Imaging Techniques for Melanoma Detection

Recruiting at 1 trial location

Overseen by Joanna Ludzik, MD

Age: 18+

Sex: Any

Travel: May Be Covered

Time Reimbursement: Varies

Trial Phase: Academic

Recruiting

Sponsor: OHSU Knight Cancer Institute

Disqualifiers: Allergy to lidocaine

No Placebo Group

Trial Summary

What is the purpose of this trial?

This trial studies if smartphone apps and special cameras can detect melanoma as well as a dermatologist. It targets people with suspicious moles and uses advanced imaging technology to spot skin cancer early.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What data supports the effectiveness of the treatment Confocal Microscopy and related technologies for melanoma detection?

Confocal microscopy, including its various forms like Confocal Laser Scanning Microscopy (CLSM), has shown promise in improving the diagnosis of skin cancers, including melanoma, by providing high-resolution, non-invasive imaging that can enhance diagnostic accuracy compared to traditional methods. Studies have demonstrated that these imaging techniques can aid in early detection and management of skin cancers, potentially reducing the need for unnecessary biopsies and improving surgical outcomes. ^{1 2 3 4 5}

Is confocal laser scanning microscopy safe for use in humans?

Confocal laser scanning microscopy (CLSM) is considered safe for use in humans as it is a non-invasive imaging technique that allows for repeated examination of the same skin area without causing any damage. ^{6 7 8 9 10}

How does the treatment using imaging techniques for melanoma detection differ from other treatments?

This treatment is unique because it uses advanced imaging techniques like Confocal Laser Scanning Microscopy (CLSM) and apps like MoleMapper to non-invasively examine skin cancer at a cellular level, providing detailed images without needing a biopsy. This approach allows for real-time, high-resolution visualization of skin structures, which is not possible with traditional methods. ^{6 7 9 11 12}

Research Team

Joanna Ludzik, MD

Principal Investigator

OHSU Knight Cancer Institute

Eligibility Criteria

This trial is for people aged 18-80 who have been recommended a biopsy for a suspicious mole during free skin cancer screenings at OHSU or identified through OHSU Dermatology clinics. It's also open to those with benign or atypical nevi for imaging only. Participants must be able to consent, and most are expected to be Non-Hispanic whites due to melanoma prevalence.

Inclusion Criteria

People of any race can participate, but we expect most participants to be Non-Hispanic whites because they are more likely to have melanoma and other skin cancers.

People who have been seen at OHSU Dermatology clinics or through OHSU e-visit and e-consult platforms for a skin lesion that needs a biopsy for skin cancer.

Persons identified via the Melanoma Community Registry (MCR) (IRB approved: 00010561)

Exclusion Criteria

You are allergic to the anesthetic lidocaine.

Trial Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Imaging and Biopsy

Participants undergo imaging of suspicious moles via smartphone app, digital dermoscopy, and confocal microscopy, followed by lidocaine SC and shave or punch biopsy of suspected melanomas

1 day

1 visit (in-person)

Follow-up

Participants are monitored for safety and effectiveness after the study intervention

1 week

1 visit (in-person or virtual)

Long-term Monitoring

Participants' imaging results are analyzed for sensitivity and specificity over a period of up to 1 year

Up to 1 year

Treatment Details

Interventions

• Confocal Microscopy (Imaging Technique)
• MoleMapper (Imaging Technique)
• Visiomed (Imaging Technique)

Trial Overview The study tests the effectiveness of MoleMapper, Visiomed, and confocal microscopy in detecting melanoma compared to traditional dermatologist examinations. These portable imaging techniques may help identify melanomas early without an office visit.

Participant Groups

Group I: Screening (imaging, biopsy) Experimental Treatment 6 Interventions

Participants undergo imaging of suspicious moles via smartphone app MoleMapper/Sklip app/native smartphone camera app, digital dermoscopy, and confocal microscopy. Participants then receive lidocaine SC and undergo shave or punch biopsy of suspected melanomas.

Confocal Microscopy is already approved in Canada, Japan for the following indications:

Approved in Canada as Confocal Microscopy for:

• Dermatological examinations
• Melanoma screening

Approved in Japan as Confocal Microscopy for:

• Dermatological examinations
• Melanoma screening

Who Is Running the Clinical Trial?

