.7), respectively] when compared to both histologically atypical nevi [4.7 (2.6–7.5) and 1.9 (1.4–3.5), respectively] and benign nevi [4.8 (3.6–7.6) and 2.6 (1.9–4.3), respectively]. A significantly higher normalized spectral power in the frequency interval associated with cardiac activity (I) (p = 0.0003) was observed at the lesion center of SMMs [10.8 (8.2–14.3)] when compared to both histologically atypical nevi [4.9 (2.2–7.3)] and benign nevi [4.4 (2.4–5.5)]. On the contrary, SMMs did not significantly differ from both histologically atypical and benign nevi for the spectral power in the frequency intervals V and VI, associated with endothelial activity.


Dynamic markers based on blood perfusion fluctuations for selecting skin melanocytic lesions for biopsy.

Lancaster G, Stefanovska A, Pesce M, Marco Vezzoni G, Loggini B, Pingitore R, Ghiara F, Barachini P, Cervadoro G, Romanelli M, Rossi M - Sci Rep (2015)

(a–c) Normalized median spectral power values obtained by wavelet analysis of laser Doppler tracings recorded for 30 minutes in SMM lesions (red line), atypical nevi (dark grey line), benign nevi (light grey line) and psoriasis (black line) in lesions centers (a), margins (b) and in contralateral healthy skin (c). Significant differences are highlighted in yellow (p < 0.05) as determined by the Kruskal Wallis test. (d–f) Normalized spectral power values within the six frequency intervals considered (see text) in SMM (red), atypical nevi (dark grey), benign nevi (light grey) and psoriasis (black) in lesion centers (d), margins (e) and healthy contralateral skin (f). *p < 0.05; **p < 0.01; ***p < 0.001.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4542467&req=5

f2: (a–c) Normalized median spectral power values obtained by wavelet analysis of laser Doppler tracings recorded for 30 minutes in SMM lesions (red line), atypical nevi (dark grey line), benign nevi (light grey line) and psoriasis (black line) in lesions centers (a), margins (b) and in contralateral healthy skin (c). Significant differences are highlighted in yellow (p < 0.05) as determined by the Kruskal Wallis test. (d–f) Normalized spectral power values within the six frequency intervals considered (see text) in SMM (red), atypical nevi (dark grey), benign nevi (light grey) and psoriasis (black) in lesion centers (d), margins (e) and healthy contralateral skin (f). *p < 0.05; **p < 0.01; ***p < 0.001.
Mentions: Quantitative analysis of blood perfusion fluctuations are summarised in Table 4 and Fig. 2. A significantly lower normalized spectral power in the frequency intervals associated with myogenic (III) and neurogenic (IV) activity (p = 0.0006 and p = 0.0005, respectively) was observed at the lesion center of SMMs [1.7 (0.9–2.7) and 1.0 (0.6–1.7), respectively] when compared to both histologically atypical nevi [4.7 (2.6–7.5) and 1.9 (1.4–3.5), respectively] and benign nevi [4.8 (3.6–7.6) and 2.6 (1.9–4.3), respectively]. A significantly higher normalized spectral power in the frequency interval associated with cardiac activity (I) (p = 0.0003) was observed at the lesion center of SMMs [10.8 (8.2–14.3)] when compared to both histologically atypical nevi [4.9 (2.2–7.3)] and benign nevi [4.4 (2.4–5.5)]. On the contrary, SMMs did not significantly differ from both histologically atypical and benign nevi for the spectral power in the frequency intervals V and VI, associated with endothelial activity.

Bottom Line: We consider a wide frequency range from 0.005-2 Hz associated with both local vascular regulation and effects of cardiac pulsation.Combining uniquely the power of oscillations associated with individual physiological processes we obtain a marker which distinguishes between melanoma and atypical nevi with sensitivity of 100% and specificity of 90.9%.It also provides the means for simple, accurate, in vivo distinction between malignant melanoma and atypical nevi, and may lead to a substantial reduction in the number of biopsies currently undertaken.

View Article: PubMed Central - PubMed

Affiliation: Department of Clinical and Experimental Medicine, University of Pisa, Italy.

ABSTRACT
Skin malignant melanoma is a highly angiogenic cancer, necessitating early diagnosis for positive prognosis. The current diagnostic standard of biopsy and histological examination inevitably leads to many unnecessary invasive excisions. Here, we propose a non-invasive method of identification of melanoma based on blood flow dynamics. We consider a wide frequency range from 0.005-2 Hz associated with both local vascular regulation and effects of cardiac pulsation. Combining uniquely the power of oscillations associated with individual physiological processes we obtain a marker which distinguishes between melanoma and atypical nevi with sensitivity of 100% and specificity of 90.9%. The method reveals valuable functional information about the melanoma microenvironment. It also provides the means for simple, accurate, in vivo distinction between malignant melanoma and atypical nevi, and may lead to a substantial reduction in the number of biopsies currently undertaken.

No MeSH data available.


Related in: MedlinePlus