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This study examined the thermal signature of pigmented lesions observed by digital infrared thermal imaging as a possible adjunct to physician diagnosis. Thermal images of pigmented lesions were compared to clinical examination by a plastic surgeon interested in skin diseases, dermatoscopy, and histopathology. A total of 35 patients with 55 pigmented skin lesions were considered. We found that all lesions emitting a dark signal on thermal imaging, compared to the nearby skin, were benign, while only one of all benign lesions (1.9%) had a bright "warm" signal. Benign lesions with papule/nodular morphology were dark in 87.5% of patients. All lesions diagnosed as malignant melanoma, both dermatoscopically and histologically, had plaque morphology; yet, only half demonstrated some signals on thermal imaging. Based on these results, we concluded that thermal imaging could be used as an adjunct to diagnosis when examining skin lesions. This study provided an introduction to using thermal imaging for spotting skin lesions.
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Rayos Infrarrojos , Melanoma , Neoplasias Cutáneas , Termografía , Humanos , Termografía/métodos , Neoplasias Cutáneas/patología , Neoplasias Cutáneas/diagnóstico , Neoplasias Cutáneas/diagnóstico por imagen , Melanoma/patología , Melanoma/diagnóstico , Melanoma/diagnóstico por imagen , Femenino , Masculino , Adulto , Persona de Mediana Edad , Dermoscopía/métodos , Anciano , Adulto Joven , AdolescenteRESUMEN
BACKGROUND: In Australia, artificial intelligence (AI) is increasingly being used in the field of melanoma diagnosis. Early diagnosis is arguably the most important prognostic factor for melanoma survival. The use of digital monitoring of naevi, especially dysplastic naevi, might reduce the number of biopsies needed in managing patients at risk of melanoma, especially in patients with high naevi counts. OBJECTIVE: This article discusses advances in imaging and early diagnosis including the use of AI in this process. DISCUSSION: The benefits of performing biopsies must be balanced with the potential to cause harm. Whole-body imaging can assist with more accurate detection of changing lesions and enable clinicians to focus on lesions where change is detected.
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Inteligencia Artificial , Melanoma , Humanos , Melanoma/diagnóstico , Melanoma/diagnóstico por imagen , Australia , Inteligencia Artificial/tendencias , Neoplasias Cutáneas/diagnóstico , Neoplasias Cutáneas/diagnóstico por imagen , Detección Precoz del Cáncer/métodos , Detección Precoz del Cáncer/tendenciasRESUMEN
Purpose: Perfusion-weighted imaging (PWI; magnetic resonance imaging [MRI]) has been shown to provide valuable biological tumor information in uveal melanoma (UM). Clinically used semiquantitative methods do not account for tumor pigmentation and eye movement. We hypothesize that a quantitative PWI method that incorporates these, provides a more accurate description of tumor perfusion than the current clinical method. The aim of this study was to test this in patients with UM before and after radiotherapy. Methods: Perfusion-weighted 3T MRIs were retrospectively analyzed in 47 patients with UM before and after radiotherapy. Tofts pharmacokinetic modeling was performed to determine vascular permeability (Ktrans), extracellular extravascular space (ve), and reflux rate (kep). These were compared with semiquantitative clinical parameters including peak intensity and outflow percentage. Results: The effect of tumor pigmentation on peak intensity and outflow percentage was statistically significant (P < 0.01) and relative peak intensity was significantly different between melanotic and amelanotic tumors (1.5 vs. 1.9, P < 0.01). Before radiotherapy, median tumor Ktrans was 0.63 min-1 (range = 0.06-1.42 min-1), median ve was 0.23 (range = 0.09-0.63), and median kep was 2.3 min-1 (range = 0.6-5.0 min-1). After radiotherapy, 85% showed a decrease in Ktrans and kep (P < 0.01). Changes in tumor pigmentation before and after radiotherapy were small and not significant (median increase in T1 of 33 ms, P = 0.55). Conclusions: Quantitative PWI parameters decreased significantly after radiotherapy and can therefore can serve as an early biomarker for treatment response assessment. However, due to the nonsignificant changes in tumor pigmentation before and after radiotherapy, the current semiquantitative method appears to be sufficiently sensitive for detection of changes in tumor perfusion.