OHSU Knight Cancer Institute

Lead Sponsor

Trials

239

Recruited

2,089,000+

Oregon Health and Science University

Collaborator

Trials

1,024

Recruited

7,420,000+

Findings from Research

Artificial intelligence-driven ex vivo confocal microscopy (XVM) can effectively mimic standard histopathology images and produce automated tumor positivity maps, showing a diagnostic sensitivity of 88% and specificity of 91% for detecting basal cell carcinoma.

The XVM method is potentially faster and less costly than traditional histopathology, making it a promising tool for determining margin status in Mohs micrographic surgery for skin cancer.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Deep learning automated pathology in ex vivo microscopy. Combalia, M., Garcia, S., Malvehy, J., et al.[2022]

Confocal scanning laser microscopy (CSLM) demonstrated a higher sensitivity (97.3%) compared to dermoscopy (89.2%) in diagnosing melanocytic lesions, indicating it may be more effective in detecting melanomas early.

Both CSLM and dermoscopy showed similar specificity (around 83%), suggesting that they can be used together as complementary tools to improve diagnostic accuracy for melanoma.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The diagnostic accuracy of in vivo confocal scanning laser microscopy compared to dermoscopy of benign and malignant melanocytic lesions: a prospective study. Langley, RG., Walsh, N., Sutherland, AE., et al.[2007]

Non-invasive skin imaging techniques, such as confocal microscopy, are being increasingly used in dermatology to aid in the early diagnosis of skin cancers, potentially reducing the need for unnecessary biopsies.

Advancements in confocal microscopy, including the use of fluorescent dyes and artificial intelligence, are enhancing the accuracy and effectiveness of skin cancer diagnosis and management.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Confocal Microscopy for Diagnosis and Management of Cutaneous Malignancies: Clinical Impacts and Innovation. Atak, MF., Farabi, B., Navarrete-Dechent, C., et al.[2023]

Ex vivo confocal microscopy has improved the speed and accuracy of skin cancer pathology assessments by allowing detailed visualization of cellular structures in both paraffin-embedded and frozen samples.

Recent advancements include new staining protocols and multimodal imaging techniques that enhance diagnostic capabilities without compromising traditional histopathology methods.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Ex vivo confocal microscopy: revolution in fast pathology in dermatology. Malvehy, J., Pérez-Anker, J., Toll, A., et al.[2021]

In a study analyzing 857 confocal laser scanning microscopy (CLSM) images of skin tumors, the classification tree analysis (CART) accurately identified 97.55% of melanoma images and 96.32% of benign nevi, demonstrating high efficacy in distinguishing between these skin conditions.

The study revealed that certain morphological features, such as monomorphic melanocytic cells in benign nevi and polymorphic cells in melanoma, can be objectively analyzed, suggesting that CLSM can enhance diagnostic accuracy beyond traditional visual assessments.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Correlation of image analysis features and visual morphology in melanocytic skin tumours using in vivo confocal laser scanning microscopy. Lorber, A., Wiltgen, M., Hofmann-Wellenhof, R., et al.[2009]

In vivo confocal laser scanning microscopy (CLSM) demonstrated high diagnostic accuracy for skin tumors, achieving a sensitivity of 97.5% and specificity of 99% when evaluating 3709 images from 20 malignant melanomas and 50 benign naevi.

A three-step diagnostic algorithm based on three key morphological features from CLSM images allowed for correct classification of 92.4% of benign naevi and 97.6% of melanoma cases, suggesting CLSM could be a valuable tool for skin cancer screening.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

In vivo confocal laser scanning microscopy of melanocytic skin tumours: diagnostic applicability using unselected tumour images. Gerger, A., Hofmann-Wellenhof, R., Langsenlehner, U., et al.[2008]

Confocal laser scanning microscopy (CLSM) is a highly effective imaging technique for evaluating superficial skin tumors, allowing for noninvasive, real-time assessment of tumor characteristics and associated vasculature.

