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Silver FH, Deshmukh T, Nadiminti H, Tan I. Melanin Stacking Differences in Pigmented and Non-Pigmented Melanomas: Quantitative Differentiation between Pigmented and Non-Pigmented Melanomas Based on Light-Scattering Properties. Life (Basel) 2023; 13:life13041004. [PMID: 37109534 PMCID: PMC10142763 DOI: 10.3390/life13041004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 04/04/2023] [Accepted: 04/11/2023] [Indexed: 04/29/2023] Open
Abstract
Cutaneous melanoma is a cancer with metastatic potential characterized by varying amounts of pigment-producing melanocytes, and it is one of the most aggressive and fatal forms of skin malignancy, with several hundreds of thousands of cases each year. Early detection and therapy can lead to decreased morbidity and decreased cost of therapy. In the clinic, this often translates to annual skin screenings, especially for high-risk patients, and generous use of the ABCDE (asymmetry, border irregularity, color, diameter, evolving) criteria. We have used a new technique termed vibrational optical coherence tomography (VOCT) to non-invasively differentiate between pigmented and non-pigmented melanomas in a pilot study. The VOCT results reported in this study indicate that both pigmented and non-pigmented melanomas have similar characteristics, including new 80, 130, and 250 Hz peaks. Pigmented melanomas have larger 80 Hz peaks and smaller 250 Hz peaks than non-pigmented cancers. The 80 and 250 Hz peaks can be used to quantitative characterize differences between different melanomas. In addition, infrared light penetration depths indicated that melanin in pigmented melanomas has higher packing densities than in non-pigmented lesions. Using machine learning techniques, the sensitivity and specificity of differentiating skin cancers from normal skin are shown to range from about 78% to over 90% in this pilot study. It is proposed that using AI on both lesion histopathology and mechanovibrational peak heights may provide even higher specificity and sensitivity for differentiating the metastatic potential of different melanocytic lesions.
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Affiliation(s)
- Frederick H Silver
- Department of Pathology and Laboratory Medicine, Robert Wood Johnson Medical School, Rutgers, The State University of New Jersey, Piscataway, NJ 08854, USA
- OptoVibronex, LLC, Bethlehem, PA 18015, USA
| | | | - Hari Nadiminti
- Summit Health, Dermatology Department, Berkeley Heights, NJ 07922, USA
| | - Isabella Tan
- Department of Pathology and Laboratory Medicine, Robert Wood Johnson Medical School, Rutgers, The State University of New Jersey, Piscataway, NJ 08854, USA
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Identification of Cancerous Skin Lesions Using Vibrational Optical Coherence Tomography (VOCT): Use of VOCT in Conjunction with Machine Learning to Diagnose Skin Cancer Remotely Using Telemedicine. Cancers (Basel) 2022; 15:cancers15010156. [PMID: 36612151 PMCID: PMC9818398 DOI: 10.3390/cancers15010156] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 12/13/2022] [Accepted: 12/16/2022] [Indexed: 12/30/2022] Open
Abstract
In this pilot study, we used vibrational optical tomography (VOCT), along with machine learning, to evaluate the specificity and sensitivity of using light and audible sound to differentiate between normal skin and skin cancers. The results reported indicate that the use of machine learning, and the height and location of the VOCT mechanovibrational peaks, have potential for being used to noninvasively differentiate between normal skin and different cancerous lesions. VOCT data, along with machine learning, is shown to predict the differences between normal skin and different skin cancers with a sensitivity and specificity at rates between 78 and 90%. The sensitivity and specificity will be improved using a larger database and by using other AI techniques. Ultimately, VOCT data, visual inspection, and dermoscopy, in conjunction with machine learning, will be useful in telemedicine to noninvasively identify potentially malignant skin cancers in remote areas of the country where dermatologists are not readily available.
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“Fingerprinting” Benign and Cancerous Skin Lesions Using Vibrational Optical Coherence Tomography: Differentiation among Cancerous Lesion Types Based on the Presence of New Cells, Blood Vessels, and Fibrosis. Biomolecules 2022; 12:biom12101332. [DOI: 10.3390/biom12101332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 08/24/2022] [Accepted: 09/13/2022] [Indexed: 11/16/2022] Open
Abstract
In this study, we use vibrational optical coherence tomography (VOCT) to examine the morphology and stiffness of benign and cancerous lesions. Lesion images and 3D plots of weighted displacement versus frequency and depth were used to compare the cellular, dermal collagen, new blood vessels, and fibrotic composition of normal skin, actinic keratoses (AK), nodular and superficial basal cell carcinomas (BCCs), squamous cell carcinomas (SCCs), and melanomas. The results of this study suggest that benign and cancerous lesions differ based on the addition of new cells with increased resonant frequency and stiffness (80Hz, 1.8MPa), new blood vessel peaks (130Hz, 4.10MPa) that appear to be less stiff than normal blood vessels, and new fibrous tissue peaks (260Hz, 15–17 MPa) that are present in carcinomas but not in normal skin and only partially present (80Hz and 130Hz only) in AKs. Results obtained by creating images based on the location of the 80Hz, 130Hz, and 260Hz peaks of cancerous skin lesions suggest that the fibrous tissue appears to surround the new cells and new lesion blood vessels. The results of this study suggest that the morphology and location of the fibrous tissues in relation to the new cancer-associated cells and lesion blood vessels may provide information on the invasiveness and metastatic potential of skin cancers. The invasiveness and metastatic potential of melanomas may be a result of the cancer-associated cells laying down fibrous tissue that is used as a pathway for migration. The new cancer-associated blood vessels in the vicinity of the new cancer-associated cells may promote this migration and eventual metastasis. The ratios of peak heights 50/130Hz and 80/130Hz of normal cells, new lesion cells, new lesion blood vessels, and fibrotic tissue may be used as a “fingerprint” for detecting melanoma and to differentiate it from other skin cancers non-invasively using VOCT.
