Voigt H, Classen R
Melanoma Research Project, Clinic Section and Research Institute, Kaltenkirchen/Holstein, Germany.
Cancer. 1995 Feb 15;75(4):981-8. doi: 10.1002/1097-0142(19950215)75:4<981::aid-cncr2820750413>3.0.co;2-a.
The clinical need to identify and evaluate changes of cutaneous lesions in melanoma screening or follow-up of patients with cancer is of paramount importance. Because skin-lesion changes may be small and numerous, clinical assessment alone does not meet the requirements of quantitative assessment. Using the computer as a diagnostic tool for the image analysis of sequentially captured skin surface images has resulted in the technical problem of insufficient registration reproducibility. This paper describes the technical logistics, setup procedure, and clinical evaluation of the novel technique termed "topodermatography," which performs the quantitative videographic image analysis of skin-lesion changes over time.
Digitized measurements of skin-surface image parameters were performed using a high-speed processor with an onboard coprocessor, a high-resolution video camera, specifically designed image processing software, and a position framework for the adjustment of the patient's standing position. The topodermatographic image analysis was performed on 109 consecutive patients who were at risk for melanoma (N = 98), had lesions from Kaposi's sarcoma (N = 4), had metastatic skin deposits from melanoma (N = 3), and had breast cancer (N = 4).
Skin lesion changes over time could be identified reliably within a few millimeters of diametric enlargement. In this series, a 0.51% early melanoma detection rate was assessed in 19 of 98 patients followed for 12 months. By monitoring manifest neoplastic skin lesions, tumor growth kinetics were analyzed quantitatively to determine the total area of skin involvement, thus facilitating precise response assessment.
Topodermatographic image analysis helps to optimize screening and follow-up procedures for patients with melanoma and populations at risk for melanoma. In addition, metastatic tumor lesions on the skin can be monitored dynamically, facilitating the accurate evaluation of the impact of systemic therapy on multiple skin deposits from melanoma and nonmelanoma cancers.
在黑色素瘤筛查或癌症患者随访中，识别和评估皮肤病变变化的临床需求至关重要。由于皮肤病变变化可能微小且数量众多，仅靠临床评估无法满足定量评估的要求。将计算机用作顺序捕获的皮肤表面图像的图像分析诊断工具，导致了配准再现性不足的技术问题。本文描述了一种名为“拓扑皮肤成像”的新技术的技术流程、设置程序和临床评估，该技术可对皮肤病变随时间的变化进行定量视频图像分析。
使用带有板载协处理器的高速处理器、高分辨率摄像机、专门设计的图像处理软件以及用于调整患者站立位置的定位框架，对皮肤表面图像参数进行数字化测量。对109例连续患者进行了拓扑皮肤成像图像分析，这些患者包括有黑色素瘤风险者（N = 98）、患有卡波西肉瘤病变者（N = 4）、有黑色素瘤皮肤转移沉积物者（N = 3）以及患有乳腺癌者（N = 4）。
随着时间推移，皮肤病变变化在直径增大几毫米范围内即可可靠识别。在本系列研究中，对98例随访12个月的患者中的19例进行评估，早期黑色素瘤检出率为0.51%。通过监测明显的肿瘤性皮肤病变，对肿瘤生长动力学进行定量分析以确定皮肤受累总面积，从而有助于进行精确的反应评估。
拓扑皮肤成像图像分析有助于优化黑色素瘤患者及黑色素瘤高危人群的筛查和随访程序。此外，可动态监测皮肤转移性肿瘤病变，有助于准确评估全身治疗对黑色素瘤和非黑色素瘤癌症的多处皮肤沉积物的影响。