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Melanoma , Neoplasias de la Úvea , Humanos , Neoplasias de la Úvea/radioterapia , Neoplasias de la Úvea/diagnóstico por imagen , Melanoma/diagnóstico por imagen , Melanoma/radioterapia , Masculino , Femenino , Estudios Retrospectivos , Persona de Mediana Edad , Anciano , Adulto , Anciano de 80 o más Años , Angiografía por Resonancia Magnética/métodos , Imagen por Resonancia Magnética/métodosRESUMEN
BACKGROUND: Risk stratification and treatment benefit prediction models are urgent to improve negative sentinel lymph node (SLN-) melanoma patient selection, thus avoiding costly and toxic treatments in patients at low risk of recurrence. To this end, the application of artificial intelligence (AI) could help clinicians to better calculate the recurrence risk and choose whether to perform adjuvant therapy. METHODS: We made use of AI to predict recurrence-free status (RFS) within 2-years from diagnosis in 94 SLN- melanoma patients. In detail, we detected quantitative imaging information from H&E slides of a cohort of 71 SLN- melanoma patients, who registered at Istituto Tumori "Giovanni Paolo II" in Bari, Italy (investigational cohort, IC). For each slide, two expert pathologists firstly annotated two Regions of Interest (ROIs) containing tumor cells alone (TUMOR ROI) or with infiltrating cells (TUMOR + INF ROI). In correspondence of the two kinds of ROIs, two AI-based models were developed to extract information directly from the tiles in which each ROI was automatically divided. This information was then used to predict RFS. Performances of the models were computed according to a 5-fold cross validation scheme. We further validated the prediction power of the two models on an independent external validation cohort of 23 SLN- melanoma patients (validation cohort, VC). RESULTS: The TUMOR ROIs have revealed more informative than the TUMOR + INF ROIs. An Area Under the Curve (AUC) value of 79.1% and 62.3%, a sensitivity value of 81.2% and 76.9%, a specificity value of 70.0% and 43.3%, an accuracy value of 73.2% and 53.4%, were achieved on the TUMOR and TUMOR + INF ROIs extracted for the IC cohort, respectively. An AUC value of 76.5% and 65.2%, a sensitivity value of 66.7% and 41.6%, a specificity value of 70.0% and 55.9%, an accuracy value of 70.0% and 56.5%, were achieved on the TUMOR and TUMOR + INF ROIs extracted for the VC cohort, respectively. CONCLUSIONS: Our approach represents a first effort to develop a non-invasive prognostic method to better define the recurrence risk and improve the management of SLN- melanoma patients.
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Inteligencia Artificial , Melanoma , Ganglio Linfático Centinela , Humanos , Melanoma/patología , Melanoma/diagnóstico por imagen , Ganglio Linfático Centinela/patología , Ganglio Linfático Centinela/diagnóstico por imagen , Femenino , Masculino , Persona de Mediana Edad , Recurrencia Local de Neoplasia/patología , Anciano , Adulto , Reproducibilidad de los Resultados , Recurrencia , Curva ROCRESUMEN
Recent improvements in artificial intelligence and computer vision make it possible to automatically detect abnormalities in medical images. Skin lesions are one broad class of them. There are types of lesions that cause skin cancer, again with several types. Melanoma is one of the deadliest types of skin cancer. Its early diagnosis is at utmost importance. The treatments are greatly aided with artificial intelligence by the quick and precise diagnosis of these conditions. The identification and delineation of boundaries inside skin lesions have shown promise when using the basic image processing approaches for edge detection. Further enhancements regarding edge detections are possible. In this paper, the use of fractional differentiation for improved edge detection is explored on the application of skin lesion detection. A framework based on fractional differential filters for edge detection in skin lesion images is proposed that can improve automatic detection rate of malignant melanoma. The derived images are used to enhance the input images. Obtained images then undergo a classification process based on deep learning. A well-studied dataset of HAM10000 is used in the experiments. The system achieves 81.04% accuracy with EfficientNet model using the proposed fractional derivative based enhancements whereas accuracies are around 77.94% when using original images. In almost all the experiments, the enhanced images improved the accuracy. The results show that the proposed method improves the recognition performance.
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Melanoma , Neoplasias Cutáneas , Melanoma/diagnóstico por imagen , Humanos , Neoplasias Cutáneas/diagnóstico por imagen , Neoplasias Cutáneas/patología , Aumento de la Imagen/métodos , Interpretación de Imagen Asistida por Computador/métodos , Aprendizaje Profundo , AlgoritmosRESUMEN
Purpose: Our study seeks to develop dual-modal organic-nanoagents for cancer therapy and real-time fluorescence imaging, followed by their pre-clinical evaluation on a murine model. Integrating NIR molecular imaging with nanotechnology, our aim is to improve outcomes for early-stage cutaneous melanoma by offering more effective and less invasive methods. This approach has the potential to enhance both photothermal therapy (PTT) and Sentinel Lymph Node Biopsy (SLNB) procedures for melanoma patients. Methods: NIR-797-isothiocyanate was encapsulated in poly(D,L-lactide-co-glycolide) acid (PLGA) nanoparticles (NPs) using a two-step protocol, followed by thorough characterization, including assessing loading efficiency, fluorescence stability, and photothermal conversion. Biocompatibility and cellular uptake were tested in vitro on melanoma cells, while PTT assay, with real-time thermal monitoring, was performed in vivo on tumor-bearing mice under irradiation with an 808 nm laser. Finally, ex vivo fluorescence microscopy, histopathological assay, and TEM imaging were performed. Results: Our PLGA NPs, with a diameter of 270 nm, negative charge, and 60% NIR-797 loading efficiency, demonstrated excellent stability and fluorescence properties, as well as efficient light-to-heat conversion. In vitro studies confirmed their biocompatibility and cellular internalization. In vivo experiments demonstrated their efficacy as photothermal agents, inducing mild hyperthermia with temperatures reaching up to 43.8 °C. Ex vivo microscopy of tumor tissue confirmed persistent NIR fluorescence and uniform distribution of the NPs. Histopathological and TEM assays revealed early apoptosis, immune cell response, ultrastructural damage, and intracellular material debris resulting from combined NP treatment and irradiation. Additionally, TEM analyses of irradiated zone margins showed attenuated cellular damage, highlighting the precision and effectiveness of our targeted treatment approach. Conclusion: Specifically tailored for dual-modal NIR functionality, our NPs offer a novel approach in cancer PTT and real-time fluorescence monitoring, signaling a promising avenue toward clinical translation.