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Kavasi RM, Neagu M, Constantin C, Munteanu A, Surcel M, Tsatsakis A, Tzanakakis GN, Nikitovic D. Matrix Effectors in the Pathogenesis of Keratinocyte-Derived Carcinomas. Front Med (Lausanne) 2022; 9:879500. [PMID: 35572966 PMCID: PMC9100789 DOI: 10.3389/fmed.2022.879500] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Accepted: 04/11/2022] [Indexed: 12/16/2022] Open
Abstract
Basal cell carcinoma (BCC) and cutaneous squamous cell carcinoma (cSCC), referred to as keratinocyte carcinomas, are skin cancer with the highest incidence. BCCs, rarely metastasize; whereas, though generally not characterized by high lethality, approximately 2–4% of primary cSCCs metastasize with patients exhibiting poor prognosis. The extracellular matrix (ECM) serves as a scaffold that provides structural and biological support to cells in all human tissues. The main components of the ECM, including fibrillar proteins, proteoglycans (PGs), glycosaminoglycans (GAGs), and adhesion proteins such as fibronectin, are secreted by the cells in a tissue-specific manner, critical for the proper function of each organ. The skin compartmentalization to the epidermis and dermis compartments is based on a basement membrane (BM), a highly specialized network of ECM proteins that separate and unify the two compartments. The stiffness and assembly of BM and tensile forces affect tumor progenitors' invasion at the stratified epithelium's stromal border. Likewise, the mechanical properties of the stroma, e.g., stiffness, are directly correlated to the pathogenesis of the keratinocyte carcinomas. Since the ECM is a pool for various growth factors, cytokines, and chemokines, its' intense remodeling in the aberrant cancer tissue milieu affects biological functions, such as angiogenesis, adhesion, proliferation, or cell motility by regulating specific signaling pathways. This review discusses the structural and functional modulations of the keratinocyte carcinoma microenvironment. Furthermore, we debate how ECM remodeling affects the pathogenesis of these skin cancers.
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Affiliation(s)
- Rafaela-Maria Kavasi
- Laboratory of Histology-Embryology, Medical School, University of Crete, Heraklion, Greece
| | - Monica Neagu
- Immunology Laboratory, Victor Babes National Institute of Pathology, Bucharest, Romania
- Colentina Hospital, Bucharest, Romania
- Doctoral School, University of Bucharest, Bucharest, Romania
| | - Carolina Constantin
- Immunology Laboratory, Victor Babes National Institute of Pathology, Bucharest, Romania
- Colentina Hospital, Bucharest, Romania
- Doctoral School, University of Bucharest, Bucharest, Romania
| | - Adriana Munteanu
- Immunology Laboratory, Victor Babes National Institute of Pathology, Bucharest, Romania
- Doctoral School, University of Bucharest, Bucharest, Romania
| | - Mihaela Surcel
- Immunology Laboratory, Victor Babes National Institute of Pathology, Bucharest, Romania
| | - Aristidis Tsatsakis
- Forensic Science Department, Medical School, University of Crete, Heraklion, Greece
| | - George N. Tzanakakis
- Laboratory of Histology-Embryology, Medical School, University of Crete, Heraklion, Greece
| | - Dragana Nikitovic
- Laboratory of Histology-Embryology, Medical School, University of Crete, Heraklion, Greece
- *Correspondence: Dragana Nikitovic
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The “Virtual Biopsy” of Cancerous Lesions in 3D: Non-Invasive Differentiation between Melanoma and Other Lesions Using Vibrational Optical Coherence Tomography. Dermatopathology (Basel) 2021; 8:539-551. [PMID: 34940035 PMCID: PMC8700642 DOI: 10.3390/dermatopathology8040058] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Revised: 12/07/2021] [Accepted: 12/08/2021] [Indexed: 01/12/2023] Open
Abstract
Early detection of skin cancer is of critical importance to provide five year survival rates that approach 99%. By 2050, one out of five Americans by age 70 will develop some form of skin cancer. This will result in a projected rate of 50 million skin biopsies per year given the current rate of escalation. In addition, the ability to differentiate between pigmented lesions and melanomas has proven a diagnostic challenge. While dermoscopy and visual analysis are useful in identifying many skin lesions, additional non-invasive techniques are needed to assist in the analysis of difficult to diagnose skin tumors. To augment dermoscopy data, we have developed 3D maps based on physical biomarker characteristics of benign and cancerous lesions using vibrational optical coherence tomography (VOCT). 3D images based on quantitative physical data involving changes in cellular and fibrous tissue stiffness along with changes in vascular quality are used to map and evaluate different types of cancers. 3D tumor maps constructed using quantitative VOCT data and OCT images have been used to characterize the differences between melanoma and other lesions. These characteristics can be used to plan the excision of difficult lesions where extensive surgery may be needed to remove the entire tumor in one step. In addition, it is now possible to use dermoscopy and VOCT to non-invasively differentiate between different cancerous lesion types using measurements of the resonant frequency of new cellular and vascular peaks. Quantitative VOCT information along with dermoscopic findings can be collected and analyzed remotely using artificial intelligence to improve cancerous tissue diagnosis.
