The Diagnostic Accuracy of in vivo Confocal Scanning Laser Microscopy Compared to Dermoscopy of Benign and Malignant Melanocytic Lesions: A Prospective Study
Background: The diagnosis of melanoma at an early, curable stage is an important challenge for clinicians. Confocal scanning laser microscopy (CSLM) is a high-resolution, noninvasive technology that may facilitate improved diagnostic accuracy over clinical examination. The aim of this study was to e...
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| Veröffentlicht in: | Dermatology (Basel) 2007-01, Vol.215 (4), p.365-372 |
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| creator | Langley, Richard G.B. Walsh, Noreen Sutherland, Ashley E. Propperova, Iva Delaney, Laura Morris, Steven F. Gallant, Christopher |
| description | Background: The diagnosis of melanoma at an early, curable stage is an important challenge for clinicians. Confocal scanning laser microscopy (CSLM) is a high-resolution, noninvasive technology that may facilitate improved diagnostic accuracy over clinical examination. The aim of this study was to evaluate the diagnostic accuracy of CSLM compared to dermoscopy in a prospective examination of benign and malignant melanocytic lesions. Methods: 125 patients with suspicious pigmented lesions were prospectively recruited to undergo a clinical, dermoscopic and CSLM examination. A diagnosis was made preoperatively with each technique, and the lesion was then excised and diagnosed using histopathology. Results: 125 patients with 125 lesions were studied comprising 88 melanocytic nevi and 37 melanomas. Dermoscopy had a sensitivity of 89.2%, a specificity of 84.1%, a positive predictive value of 70.2% and a negative predictive value of 94.9%. CSLM was found to have a sensitivity of 97.3%, a specificity of 83.0%, a positive predictive value of 70.6% and a negative predictive value of 98.6%. No melanomas were misidentified when both techniques were used together. Conclusions: CSLM had a relatively higher sensitivity than dermoscopy; however, the specificity was similar with CSLM and dermoscopy. These results suggest that dermoscopy and CSLM are complementary. |
| doi_str_mv | 10.1159/000109087 |
| format | Article |
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Confocal scanning laser microscopy (CSLM) is a high-resolution, noninvasive technology that may facilitate improved diagnostic accuracy over clinical examination. The aim of this study was to evaluate the diagnostic accuracy of CSLM compared to dermoscopy in a prospective examination of benign and malignant melanocytic lesions. Methods: 125 patients with suspicious pigmented lesions were prospectively recruited to undergo a clinical, dermoscopic and CSLM examination. A diagnosis was made preoperatively with each technique, and the lesion was then excised and diagnosed using histopathology. Results: 125 patients with 125 lesions were studied comprising 88 melanocytic nevi and 37 melanomas. Dermoscopy had a sensitivity of 89.2%, a specificity of 84.1%, a positive predictive value of 70.2% and a negative predictive value of 94.9%. CSLM was found to have a sensitivity of 97.3%, a specificity of 83.0%, a positive predictive value of 70.6% and a negative predictive value of 98.6%. No melanomas were misidentified when both techniques were used together. Conclusions: CSLM had a relatively higher sensitivity than dermoscopy; however, the specificity was similar with CSLM and dermoscopy. These results suggest that dermoscopy and CSLM are complementary.</description><identifier>ISSN: 1018-8665</identifier><identifier>EISSN: 1421-9832</identifier><identifier>DOI: 10.1159/000109087</identifier><identifier>PMID: 17912001</identifier><language>eng</language><publisher>Basel, Switzerland: Karger</publisher><subject>Accuracy ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Biological and medical sciences ; Biopsy ; Clinical and Laboratory Investigations ; Comparative analysis ; Dermatology ; Dermoscopy - methods ; Diagnosis, Differential ; Diagnostic tests ; Female ; Follow-Up Studies ; Humans ; Male ; Medical sciences ; Melanocytes - pathology ; Melanoma - pathology ; Microscopy ; Microscopy, Confocal - methods ; Middle Aged ; Predictive Value of Tests ; Prospective Studies ; Reproducibility of Results ; Skin cancer ; Skin Neoplasms - pathology ; Tumors of the skin and soft tissue. Premalignant lesions</subject><ispartof>Dermatology (Basel), 2007-01, Vol.215 (4), p.365-372</ispartof><rights>2007 S. Karger AG, Basel</rights><rights>2007 INIST-CNRS</rights><rights>Copyright (c) 2007 S. Karger AG, Basel</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c396t-6264de14c6e9f0ee2aa684bd8fe317eacf3ac1f3efa11c946afeb112662d077d3</citedby><cites>FETCH-LOGICAL-c396t-6264de14c6e9f0ee2aa684bd8fe317eacf3ac1f3efa11c946afeb112662d077d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,2429,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=19141996$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17912001$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Langley, Richard G.B.</creatorcontrib><creatorcontrib>Walsh, Noreen</creatorcontrib><creatorcontrib>Sutherland, Ashley E.</creatorcontrib><creatorcontrib>Propperova, Iva</creatorcontrib><creatorcontrib>Delaney, Laura</creatorcontrib><creatorcontrib>Morris, Steven F.