Detecting field cancerization using a hyperspectral imaging system

Lasers Surg Med. 2013 Sep;45(7):410-7. doi: 10.1002/lsm.22160.

Abstract

Background: Field cancerization denotes subclinical abnormalities in a tissue chronically exposed to UV radiation. These abnormalities can be found surrounding the clinically visible actinic keratoses.

Objectives: The aim of this study was to test the feasibility of a hyperspectral imaging system in the detection of multiple clinical and subclinical AKs for early treatment of the affected areas.

Materials and methods: Altogether 52 clinical AKs in 12 patients were included in this study. In six patients digital photos were taken of the naive AKs, and again after methylaminolevulinate(MAL)-fluorescence diagnosis which was used to teach HIS to find subclinical lesions. After 2-3 days when the MAL had vanished, the hyperspectral images were taken. Biopsies were taken from clinical AKs, healthy-looking skin and several suspected subclinical AKs. In the other six patients digital and hyperspectral images were taken of the naive AKs followed by one biopsy per patient.

Results: HIS detected all clinically visible 52 AKs and numerous subclinical lesions. The histopathology of the 33 biopsied lesions were concordant with the HIS results showing either AK (n = 28) or photodamage (n = 5). Of the 28 histopathologically confirmed AKs, 16 were subclinical. A specific diffuse reflectance spectrum of an AK and healthy skin was defined.

Conclusion: The hyperspectral imaging system offers a new, non-invasive method for early detection of field cancerization. Lasers Surg. Med. 45:410-417, 2013. © 2013 Wiley Periodicals, Inc.

Keywords: actinic keratosis; field cancerization; hyperspectral imaging.

Publication types

  • Clinical Trial

MeSH terms

  • Aged
  • Aged, 80 and over
  • Aminolevulinic Acid / analogs & derivatives*
  • Asymptomatic Diseases
  • Biopsy
  • Feasibility Studies
  • Female
  • Humans
  • Image Interpretation, Computer-Assisted*
  • Keratosis, Actinic / diagnosis*
  • Keratosis, Actinic / pathology
  • Male
  • Narrow Band Imaging / methods*
  • Photography
  • Photosensitizing Agents*
  • Pilot Projects
  • Skin / pathology

Substances

  • Photosensitizing Agents
  • methyl 5-aminolevulinate
  • Aminolevulinic Acid