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New imaging test can detect skin cancers without the need for biopsy

Diagram showing differences that can be observed in cell morphology in normal skin cells versus melanomas. Pink images show differences following biopsy and staining by a pathologist. Green slices show differences in fluorescence pattern of mitochondria using multiphoton microscopy.

Image source: Irene Georgakoudi, PhD, associate professor at Tufts University.

Researchers have developed a new imaging technique that can detect skin cancer without a surgical biopsy, according to findings published in Science Translational Medicine (Nov. 30, 2016; 8(367):367ra169).

During the investigation, co-senior author Irene Georgakoudi, PhD, along with a group of international collaborators, found that the behaviour of the mitochondria in healthy versus cancerous tissue differs significantly. By using this laser microscopy technique, the research team found that one molecule—nicotinamide adenine dinucleotide (NADH)—provides diagnostically useful information regarding the organization of mitochondria within skin cells.

“The system allows us to obtain very high-resolution images of individual cells without having to slice the tissue physically,” said Dr. Georgakoudi, associate professor in the Department of Biomedical Engineering at Tufts University in Medford, Mass.

“With this technique, we found that in normal cells the mitochondria are spread throughout the cell in a web-like pattern. Conversely, cancerous skin cells show a very different pattern with the mitochondria found in clumps or clusters, typically at the center of the cell along the border of the nucleus,” added Dr. Georgakoudi, who was quoted in a press release.

In this study, the researchers tested this technique on 10 patients with either melanoma or basal carcinoma and four patients who did not have skin cancer. Results of the imaging techniques from both groups were compared to the traditional biopsy results obtained from each patient. The findings revealed that the imaging technique correctly identified skin cancer in the 10 patients, and made no false diagnosis in the four individuals without skin cancer.

Technology may help diagnose skin cancer earlier

“The technology developed here has the potential to make the detection of skin cancers extremely rapid and feasible at very early stages,” said Behrouz Shabestari, PhD, program director for Optical Imaging and Spectroscopy at the National Institute of Biomedical Imaging and Bioengineering in Bethesda, Md.

“Rather than taking a biopsy sample that must be processed and then examined under a microscope by a pathologist, this system involves simply looking through the microscope at the patient’s skin and determining whether it is cancerous or not, within minutes,” added Dr. Shabestari.

While the US$100,000 price tag of the laser in the microscope can deter medical facilities from the investment, Dr. Georgakoudi suggested that this test could be regularly used in doctor’s offices within the next five years.

“Less-expensive lasers are on the horizon,” concluded Dr. Georgakoudi. “However, this approach would enable a doctor to make a quick diagnosis and begin treatment immediately, which could ultimately lower health care costs associated with these very common cancers.”

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