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Varga NN, Boostani M, Farkas K, Bánvölgyi A, Lőrincz K, Posta M, Lihacova I, Lihachev A, Medvecz M, Holló P, Paragh G, Wikonkál NM, Bozsányi S, Kiss N. Optically Guided High-Frequency Ultrasound Shows Superior Efficacy for Preoperative Estimation of Breslow Thickness in Comparison with Multispectral Imaging: A Single-Center Prospective Validation Study. Cancers (Basel) 2023; 16:157. [PMID: 38201584 PMCID: PMC10778011 DOI: 10.3390/cancers16010157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 12/07/2023] [Accepted: 12/21/2023] [Indexed: 01/12/2024] Open
Abstract
Melanoma is the most aggressive form of skin cancer that is known for its metastatic potential and has an increasing incidence worldwide. Breslow thickness, which determines the staging and surgical margin of the tumor, is unavailable at initial diagnosis. Novel imaging techniques for assessing Breslow thickness lack comparative data. This study evaluates optically guided high-frequency ultrasound (OG-HFUS) and multispectral imaging (MSI) for preoperative estimation of Breslow thickness and staging. We enrolled 101 patients with histologically confirmed primary melanoma and categorized them based on tumor thickness. Optically guided 33 MHz HFUS and MSI were utilized for the assessment. Our MSI-based algorithm categorized melanomas into three subgroups with a sensitivity of 62.6%, specificity of 81.3%, and fair agreement (κ = 0.440, CI: 0.298-0.583). In contrast, OG-HFUS demonstrated a sensitivity of 91.8%, specificity of 96.0%, and almost perfect agreement (κ = 0.858, CI: 0.763-0.952). OG-HFUS performed better than MSI in estimating Breslow thickness, emphasizing its potential as a valuable tool for melanoma diagnosis and patient management. OG-HFUS holds promise for enhancing preoperative staging and treatment decision-making in melanoma.
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Affiliation(s)
- Noémi Nóra Varga
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary; (N.N.V.); (M.B.); (K.F.); (A.B.); (K.L.); (M.M.); (P.H.); (N.M.W.); (S.B.)
| | - Mehdi Boostani
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary; (N.N.V.); (M.B.); (K.F.); (A.B.); (K.L.); (M.M.); (P.H.); (N.M.W.); (S.B.)
| | - Klára Farkas
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary; (N.N.V.); (M.B.); (K.F.); (A.B.); (K.L.); (M.M.); (P.H.); (N.M.W.); (S.B.)
| | - András Bánvölgyi
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary; (N.N.V.); (M.B.); (K.F.); (A.B.); (K.L.); (M.M.); (P.H.); (N.M.W.); (S.B.)
| | - Kende Lőrincz
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary; (N.N.V.); (M.B.); (K.F.); (A.B.); (K.L.); (M.M.); (P.H.); (N.M.W.); (S.B.)
| | - Máté Posta
- Systems Biology of Reproduction Research Group, Institute of Molecular Life Sciences, HUN-REN Research Centre for Natural Sciences, 1117 Budapest, Hungary;
| | - Ilze Lihacova
- Biophotonics Laboratory, Institute of Atomic Physics and Spectroscopy, University of Latvia, 1004 Riga, Latvia; (I.L.); (A.L.)
| | - Alexey Lihachev
- Biophotonics Laboratory, Institute of Atomic Physics and Spectroscopy, University of Latvia, 1004 Riga, Latvia; (I.L.); (A.L.)
| | - Márta Medvecz
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary; (N.N.V.); (M.B.); (K.F.); (A.B.); (K.L.); (M.M.); (P.H.); (N.M.W.); (S.B.)
| | - Péter Holló
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary; (N.N.V.); (M.B.); (K.F.); (A.B.); (K.L.); (M.M.); (P.H.); (N.M.W.); (S.B.)
| | - Gyorgy Paragh
- Department of Dermatology, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14203, USA;
| | - Norbert M. Wikonkál
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary; (N.N.V.); (M.B.); (K.F.); (A.B.); (K.L.); (M.M.); (P.H.); (N.M.W.); (S.B.)
| | - Szabolcs Bozsányi
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary; (N.N.V.); (M.B.); (K.F.); (A.B.); (K.L.); (M.M.); (P.H.); (N.M.W.); (S.B.)
- Department of Dermatology, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14203, USA;
| | - Norbert Kiss
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary; (N.N.V.); (M.B.); (K.F.); (A.B.); (K.L.); (M.M.); (P.H.); (N.M.W.); (S.B.)
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Anker P, Fésűs L, Kiss N, Lengyel A, Pinti É, Lihacova I, Lihachev A, Plorina EV, Fekete G, Medvecz M. A Cross-Sectional Study of the Dermatological Manifestations of Patients with Fabry Disease and the Assessment of Angiokeratomas with Multimodal Imaging. Diagnostics (Basel) 2023; 13:2368. [PMID: 37510112 PMCID: PMC10378346 DOI: 10.3390/diagnostics13142368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 06/24/2023] [Accepted: 07/12/2023] [Indexed: 07/30/2023] Open
Abstract
Fabry disease (FD) is a multisystemic X-linked lysosomal storage disease that presents with angiokeratomas (AKs). Our objective was to investigate the clinical and morphologic features of AKs and to present two experimental techniques, multispectral imaging (MSI) and non-linear microscopy (NLM). A thorough dermatological examination was carried out in our 26 FD patients and dermoscopic images (n = 136) were evaluated for specific structures. MSI was used for the evaluation of AKs in seven patients. NLM was carried out to obtain histology samples of two AKs and two hemangiomas. Although AKs were the most common manifestation, the majority of patients presented an atypical distribution and appearance, which could cause a diagnostic challenge. Dermoscopy revealed lacunae (65%) and dotted vessels (56%) as the most common structures, with a whitish veil present in only 25%. Autofluorescence (405 nm) and diffuse reflectance (526 nm) images showed the underlying vasculature more prominently compared to dermoscopy. Using NLM, AKs and hemangiomas could be distinguished based on morphologic features. The clinical heterogeneity of FD can result in a diagnostic delay. Although AKs are often the first sign of FD, their presentation is diverse. A thorough dermatological examination and the evaluation of other cutaneous signs are essential for the early diagnosis of FD.
