Automated detection of malignant features in 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 epi-dermis 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 [D SPS (x,y)] containing PMs in the epidermis and pigmented basal cells near the DEJ. The algo-rithm 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 D SPS (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). Quanti-tative 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. C 2010 Society of Photo-Optical Instrumentation Engineers.