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Hipertermia Inducida , Nanopartículas , Imagen Óptica , Copolímero de Ácido Poliláctico-Ácido Poliglicólico , Animales , Nanopartículas/química , Ratones , Copolímero de Ácido Poliláctico-Ácido Poliglicólico/química , Línea Celular Tumoral , Hipertermia Inducida/métodos , Humanos , Terapia Fototérmica/métodos , Neoplasias Cutáneas/terapia , Neoplasias Cutáneas/diagnóstico por imagen , Neoplasias Cutáneas/patología , Melanoma/terapia , Melanoma/diagnóstico por imagen , Fototerapia/métodosRESUMEN
Correlative imaging of cutaneous tumors provides additional information to the standard histopathologic examination. However, the joint progress in the establishment of analytical techniques, such as Laser-Induced Breakdown Spectroscopy (LIBS) and Laser Ablation Inductively Coupled Plasma Mass Spectrometry (LA-ICP-MS) in clinical practice is still limited. Their combination provides complementary information as it is also shown in our study in terms of major biotic (Ca, Mg, and P) and trace (Cu and Zn) elements. To elucidate changes in the elemental composition in tumors, we have compiled a set of malignant tumors (Squamous Cell Carcinoma, Basal Cell Carcinoma, Malignant Melanoma, and Epithelioid Angiosarcoma), one benign tumor (Pigmented Nevus) and one healthy-skin sample. The data processing was based on a methodological pipeline involving binary image registration and affine transformation. Thus, our paper brings a feasibility study of a practical methodological concept that enables us to compare LIBS and LA-ICP-MS results despite the mutual spatial distortion of original elemental images. Moreover, we also show that LIBS could be a sufficient pre-screening method even for a larger number of samples according to the speed and reproducibility of the analyses. Whereas LA-ICP-MS could serve as a ground truth and reference technique for preselected samples.
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Neoplasias Cutáneas , Neoplasias Cutáneas/diagnóstico por imagen , Neoplasias Cutáneas/patología , Humanos , Terapia por Láser , Melanoma/diagnóstico por imagen , Melanoma/patología , Espectrometría de Masas/métodos , Carcinoma Basocelular/diagnóstico por imagen , Oligoelementos/análisis , Carcinoma de Células Escamosas/diagnóstico por imagen , Carcinoma de Células Escamosas/patología , Análisis Espectral/métodos , Nevo Pigmentado/diagnóstico por imagen , Rayos LáserRESUMEN
With rising melanoma incidence and mortality, early detection and surgical removal of primary lesions is essential. Multispectral imaging is a new, non-invasive technique that can facilitate skin cancer detection by measuring the reflectance spectra of biological tissues. Currently, incident illumination allows little light to be reflected from deeper skin layers due to high surface reflectance. A pilot study was conducted at the University Hospital Basel to evaluate, whether multispectral imaging with direct light coupling could extract more information from deeper skin layers for more accurate dignity classification of melanocytic lesions. 27 suspicious pigmented lesions from 23 patients were included (6 melanomas, 6 dysplastic nevi, 12 melanocytic nevi, 3 other). Lesions were imaged before excision using a prototype snapshot mosaic multispectral camera with incident and direct illumination with subsequent dignity classification by a pre-trained multispectral image analysis model. Using incident light, a sensitivity of 83.3% and a specificity of 58.8% were achieved compared to dignity as determined by histopathological examination. Direct light coupling resulted in a superior sensitivity of 100% and specificity of 82.4%. Convolutional neural network classification of corresponding red, green, and blue lesion images resulted in 16.7% lower sensitivity (83.3%, 5/6 malignant lesions detected) and 20.9% lower specificity (61.5%) compared to direct light coupling with multispectral image classification. Our results show that incorporating direct light multispectral imaging into the melanoma detection process could potentially increase the accuracy of dignity classification. This newly evaluated illumination method could improve multispectral applications in skin cancer detection. Further larger studies are needed to validate the camera prototype.