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Affiliation(s)
- Pálma Anker
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary
| | - Luca Fésűs
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary
- Institute for Solid State Physics and Optics, Wigner RCP, 1525 Budapest, Hungary
| | - Norbert Kiss
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary
| | - Anna Lengyel
- Pediatric Center, Semmelweis University, 1085 Budapest, Hungary
| | - Éva Pinti
- Pediatric Center, Semmelweis University, 1085 Budapest, Hungary
| | - Ilze Lihacova
- Institute of Atomic Physics and Spectroscopy, University of Latvia, 1586 Riga, Latvia
| | - Alexey Lihachev
- Institute of Atomic Physics and Spectroscopy, University of Latvia, 1586 Riga, Latvia
| | - Emilija Vija Plorina
- Institute of Atomic Physics and Spectroscopy, University of Latvia, 1586 Riga, Latvia
| | - György Fekete
- Pediatric Center, Semmelweis University, 1085 Budapest, Hungary
| | - Márta Medvecz
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary
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Fedorov Kukk A, Wu D, Gaffal E, Panzer R, Emmert S, Roth B. Multimodal system for optical biopsy of melanoma with integrated ultrasound, optical coherence tomography and Raman spectroscopy. JOURNAL OF BIOPHOTONICS 2022; 15:e202200129. [PMID: 35802400 DOI: 10.1002/jbio.202200129] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 06/20/2022] [Accepted: 06/22/2022] [Indexed: 06/15/2023]
Abstract
We introduce a new single-head multimodal optical system that integrates optical coherence tomography (OCT), 18 MHz ultrasound (US) tomography and Raman spectroscopy (RS), allowing for fast (<2 min) and noninvasive skin cancer diagnostics and lesion depth measurement. The OCT can deliver structural and depth information of smaller skin lesions (<1 mm), while the US allows to measure the penetration depth of thicker lesions (≥4 mm), and the RS analyzes the chemical composition from a small chosen spot (≤300 μm) that can be used to distinguish between benign and malignant melanoma. The RS and OCT utilize the same scanning and optical setup, allowing for co-localized measurements. The US on the other side is integrated with an acoustical reflector, which enables B-mode measurements on the same position as OCT and RS. The US B-mode scans can be translated across the sample by laterally moving the US transducer, which is made possible by the developed adapter with a flexible membrane. We present the results on custom-made liquid and agar phantoms that show the resolution and depth capabilities of the setup, as well as preliminary ex vivo measurements on mouse models with ∼4.3 mm thick melanoma.
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Affiliation(s)
- Anatoly Fedorov Kukk
- Hannover Centre for Optical Technologies, Leibniz University of Hannover, Hannover, Germany
| | - Di Wu
- Hannover Centre for Optical Technologies, Leibniz University of Hannover, Hannover, Germany
| | | | | | | | - Bernhard Roth
- Hannover Centre for Optical Technologies, Leibniz University of Hannover, Hannover, Germany
- Cluster of Excellence PhoenixD (Photonics, Optics and Engineering - Innovation Across Disciplines), Hannover, Germany
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Fedorov Kukk A, Blumenröther E, Roth B. Self-made transparent optoacoustic detector for measurement of skin lesion thickness in vivo. Biomed Phys Eng Express 2022; 8. [PMID: 35413695 DOI: 10.1088/2057-1976/ac669b] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 04/12/2022] [Indexed: 11/11/2022]
Abstract
In skin cancer diagnosis and treatment, one of the key factors is tumor depth, which is connected to the severity and the required excision depth. Optoacoustical (OA) imaging is a relatively popular technique that provides information based on the optical absorption of the sample. Although often demonstrated withex vivomeasurements orin vivoimaging on parts of small animals,in vivomeasurements on humans are more challenging. This is presumably because it is too time consuming and the required excitation pulse energies and their number exceed the allowed maximum permissible exposure (MPE). Here, we demonstrate thickness measurements with a transparent optoacoustical detector of different suspicious skin lesionsin vivoon patients. We develop the signal processing technique to automatically convert the raw signal into thickness via deconvolution with the impulse response function. The transparency of the detector allows optical excitation with the pulsed laser to be performed perpendicularly on the lesion, in contrast to the conventional illumination from the side. For validation, the measured results were compared to the histological thickness determined after excision. We show that this simple transparent detector allows to determine the thickness of a lesion and thus, aid the dermatologist to estimate the excision depth in the future.
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Affiliation(s)
- Anatoly Fedorov Kukk
- Hannover Centre for Optical Technologies, Leibniz University Hannover, Nienburger Str. 17, 30167 Hannover, Germany
| | - Elias Blumenröther
- Hannover Centre for Optical Technologies, Leibniz University Hannover, Nienburger Str. 17, 30167 Hannover, Germany
| | - Bernhard Roth
- Hannover Centre for Optical Technologies, Leibniz University Hannover, Nienburger Str. 17, 30167 Hannover, Germany.,Cluster of Excellence PhoenixD (Photonics, Optics and Engineering - Innovation Across Disciplines), Welfengarten 1a, 30167 Hannover, Germany
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