CLSM can help differentiate between various histologic subtypes of skin tumors, guiding treatment decisions and improving monitoring of disease progression without causing damage to the skin.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Current and future applications of confocal laser scanning microscopy imaging in skin oncology. Ilie, MA., Caruntu, C., Lupu, M., et al.[2023]

Confocal laser scanning microscopy (CLSM) provides clearer images of living cells in the skin by eliminating out-of-focus blur, making it superior to conventional microscopy for detailed analysis.

CLSM has significant potential for future applications in dermatology, allowing for detailed imaging of both fixed and living tissues, which could enhance diagnostic capabilities and research in skin-related conditions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Confocal laser scanning microscopy: a new optical microscopic technique for applications in pathology and dermatology. Fink-Puches, R., Hofmann-Wellenhof, R., Smolle, J., et al.[2019]

Confocal laser scanning microscopy (CLSM) is a promising noninvasive technique for analyzing skin structure in real-time, which can enhance both dermatological research and clinical management of skin cancer patients.

CLSM has various clinical applications in dermatology, making it a valuable tool for improving diagnosis and treatment strategies in skin-related conditions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

In vivo confocal microscopy in dermatology: from research to clinical application. Ulrich, M., Lange-Asschenfeldt, S.[2019]

Early detection and removal of melanoma significantly improves patient prognosis and survival rates, highlighting the importance of effective detection methods.

The chapter reviews various advanced detection technologies, including in vivo confocal microscopy and noninvasive optical biopsies, which may enhance the accuracy of melanoma diagnosis compared to traditional methods.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Methods of Melanoma Detection. Leachman, SA., Cassidy, PB., Chen, SC., et al.[2015]

Confocal laser-scanning microscopy (CLSM) allows for non-invasive visualization and measurement of skin capillaries in healthy individuals, demonstrating consistent parameters across different ages and sexes.

This technique offers significant advantages over traditional methods like nailfold capillaroscopy and histological analysis, enabling precise in vivo analysis of skin vasculature, which could be beneficial for diagnosing systemic and proliferative skin diseases.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Confocal laser-scanning capillaroscopy: a novel approach to the analysis of skin capillaries in vivo. Hegyi, J., Hegyi, V., Messer, G., et al.[2009]

References

1. United States pubmed.ncbi.nlm.nih.gov

Confocal microscopy of skin cancers: translational advances toward clinical utility. [2021]

2. United States pubmed.ncbi.nlm.nih.gov

Deep learning automated pathology in ex vivo microscopy. [2022]

3. Switzerland pubmed.ncbi.nlm.nih.gov

The diagnostic accuracy of in vivo confocal scanning laser microscopy compared to dermoscopy of benign and malignant melanocytic lesions: a prospective study. [2007]

4. Switzerland pubmed.ncbi.nlm.nih.gov

Confocal Microscopy for Diagnosis and Management of Cutaneous Malignancies: Clinical Impacts and Innovation. [2023]

5. England pubmed.ncbi.nlm.nih.gov

Ex vivo confocal microscopy: revolution in fast pathology in dermatology. [2021]

6. England pubmed.ncbi.nlm.nih.gov

Correlation of image analysis features and visual morphology in melanocytic skin tumours using in vivo confocal laser scanning microscopy. [2009]

7. England pubmed.ncbi.nlm.nih.gov

In vivo confocal laser scanning microscopy of melanocytic skin tumours: diagnostic applicability using unselected tumour images. [2008]

8. Greece pubmed.ncbi.nlm.nih.gov

Current and future applications of confocal laser scanning microscopy imaging in skin oncology. [2023]

9. United States pubmed.ncbi.nlm.nih.gov

Confocal laser scanning microscopy: a new optical microscopic technique for applications in pathology and dermatology. [2019]

10. United States pubmed.ncbi.nlm.nih.gov

In vivo confocal microscopy in dermatology: from research to clinical application. [2019]

11. United States pubmed.ncbi.nlm.nih.gov

Methods of Melanoma Detection. [2015]

12. England pubmed.ncbi.nlm.nih.gov

Confocal laser-scanning capillaroscopy: a novel approach to the analysis of skin capillaries in vivo. [2009]