Automated detection of malignant features by confocal microscopy on superficial spreading melanoma versus nevi

Abstract. In-vivo reflectance confocal microscopy (RCM) shows

promise for the early detection of superficial spreading melanoma

(SSM). RCM of SSM shows pagetoid melanocytes (PMs) in the epidermis

and disarray at the dermal-epidermal junction (DEJ), which are

automatically quantified with a computer algorithm that locates depth

of the most superficial pigmented surface [DSPS(x,y)] containing PMs

in the epidermis and pigmented basal cells near the DEJ. The algorithm

uses 200 noninvasive confocal optical sections that image the

superficial 200 μm of ten skin sites: five unequivocal SSMs and five

nevi. The pattern recognition algorithm automatically identifies PMs

in all five SSMs and finds none in the nevi. A large mean gradient ψ

(roughness) between laterally adjacent points on DSPS(x,y) identifies DEJ

disruption in SSM ψ = 11.7 ± 3.7 [−] for n = 5 SSMs versus a small

ψ = 5.5 ± 1.0 [−] for n = 5 nevi (significance, p = 0.0035). Quantitative

endpoint metrics for malignant characteristics make digital RCM

data an attractive diagnostic asset for pathologists, augmenting studies

thus far, which have relied largely on visual assessment. C2010 Society of

Photo-Optical Instrumentation Engineers. [DOI: 10.1117/1.3524301]