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Melanoma , Nevo Pigmentado , Neoplasias Cutáneas , Humanos , Melanoma/diagnóstico por imagen , Melanoma/clasificación , Melanoma/patología , Melanoma/diagnóstico , Neoplasias Cutáneas/diagnóstico por imagen , Neoplasias Cutáneas/patología , Neoplasias Cutáneas/clasificación , Neoplasias Cutáneas/diagnóstico , Femenino , Nevo Pigmentado/diagnóstico por imagen , Nevo Pigmentado/diagnóstico , Nevo Pigmentado/clasificación , Nevo Pigmentado/patología , Masculino , Persona de Mediana Edad , Adulto , Proyectos Piloto , Anciano , Melanocitos/patología , Iluminación/métodos , Procesamiento de Imagen Asistido por Computador/métodos , Sensibilidad y EspecificidadRESUMEN
There is a critical need to non-invasively assess the PD-L1 expression in tumors as a predictive biomarker for determining the efficacy of anti-PD-1/PD-L1 immunotherapies. Non-invasive imaging modality like positron emission tomography (PET) can be a powerful tool to assess the PD-L1 expression in the whole body including multiple metastases as a patient selection criterion for the anti-PD-1/PD-L1 immunotherapy. In this study, we synthesized B11-nanobody, B11-scFv and B11-diabody fragments from the full-length anti-PD-L1 B11 IgG. Out of the three antibody fragments, B11-diabody showed higher nM affinity towards PD-L1 antigen as compared to B11-scFv and B11-nanobody. All three antibody fragments were successfully radiolabeled with 64Cu, a PET radioisotope. For radiolabeling, the antibody fragments were first conjugated with p-SCN-Bn-NOTA followed by chelation with 64Cu. All three radiolabeled antibody fragments were found to be stable in mouse and human sera for up to 24 h. Additionally, all three [64Cu]Cu-NOTA-B11-antibody fragments were evaluated in PD-L1 negative and human PD-L1 expressing cancer cells and subcutaneous tumor models. Based on the results, [64Cu]Cu-NOTA-B11-diabody has potential to be used as a PET imaging probe for assessing PD-L1 expression in tumors as early as 4 h post-injection, allowing faster assessment compared to the full length IgG based PET imaging probe.
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Antígeno B7-H1 , Neoplasias de la Mama , Tomografía de Emisión de Positrones , Tomografía de Emisión de Positrones/métodos , Antígeno B7-H1/metabolismo , Antígeno B7-H1/inmunología , Animales , Humanos , Femenino , Ratones , Neoplasias de la Mama/diagnóstico por imagen , Neoplasias de la Mama/inmunología , Línea Celular Tumoral , Melanoma/diagnóstico por imagen , Melanoma/inmunología , Melanoma/metabolismo , Anticuerpos de Cadena Única/inmunología , Radioisótopos de Cobre , Fragmentos de Inmunoglobulinas/inmunologíaRESUMEN
BACKGROUND: In recent years, the increasing prevalence of skin cancers, particularly malignant melanoma, has become a major concern for public health. The development of accurate automated segmentation techniques for skin lesions holds immense potential in alleviating the burden on medical professionals. It is of substantial clinical importance for the early identification and intervention of skin cancer. Nevertheless, the irregular shape, uneven color, and noise interference of the skin lesions have presented significant challenges to the precise segmentation. Therefore, it is crucial to develop a high-precision and intelligent skin lesion segmentation framework for clinical treatment. METHODS: A precision-driven segmentation model for skin cancer images is proposed based on the Transformer U-Net, called BiADATU-Net, which integrates the deformable attention Transformer and bidirectional attention blocks into the U-Net. The encoder part utilizes deformable attention Transformer with dual attention block, allowing adaptive learning of global and local features. The decoder part incorporates specifically tailored scSE attention modules within skip connection layers to capture image-specific context information for strong feature fusion. Additionally, deformable convolution is aggregated into two different attention blocks to learn irregular lesion features for high-precision prediction. RESULTS: A series of experiments are conducted on four skin cancer image datasets (i.e., ISIC2016, ISIC2017, ISIC2018, and PH2). The findings show that our model exhibits satisfactory segmentation performance, all achieving an accuracy rate of over 96%. CONCLUSION: Our experiment results validate the proposed BiADATU-Net achieves competitive performance supremacy compared to some state-of-the-art methods. It is potential and valuable in the field of skin lesion segmentation.
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Melanoma , Neoplasias Cutáneas , Humanos , Neoplasias Cutáneas/diagnóstico por imagen , Neoplasias Cutáneas/patología , Melanoma/diagnóstico por imagen , Melanoma/patología , Algoritmos , Redes Neurales de la Computación , Procesamiento de Imagen Asistido por Computador/métodos , Interpretación de Imagen Asistida por Computador/métodos , Dermoscopía/métodos , Aprendizaje ProfundoRESUMEN
Positron emission tomography (PET) is a powerful tool for investigating the in vivo behavior of drug delivery systems. We aimed to assess the biodistribution of extracellular vesicles (EVs), nanosized vesicles secreted by cells isolated from various human cell sources using PET. EVs were isolated from mesenchymal stromal cells (MSCs) (MSC EVs), human macrophages (MÏ EVs), and a melanoma cell line (A375 EVs) by centrifugation and were conjugated with deferoxamine for radiolabeling with Zr-89. PET using conjugated and radiolabeled EVs evaluated their in vivo biodistribution and tissue tropisms. Our study also investigated differences in mouse models, utilizing immunocompetent and immunocompromised mice and an A375 xenograft tumor model. Lastly, we investigated the impact of different labeling techniques on the observed EV biodistribution, including covalent surface modification and membrane incorporation. PET showed that all tested EVs exhibited extended in vivo circulation and generally low uptake in the liver, spleen, and lungs. However, MÏ EVs showed high liver uptake, potentially attributable to the intrinsic tissue tropism of these EVs from the surface protein composition. MSC EV biodistribution differed between immunocompetent and immunodeficient mice, with increased spleen uptake observed in the latter. PET using A375 xenografts demonstrated efficient tumor uptake of EVs, but no preferential tissue-specific tropism of A375 EVs was found. Biodistribution differences between labeling techniques showed that surface-conjugated EVs had preferential blood circulation and low liver, spleen, and lung uptake compared to membrane integration. This study demonstrates the potential of EVs as effective drug carriers for various diseases, highlights the importance of selecting appropriate cell sources for EV-based drug delivery, and suggests that EV tropism can be harnessed to optimize therapeutic efficacy. Our findings indicate that the cellular source of EVs, labeling technique, and animal model can influence the observed biodistribution.