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Silver FH, Kelkar N, Deshmukh T, Ritter K, Ryan N, Nadiminti H. Characterization of the Biomechanical Properties of Skin Using Vibrational Optical Coherence Tomography: Do Changes in the Biomechanical Properties of Skin Stroma Reflect Structural Changes in the Extracellular Matrix of Cancerous Lesions? Biomolecules 2021; 11:1712. [PMID: 34827711 PMCID: PMC8615800 DOI: 10.3390/biom11111712] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 11/12/2021] [Indexed: 12/12/2022] Open
Abstract
Early detection of skin cancer is of critical importance since the five-year survival rate for early detected skin malignancies is 99% but drops to 27% for cancer that has spread to distant lymph nodes and other organs. Over 2.5 million benign skin biopsies (55% of the total) are performed each year in the US at an alarming cost of USD ~2.5 B. Therefore there is an unmet need for novel non-invasive diagnostic approaches to better differentiate between cancerous and non-cancerous lesions, especially in cases when there is a legitimate doubt that a biopsy may be required. The purpose of this study is to determine whether the differences in the extracellular matrices among normal skin, actinic keratosis (AK), basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) can be assessed non-invasively using vibrational optical coherence tomography (VOCT). VOCT is a new diagnostic technology that uses infrared light and audible sound applied transversely to tissue to measure the resonant frequencies and elastic moduli of cells, dermal collagen, blood vessels and fibrous tissue in skin and lesion stroma without physically touching the skin. Our results indicate that the cellular, vascular and fibrotic resonant frequency peaks are altered in AK, BCC and SCC compared to those peaks observed in normal skin and can serve as physical biomarkers defining the differences between benign and cancerous skin lesions. The resonant frequency is increased from a value of 50 Hz in normal skin to a value of about 80 Hz in pre- and cancerous lesions. A new vascular peak is seen at 130 Hz in cancerous lesions that may reflect the formation of new tumor blood vessels. The peak at 260 Hz is similar to that seen in the skin of a subject with Scleroderma and skin wounds that have healed. The peak at 260 Hz appears to be associated with the deposition of large amounts of stiff fibrous collagen in the stroma surrounding cancerous lesions. Based on the results of this pilot study, VOCT can be used to non-invasively identify physical biomarkers that can help differentiate between benign and cancerous skin lesions. The appearance of new stiff cellular, fragile new vessels, and stiff fibrous material based on resonant frequency peaks and changes in the extracellular matrix can be used as a fingerprint of pre- and cancerous skin lesions.
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Affiliation(s)
- Frederick H. Silver
- Department of Pathology and Laboratory Medicine, Robert Wood Johnson Medical School, Rutgers, The State University of New Jersey, Piscataway, NJ 08854, USA
- OptoVibronex, LLC., Allentown, PA 18104, USA; (N.K.); (T.D.)
| | - Nikita Kelkar
- OptoVibronex, LLC., Allentown, PA 18104, USA; (N.K.); (T.D.)
| | - Tanmay Deshmukh
- OptoVibronex, LLC., Allentown, PA 18104, USA; (N.K.); (T.D.)
| | - Kelly Ritter
- Dermatology, Summit Health, Berkeley Heights, NJ 07922, USA; (K.R.); (N.R.); (H.N.)
| | - Nicole Ryan
- Dermatology, Summit Health, Berkeley Heights, NJ 07922, USA; (K.R.); (N.R.); (H.N.)
| | - Hari Nadiminti
- Dermatology, Summit Health, Berkeley Heights, NJ 07922, USA; (K.R.); (N.R.); (H.N.)
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