</creatorcontrib><creatorcontrib>Gallant, Christopher</creatorcontrib><title>The Diagnostic Accuracy of in vivo Confocal Scanning Laser Microscopy Compared to Dermoscopy of Benign and Malignant Melanocytic Lesions: A Prospective Study</title><title>Dermatology (Basel)</title><addtitle>Dermatology</addtitle><description>Background: The diagnosis of melanoma at an early, curable stage is an important challenge for clinicians. Confocal scanning laser microscopy (CSLM) is a high-resolution, noninvasive technology that may facilitate improved diagnostic accuracy over clinical examination. The aim of this study was to evaluate the diagnostic accuracy of CSLM compared to dermoscopy in a prospective examination of benign and malignant melanocytic lesions. Methods: 125 patients with suspicious pigmented lesions were prospectively recruited to undergo a clinical, dermoscopic and CSLM examination. A diagnosis was made preoperatively with each technique, and the lesion was then excised and diagnosed using histopathology. Results: 125 patients with 125 lesions were studied comprising 88 melanocytic nevi and 37 melanomas. Dermoscopy had a sensitivity of 89.2%, a specificity of 84.1%, a positive predictive value of 70.2% and a negative predictive value of 94.9%. CSLM was found to have a sensitivity of 97.3%, a specificity of 83.0%, a positive predictive value of 70.6% and a negative predictive value of 98.6%. No melanomas were misidentified when both techniques were used together. Conclusions: CSLM had a relatively higher sensitivity than dermoscopy; however, the specificity was similar with CSLM and dermoscopy. These results suggest that dermoscopy and CSLM are complementary.</description><subject>Accuracy</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biological and medical sciences</subject><subject>Biopsy</subject><subject>Clinical and Laboratory Investigations</subject><subject>Comparative analysis</subject><subject>Dermatology</subject><subject>Dermoscopy - methods</subject><subject>Diagnosis, Differential</subject><subject>Diagnostic tests</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Melanocytes - pathology</subject><subject>Melanoma - pathology</subject><subject>Microscopy</subject><subject>Microscopy, Confocal - methods</subject><subject>Middle Aged</subject><subject>Predictive Value of Tests</subject><subject>Prospective Studies</subject><subject>Reproducibility of Results</subject><subject>Skin cancer</subject><subject>Skin Neoplasms - pathology</subject><subject>Tumors of the skin and soft tissue. 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Premalignant lesions</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Langley, Richard G.B.</creatorcontrib><creatorcontrib>Walsh, Noreen</creatorcontrib><creatorcontrib>Sutherland, Ashley E.</creatorcontrib><creatorcontrib>Propperova, Iva</creatorcontrib><creatorcontrib>Delaney, Laura</creatorcontrib><creatorcontrib>Morris, Steven F.</creatorcontrib><creatorcontrib>Gallant, Christopher</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Proquest Nursing & Allied Health Source</collection><collection>Toxicology Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Dermatology (Basel)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Langley, Richard G.B.</au><au>Walsh, Noreen</au><au>Sutherland, Ashley E.</au><au>Propperova, Iva</au><au>Delaney, Laura</au><au>Morris, Steven F.</au><au>Gallant, Christopher</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The Diagnostic Accuracy of in vivo Confocal Scanning Laser Microscopy Compared to Dermoscopy of Benign and Malignant Melanocytic Lesions: A Prospective Study</atitle><jtitle>Dermatology (Basel)</jtitle><addtitle>Dermatology</addtitle><date>2007-01-01</date><risdate>2007</risdate><volume>215</volume><issue>4</issue><spage>365</spage><epage>372</epage><pages>365-372</pages><issn>1018-8665</issn><eissn>1421-9832</eissn><abstract>Background: The diagnosis of melanoma at an early, curable stage is an important challenge for clinicians. Confocal scanning laser microscopy (CSLM) is a high-resolution, noninvasive technology that may facilitate improved diagnostic accuracy over clinical examination. The aim of this study was to evaluate the diagnostic accuracy of CSLM compared to dermoscopy in a prospective examination of benign and malignant melanocytic lesions. Methods: 125 patients with suspicious pigmented lesions were prospectively recruited to undergo a clinical, dermoscopic and CSLM examination. A diagnosis was made preoperatively with each technique, and the lesion was then excised and diagnosed using histopathology. Results: 125 patients with 125 lesions were studied comprising 88 melanocytic nevi and 37 melanomas. Dermoscopy had a sensitivity of 89.2%, a specificity of 84.1%, a positive predictive value of 70.2% and a negative predictive value of 94.9%. CSLM was found to have a sensitivity of 97.3%, a specificity of 83.0%, a positive predictive value of 70.6% and a negative predictive value of 98.6%. No melanomas were misidentified when both techniques were used together. Conclusions: CSLM had a relatively higher sensitivity than dermoscopy; however, the specificity was similar with CSLM and dermoscopy. These results suggest that dermoscopy and CSLM are complementary.</abstract><cop>Basel, Switzerland</cop><pub>Karger</pub><pmid>17912001</pmid><doi>10.1159/000109087</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Accuracy Adolescent Adult Aged Aged, 80 and over Biological and medical sciences Biopsy Clinical and Laboratory Investigations Comparative analysis Dermatology Dermoscopy - methods Diagnosis, Differential Diagnostic tests Female Follow-Up Studies Humans Male Medical sciences Melanocytes - pathology Melanoma - pathology Microscopy Microscopy, Confocal - methods Middle Aged Predictive Value of Tests Prospective Studies Reproducibility of Results Skin cancer Skin Neoplasms - pathology Tumors of the skin and soft tissue. Premalignant lesions |
| title | The Diagnostic Accuracy of in vivo Confocal Scanning Laser Microscopy Compared to Dermoscopy of Benign and Malignant Melanocytic Lesions: A Prospective Study |
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