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Vesículas Extracelulares , Células Madre Mesenquimatosas , Tomografía de Emisión de Positrones , Animales , Humanos , Vesículas Extracelulares/metabolismo , Distribución Tisular , Ratones , Tomografía de Emisión de Positrones/métodos , Línea Celular Tumoral , Células Madre Mesenquimatosas/metabolismo , Macrófagos/metabolismo , Circonio/química , Circonio/farmacocinética , Deferoxamina/química , Deferoxamina/farmacocinética , Radioisótopos/química , Radioisótopos/farmacocinética , Sistemas de Liberación de Medicamentos/métodos , Ensayos Antitumor por Modelo de Xenoinjerto , Femenino , Melanoma/metabolismo , Melanoma/diagnóstico por imagenRESUMEN
Background and Objectives: Amelanotic/hypomelanotic melanomas (AHMs) account for 2-8% of all cutaneous melanomas. Due to their clinical appearance and the lack of specific dermoscopic indicators, AHMs are challenging to diagnose, particularly in thinner cutaneous lesions. The aim of our study was to evaluate the clinicopathological and dermoscopic features of thin AHMs. Identifying the baseline clinical-pathological features and dermoscopic aspects of thin AHMs is crucial to better understand this entity. Materials and Methods: We divided the AHM cohort into two groups based on Breslow thickness: thin (≤1.00 mm) and thick (>1.00 mm). This stratification helped identify any significant clinicopathological differences between the groups. For dermoscopic analysis, we employed the "pattern analysis" approach, which involves a simultaneous and subjective assessment of different criteria. Results: Out of the 2.800 melanomas analyzed for Breslow thickness, 153 were identified as AHMs. Among these, 65 patients presented with thin AHMs and 88 with thick AHMs. Red hair color and phototype II were more prevalent in patients with thin AHMs. The trunk was the most common anatomic site for thin AHMs. Patients with thin AHMs showed a higher number of multiple melanomas. Dermoscopic analysis revealed no significant difference between thin AHMs and thick AHMs, except for a more frequent occurrence of residual reticulum in thin AHMs. Conclusions: Thin AHMs typically affect individuals with lower phototypes and red hair color. These aspects can be related to the higher presence of pheomelanin, which provides limited protection against sun damage. This also correlates with the fact that the trunk, a site commonly exposed to intermittent sun exposure, is the primary anatomical location for thin AHMs. Multiple primary melanomas are more common in patients with thin AHMs, likely due to an intrinsic predisposition as well as greater periodic dermatologic follow-ups in this class of patients. Apart from the presence of residual reticulum, no other significant dermoscopic differences were observed, complicating the differential diagnosis between thin and thick AHMs based on dermoscopy alone.
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Dermoscopía , Melanoma Amelanótico , Melanoma , Neoplasias Cutáneas , Humanos , Dermoscopía/métodos , Masculino , Persona de Mediana Edad , Femenino , Melanoma Amelanótico/patología , Melanoma Amelanótico/diagnóstico por imagen , Neoplasias Cutáneas/patología , Neoplasias Cutáneas/diagnóstico por imagen , Anciano , Melanoma/diagnóstico por imagen , Melanoma/patología , Adulto , Estudios de Cohortes , Hipopigmentación/patologíaRESUMEN
In dermoscopic images, which allow visualization of surface skin structures not visible to the naked eye, lesion shape offers vital insights into skin diseases. In clinically practiced methods, asymmetric lesion shape is one of the criteria for diagnosing Melanoma. Initially, we labeled data for a non-annotated dataset with symmetrical information based on clinical assessments. Subsequently, we propose a supporting technique-a supervised learning image processing algorithm-to analyze the geometrical pattern of lesion shape, aiding non-experts in understanding the criteria of an asymmetric lesion. We then utilize a pre-trained convolutional neural network (CNN) to extract shape, color, and texture features from dermoscopic images for training a multiclass support vector machine (SVM) classifier, outperforming state-of-the-art methods from the literature. In the geometry-based experiment, we achieved a 99.00 % detection rate for dermatological asymmetric lesions. In the CNN-based experiment, the best performance is found 94 % Kappa Score, 95 % Macro F1-score, and 97 % weighted F1-score for classifying lesion shapes (Asymmetric, Half-Symmetric, and Symmetric).
