New imaging approaches for the diagnosis of melanoma and skin cancer

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Published: 17 May 2017
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Dr Josep Malvehy - University Hospital Clinic of Barcelona, Barcelona, Spain

Dr Malvehy speaks with ecancer at EADO 2017 about advances in imaging to improve speed and accuracy of skin cancer diagnoses.

He emphasises the clinical utility of reflectance confocal microscopy (RCM) for non-invasive, high resolution detection of cancerous skin cells within a matter of minutes, if not seconds.

Dr Malvehy also notes the complementary use of RCM with other imaging techniques to gain consensus in diagnosis, though cautions about the cost and training associated with 

ecancer's filming has been kindly supported by Amgen through the ECMS Foundation. ecancer is editorially independent and there is no influence over content.

Confocal microscopy is one of the new technologies we have for the non-invasive examination of skin cancer. We use these microscopes to have in real time images at the cellular resolution of the tissue without any damage for the patient. With that we can detect melanoma and other skin cancers even in situations where these lesions are sub-clinical.

How fast can this be done?

Really confocal microscopy today can be very fast; we are able to detect a skin tumour in very few seconds indeed. If we want to have a full reconstruction of the tumour it takes about ten minutes but we can use this in the clinical setting for fast detection and monitoring of patients using the handheld microscopes.

Does it work in combination with other imaging techniques?

Absolutely. Confocal has to be in combination with dermoscopy and of course cannot be a part of the clinical information that you need from the patient. So we combine dermoscopy and confocal microscopy in most of the situations to have a good correlation of the two things.

Why is this not currently in practice?

The main barrier is probably the cost of the technology at the moment and the second barrier could be the training. But it’s something that for sure will have to evolve in the future because it’s very clear that confocal makes a big difference for our patients in very particular situations and this has been proven today. We have to see if in the future we can implement more centres with confocal in Europe and in other places all over the world.