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A Wolf in Sheep’s Clothing
It is frequently difficult to distinguish whether something is dangerous or harmless. In the case of melanoma diagnosis, a misdiagnosed lesion could have deadly consequences. Rightly, doctors err on the side of caution; however, false-positive diagnoses result in unnecessary surgeries and biopsies, as well as emotional distress for the patient. Matthews et al. have developed a new imaging technique that can distinguish melanoma from benign lesions, which in concert with current techniques could improve patient diagnosis and decrease the need for unnecessary tests.
The pigment melanin is the primary determinant of skin color. There are two dominant types of melanin in melanocytic lesions: eumelanin and pheomelanin. Eumelanin, which is brown/black, is the most common biological form of melanin, whereas pheomelanin is largely responsible for red hair and freckles. The authors use a multiphoton imaging technique, pump-probe spectroscopy, to determine the ratio of these different melanins in melanocytic lesions in the context of lesion architectural and cytological features. Eumelanin was found at higher levels in melanoma compared with both dysplastic and benign nevi. When combined with pathological examination, imaging-based determination of the melanin ratio decreased the number of false-positive diagnoses compared with pathological examination alone. Moreover, this imaging technique could be used on hematoxylin and eosin–stained slides, which are currently used by pathologists for melanoma diagnosis, and may even be able to be adapted for noninvasive diagnostics. In conjunction with traditional diagnostic methods, melanocytic imaging should greatly improve doctor’s ability to sort the wolves from the sheep.
Footnotes
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↵* Present address: U.S. Environmental Protection Agency, Research Triangle Park, NC 27711, USA.
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Citation: T. E. Matthews, I. R. Piletic, M. A. Selim, M. J. Simpson, W. S. Warren, Pump-Probe Imaging Differentiates Melanoma from Melanocytic Nevi. Sci. Transl. Med. 3, 71ra15 (2011).
- Copyright © 2011, American Association for the Advancement of Science