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Melanoma , Redes Neurales de la Computación , Neoplasias Cutáneas , Máquina de Vectores de Soporte , Humanos , Melanoma/diagnóstico por imagen , Melanoma/patología , Melanoma/clasificación , Neoplasias Cutáneas/diagnóstico por imagen , Neoplasias Cutáneas/patología , Neoplasias Cutáneas/clasificación , Dermoscopía/métodos , Interpretación de Imagen Asistida por Computador/métodos , Algoritmos , Piel/diagnóstico por imagen , Piel/patologíaRESUMEN
The aim of this study was to evaluate the preclinical efficacy of [89Zr]Zr-DFO-Ab253 as a novel positron emission tomography (PET) tracer for CD146-positive malignant melanoma imaging. Considering the high expression of CD146 in malignant melanoma, this study investigated the effect of different CD146 expression levels on the tumor uptake of [89Zr]Zr-DFO-Ab253. CD146 selectivity was investigated by using the CD146-positive human melanoma cell A375 and the CD146-negative human alveolar epithelial cell A549. The cell uptake of [89Zr]Zr-DFO-Ab253 tracers was investigated, and receptor-binding affinities were measured by radioactive enzyme-linked immunosorbent assay. Biodistribution studies and micro-PET imaging of the radiotracers were performed on mice bearing A375 and A549 xenografts under baseline and blocking conditions. An immunohistochemical test was performed using A375 and A549 tissue sections for CD146 expression level analysis. [89Zr]Zr-DFO-Ab253 was obtained with a high radiochemical yield (87.86 ± 4.66%) and a satisfactory radiochemical purity (>98.0%). The specificity and affinity of [89Zr]Zr-DFO-Ab253 were confirmed in melanoma A375 cells and in vivo PET imaging of A375 tumor models. [89Zr]Zr-DFO-IgG and A549 lung tumors were prepared as control radiotracers and negative models to verify the specificity of [89Zr]Zr-DFO-Ab253 on CD146. [89Zr]Zr-DFO-Ab253 has a Kd of 4.01 ± 0.50 nM. PET imaging and biodistribution showed a higher uptake of [89Zr]Zr-DFO-Ab253 in A375 melanomas than that in A549 tumors (42.1 ± 4.04% vs 7.87 ± 1.30% ID/g at 120 h, P < 0.05). A low tumor uptake of [89Zr]Zr-DFO-IgG was observed with uptakes of 1.91 ± 0.41 and 2.80 ± 0.14 ID%/g when blocked at 120 h. The radiation-absorbed dose was calculated to be 0.13 mSv/MBq. This study demonstrates the synthesis and preclinical evaluation of [89Zr]Zr-DFO-Ab253 and indicates that the novel tracer has promising applications in malignant melanoma-specific PET imaging because of its high uptake and long-time retention in malignant melanoma. It also provides feasibility for the development of integrated molecular probes for diagnosis and treatment based on the CD146 target.
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Anticuerpos Monoclonales , Antígeno CD146 , Melanoma , Tomografía de Emisión de Positrones , Radioisótopos , Circonio , Antígeno CD146/metabolismo , Antígeno CD146/inmunología , Animales , Humanos , Circonio/química , Melanoma/diagnóstico por imagen , Ratones , Tomografía de Emisión de Positrones/métodos , Anticuerpos Monoclonales/química , Distribución Tisular , Línea Celular Tumoral , Ratones Desnudos , Células A549 , Radiofármacos/química , Radiofármacos/farmacocinética , FemeninoRESUMEN
The objective of this review was to conduct a systematic review and meta-analysis on the efficacy of ICG (indocyanine green) for sentinel lymph node (SLN) detection in head and neck melanoma. The Preferred Reporting Items for Systematic reviews and Meta-Analyses statement standards (PRISMA) were followed when conducting this review with a comprehensive search of the following online databases; Google Scholar, PubMed, MEDLINE, CINAHL, and CENTRAL, World Health Organization International Clinical Trials Registry (http://apps.who.int/trialsearch/), ClinicalTrials.gov (http://clinical-trials.gov/), and the ISRCTN registry (http://www.isrctn.com/). Nine studies met the inclusion criteria and results were reported with forest plots at 95% confidence intervals. Primary outcomes of interest included the localisation rate for sentinel node biopsies in head and neck melanoma using ICG and compared with other adjunct modalities. Secondary outcome measures included false negative rates as well as sensitivity rates for nodal detection with radiocolloid as well as blue dye. ICG reported an overall sensitivity rate of 95% with an untransformed proportion metric analysis (0.950, 0.922, 0.978 (95% CI)). It demonstrated a superior detection rate to blue dye (Odds ratio 15.417, 95% CI, 4.652 to 51.091, p < 0.001) and a comparable localisation efficacy to radiocolloid (Odds ratio 1.425, 95% CI, 0.535 to 3.794, p = 0.478). The sensitivity rate for radiocolloid utilisation in isolation was 90.6% (untransformed proportion metric, 0.906, 0.855, 0.957) and blue dye was 48.7% (untransformed proportion metric, 0.487, 0.364, 0.610). This is the first meta-analysis on the efficacy of ICG for sentinel node detection in head and neck melanoma. The authors advocate for a dual modality approach with ICG and radiocolloid to mitigate the inherent limitations of both methods when conducting sentinel node retrieval for head and neck melanoma. Further high-quality randomised trials are needed to improve the current evidence base.
