A new perspective on the treatment and management of atypical nevi: A blinded retrospective analysis of atypical nevi utilizing line-field confocal optical coherence tomography

Abstract

Background: Limitations exist among current noninvasive imaging techniques for evaluating equivocal melanocytic lesions. Line-field confocal optical coherence tomography was introduced to bridge the gap between these technologies.

Objective: To further establish this device as a useful imaging modality and refine the current criteria for differentiating between benign and malignant lesions.

Methods: Seventy-five lesions were included in this study, and each was subjected to a biopsy, short-term mole monitoring, or DermTech Melanoma Test. The existing criteria for line-field confocal optical coherence tomography were analyzed retrospectively.

Results: The statistically significant criteria for distinguishing between benign vs malignant lesions include the presence of atypical honeycomb, dendritic cells with moderate or severe levels of pleomorphism, and clefting.

Limitations: This study has a limited sample size and was conducted at a single center.

Conclusion: We have identified diagnostic criteria that can be useful in analyzing equivocal melanocytic lesions.

Keywords: DermTech Melanoma Test; atypical (dysplastic) nevus; benign nevus; line-field confocal optical coherence tomography (LC-OCT); malignant melanoma (MM); melanocytic nevus; noninvasive imaging; optical coherence tomography (OCT); pigmented lesion assay (PLA); reflectance confocal microscopy (RCM).