Optical probe could reduce unnecessary biopsies

Researchers have developed a spectroscopic device that combines three ways of using light to measure the properties of skin tissue and potentially detect skin cancer.

The research team from University of Texas at Austin has begun testing the three-in-one probe in pilot clinical trials. Lead researcher James Tunnell, Ph.D., an associate professor in the biomedical engineering department, and his colleagues combined three spectroscopic techniques - Raman, diffuse reflectance and laser-induced fluorescence - into one probe, which they say provides a more complete picture of a skin lesion. The probe is about the size of a pen, and supporting equipment fits on a portable wheeled cart. Readings take less than five seconds to perform.

According to the paper published in the August issue of Review of Scientific Instruments, the researchers say the device could eventually replace biopsy as the definitive way to diagnose skin cancer. The researchers write that biopsy is imprecise, and that for every case of skin cancer it detects there are about 25 negative biopsies. This, they write, adds $6 billion in costs to the U.S. healthcare system.

Dr. Tunnell tells Dermatology Times that the new device offers significant potential benefits to patients and physicians alike.

“The primary benefits to the patient center on having fewer ‘unnecessary biopsies,’" he says. “This obviously leads to less morbidity for them, but it also has to potential to increase patient compliance with screening recommendations. They may be more likely to get screened knowing there is less of a chance they will be cut on unless absolutely necessary. This in turn has the potential to catch more early cancers and increase survival.”

A major benefit for dermatologists, Dr. Tunnell says, is the opportunity to see more patients.

“This type of device has the potential to change the workflow in their office, allowing for faster screening of patients,” he says. “In addition, the device offers the potential to document a lesion, (which can) aid in monitoring lesions over time - not to mention the benefits in the legal arena. Finally - and most importantly - they should see a benefit to their patients in identifying earlier lesions, reducing morbidity and reducing mortality.”

The researchers have launched a three-year effort to enroll 250 patients in a clinical pilot study to determine the device’s accuracy in a screening setting.

“We just completed a smaller-scale study of a first-generation prototype that showed perfect agreement between study pathologists and our device for detecting melanoma,” he says. “If those results hold in this larger study, then I would expect to see translation of this device into the clinic shortly thereafter.”