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Colorantes , Neoplasias de Cabeza y Cuello , Verde de Indocianina , Melanoma , Biopsia del Ganglio Linfático Centinela , Neoplasias Cutáneas , Humanos , Fluoroscopía , Neoplasias de Cabeza y Cuello/patología , Neoplasias de Cabeza y Cuello/diagnóstico por imagen , Melanoma/patología , Melanoma/diagnóstico por imagen , Sensibilidad y Especificidad , Biopsia del Ganglio Linfático Centinela/métodos , Neoplasias Cutáneas/patología , Neoplasias Cutáneas/diagnóstico por imagenRESUMEN
BACKGROUND: In tissue engineering, real-time monitoring of tumors and of the dynamics of the microenvironment within in vitro models has traditionally been hindered by the need to harvest the cultures to obtain material to analyze. Line-field confocal optical coherence tomography (LC-OCT) has proven to be useful in evaluating in vivo skin conditions, including melanoma, by capturing dynamic, three-dimensional (3D) information without the need for invasive procedures, such as biopsies. Additionally, the M-Duo Technology® developed by IMcoMET presents a unique opportunity for continuous in situ biomarker sampling, providing insights into local cellular behavior and interactions. OBJECTIVE: This study aimed to validate the non-destructive mapping capabilities of two advanced methodologies (LC-OCT by DAMAE Medical and M-Duo Technology® by IMcoMET) to investigate the living microenvironment of in vitro reconstructed human skin (RhS) and melanoma-RhS (Mel-RhS). METHODS: LC-OCT and M-Duo Technology® were compared to conventional analysis of the RhS and Mel-RhS microenvironments. RESULTS: LC-OCT successfully visualized the distinct layers of the epidermis and tumor structures within the Mel-RhS, identifying keratinocytes, melanocytes, tumor nests, and fibroblasts. The M-Duo Technology® revealed differences in in situ cytokine (IL-6) and chemokine (CCL2, CXCL10, and IL-8) secretion between Mel-RhS and the control RhS. Notably, such differences were not detected through conventional investigation of secreted proteins in culture supernatants. CONCLUSION: The combination of LC-OCT's high-resolution imaging and M-Duo Technology®'s in situ microenvironmental mapping has the potential to provide a synergistic platform for non-invasive, real-time analysis, allowing for prolonged observation of processes within Mel-RhS models without the need for culture disruption.
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Melanoma , Neoplasias Cutáneas , Piel , Tomografía de Coherencia Óptica , Microambiente Tumoral , Humanos , Melanoma/patología , Melanoma/diagnóstico por imagen , Tomografía de Coherencia Óptica/métodos , Neoplasias Cutáneas/patología , Neoplasias Cutáneas/diagnóstico por imagen , Piel/diagnóstico por imagen , Piel/patología , Ingeniería de Tejidos/métodos , Fibroblastos , Queratinocitos/patología , Melanocitos/patología , Quimiocina CXCL10/metabolismo , Quimiocina CXCL10/análisis , Imagenología Tridimensional/métodosRESUMEN
OBJECTIVE: 18F-N-(2-(Diethylamino)ethyl)-5-(2-(2-(2-fluoroethoxy)ethoxy)ethoxy) picolinamide (18F-PFPN) is a novel positron emission tomography (PET) probe designed to specifically targets melanin. This study aimed to evaluate the diagnostic feasibility of 18F-PFPN in patients with ocular or orbital melanoma. MATERIALS AND METHODS: Three patients with pathologically confirmed ocular or orbital melanoma (one male, two females; age 41-59 years) were retrospectively reviewed. Each patient underwent comprehensive 18F-PFPN and 18F-fluorodeoxyglucose (18F-FDG) PET scans. The maximum standardized uptake value (SUVmax) of the lesion and the interference caused by background tissue were compared between 18F-PFPN and 18F-FDG PET imaging. In addition, the effect of intrinsic pigments in the uvea and retina on the interpretation of the results was examined. The contralateral non-tumorous eye of each patient served as a control. RESULTS: All primary tumors (3/3) were detected using 18F-PFPN PET, while only two primary tumors were detected using 18F-FDG PET. Within each lesion, the SUVmax of 18F-PFPN was 2.6 to 8.3 times higher than that of 18F-FDG. Regarding the quality of PET imaging, the physiological uptake of 18F-FDG PET in the brain and periocular tissues limited the imaging of tumors. However, 18F-PFPN PET minimized this interference. Notably, intrinsic pigments in the uvea and retina did not cause abnormal concentrations of 18F-PFPN, as no anomalous uptake of 18F-PFPN was detected in the healthy contralateral eyes. CONCLUSION: Compared to 18F-FDG, 18F-PFPN demonstrated higher detection rates for ocular and orbital melanomas with minimal interference from surrounding tissues. This suggests that 18F-PFPN could be a promising clinical diagnostic tool for distinguishing malignant melanoma from benign pigmentation in ocular and orbital melanomas.
