Department of Mechanical Engineering, Johns Hopkins University, Baltimore, MD, USA.
Clin Cosmet Investig Dermatol. 2012;5:195-212. doi: 10.2147/CCID.S27902. Epub 2012 Nov 12.
Every year around 2.5-3 million skin lesions are biopsied in the US, and a fraction of these - between 50,000 and 100,000 - are diagnosed as melanoma. Diagnostic instruments that allow early detection of melanoma are the key to improving survival rates and reducing the number of unnecessary biopsies, the associated morbidity, and the costs of care. Advances in technology over the past 2 decades have enabled the development of new, sophisticated test methods, which are currently undergoing laboratory and small-scale clinical testing. This review highlights and compares some of the emerging technologies that hold the promise of melanoma diagnosis at an early stage of the disease. The needs for detection at different levels (patient, primary care, specialized care) are discussed, and three broad classes of instruments are identified that are capable of satisfying these needs. Technical and clinical requirements on the diagnostic instruments are introduced to aid the comparison and evaluation of new technologies. White- and polarized-light imaging, spatial and spectroscopic multispectral methods, quantitative thermographic imaging, confocal microscopy, Optical Coherence Tomography (OCT), and Terahertz (THZ) imaging methods are highlighted in light of the criteria identified in the review. Based on the properties, possibilities, and limitations of individual methods, those best suited for a particular setting are identified. Challenges faced in development and wide-scale application of novel technologies are addressed.
每年美国有 250 万至 300 万例皮肤病变需要进行活检，其中有 5 万至 10 万例被诊断为黑色素瘤。能够早期发现黑色素瘤的诊断仪器是提高存活率、减少不必要的活检、相关发病率和医疗成本的关键。过去 20 年技术的进步使得新的复杂检测方法得以开发，目前这些方法正在进行实验室和小规模临床测试。本综述重点介绍并比较了一些新兴技术，这些技术有望在疾病早期阶段进行黑色素瘤诊断。讨论了在不同水平（患者、初级保健、专业护理）检测的需求，并确定了能够满足这些需求的三类广泛的仪器。介绍了诊断仪器的技术和临床要求，以帮助比较和评估新技术。鉴于本综述中确定的标准，重点介绍了白光和偏振光成像、空间和光谱多光谱方法、定量热成像、共焦显微镜、光学相干断层扫描 (OCT) 和太赫兹 (THZ) 成像方法。根据各个方法的特性、可能性和局限性，确定了最适合特定环境的方法。还讨论了新型技术在开发和广泛应用中面临的挑战。