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Neoplasias del Ojo , Fluorodesoxiglucosa F18 , Melaninas , Melanoma , Neoplasias Orbitales , Tomografía de Emisión de Positrones , Radiofármacos , Humanos , Masculino , Melanoma/diagnóstico por imagen , Melanoma/metabolismo , Persona de Mediana Edad , Femenino , Adulto , Melaninas/metabolismo , Estudios Retrospectivos , Tomografía de Emisión de Positrones/métodos , Neoplasias Orbitales/diagnóstico por imagen , Neoplasias Orbitales/metabolismo , Neoplasias del Ojo/diagnóstico por imagen , Neoplasias del Ojo/metabolismo , Estudios de Factibilidad , Ácidos PicolínicosRESUMEN
Over the past decade, several strategies have revolutionized the clinical management of patients with cutaneous melanoma (CM), including immunotherapy and targeted tyrosine kinase inhibitor (TKI)-based therapies. Indeed, immune checkpoint inhibitors (ICIs), alone or in combination, represent the standard of care for patients with advanced disease without an actionable mutation. Notably BRAF combined with MEK inhibitors represent the therapeutic standard for disease disclosing BRAF mutation. At the same time, FDG PET/CT has become part of the routine staging and evaluation of patients with cutaneous melanoma. There is growing interest in using FDG PET/CT measurements to predict response to ICI therapy and/or target therapy. While semiquantitative values such as standardized uptake value (SUV) are limited for predicting outcome, new measures including tumor metabolic volume, total lesion glycolysis and radiomics seem promising as potential imaging biomarkers for nuclear medicine. The aim of this review, prepared by an interdisciplinary group of experts, is to take stock of the current literature on radiomics approaches that could improve outcomes in CM.
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Fluorodesoxiglucosa F18 , Melanoma , Tomografía Computarizada por Tomografía de Emisión de Positrones , Radiofármacos , Humanos , Melanoma/diagnóstico por imagen , Melanoma/tratamiento farmacológico , Melanoma/patología , Tomografía Computarizada por Tomografía de Emisión de Positrones/métodos , Neoplasias Cutáneas/diagnóstico por imagen , Neoplasias Cutáneas/patología , Neoplasias Cutáneas/tratamiento farmacológico , RadiómicaRESUMEN
Objective:To explore the imaging features of rare tumors of nasal cavity and sinuses, and to improve the understanding of these diseases, thereby aiding clinical diagnosis and treatment. Methods:The CT and MRI findings of 79 cases of rare neoplasm of nasal cavity and sinuses confirmed by pathology were retrospectively analyzed, and the imaging features were summarized. Results:Among the 79 cases, there were 16 cases of neuroendocrine carcinoma, most showing expansive and infiltrative bone destruction without hyperosteogeny and sclerosis. The sphenoid sinus exhibited a "pigeon" shape. In 28 cases of malignant melanoma, MRI signals were diverse, typical signals were rare, but mixed signals were more common. In 12 cases of rhabdomyosarcoma, MRI enhancement mostly showed "grape-like" enhancement and partial ring enhancement; There were 10 cases of olfactory neuroblastoma, the lesions were consistent with the distribution area of olfactory mucosa, most of them were lobulated, marginal nodules, and "flower ring" enhancement, and 2 cases grew across intracranial and external, with multiple cystic lesions and surrounding flaky edema bands. In 5 cases of solitary fibrous tumor, Benign tumors had regular shape and uniform density, while malignant tumors had irregular shape and uneven density, The enhancement was obviously uneven and showed a "pattern" change. There were 2 cases of sarcomatoid carcinoma, both with lobed appearance, uneven density, lamellar low-density shadow, and osteolytic bone destruction. In 4 cases of schwannoma, the enhancement showed obvious inhomogeneous enhancement. One case showed cystic necrosis, one case showed calcification, and the surrounding structure was compressed without damage. There was 1 case of neurofibroma, with many cystic components, low signal separation and compartmentalized enhancement. One case of paraganglioma showed moderate enhancement in the arterial phase and progressive enhancement in the venous phase, accompanied by significant swelling bone destruction. Conclusion:Rare tumors of nasal cavity and paranasal sinuses have distinctive imaging features. CT and MRI can effectively show the extent of the lesions and the degree of infiltration into adjacent tissues and organs, which is helpful for early clinical diagnosis and staging. However, definitive diagnosis still depends on pathology and immunohistochemistry.
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Imagen por Resonancia Magnética , Cavidad Nasal , Neoplasias Nasales , Neoplasias de los Senos Paranasales , Tomografía Computarizada por Rayos X , Humanos , Cavidad Nasal/diagnóstico por imagen , Cavidad Nasal/patología , Estudios Retrospectivos , Imagen por Resonancia Magnética/métodos , Neoplasias Nasales/diagnóstico por imagen , Neoplasias Nasales/patología , Neoplasias de los Senos Paranasales/diagnóstico por imagen , Neoplasias de los Senos Paranasales/patología , Masculino , Rabdomiosarcoma/diagnóstico por imagen , Rabdomiosarcoma/patología , Femenino , Carcinoma Neuroendocrino/diagnóstico por imagen , Carcinoma Neuroendocrino/patología , Persona de Mediana Edad , Senos Paranasales/diagnóstico por imagen , Senos Paranasales/patología , Melanoma/diagnóstico por imagen , Melanoma/patología , Adulto , Tumores Fibrosos Solitarios/diagnóstico por imagen , Tumores Fibrosos Solitarios/patología , Adulto Joven , AncianoRESUMEN
ABSTRACT: Skin cancer is the most common cancer in the United States, with an estimated 9,500 new diagnoses made each day. Dermoscopy (also called dermatoscopy) is an established clinical approach to improving skin cancer evaluation. However, only 8% to 9% of primary care physicians use it, and no data are available for physician associate/assistant or NP use. This article reports a dermoscopy algorithm that primary care providers can use to increase the detection of skin cancer and reduce unnecessary referrals and biopsies.