Cargando…

Systematic review of diagnostic accuracy of reflectance confocal microscopy for melanoma diagnosis in patients with clinically equivocal skin lesions

BACKGROUND: Melanoma is a cancer of the skin and is increasing in incidence in the UK and Europe. Melanoma is a condition that is often curable if detected at an early stage, which makes accurate diagnosis vital. Reflectance confocal microscopy (RCM) is a tool used to image the skin. It gives high m...

Descripción completa

Detalles Bibliográficos
Autores principales: Stevenson, Alexander D., Mickan, Sharon, Mallett, Susan, Ayya, Mekhala
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Derm101.com 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3839827/
https://www.ncbi.nlm.nih.gov/pubmed/24282659
http://dx.doi.org/10.5826/dpc.0304a05
_version_ 1782478439882686464
author Stevenson, Alexander D.
Mickan, Sharon
Mallett, Susan
Ayya, Mekhala
author_facet Stevenson, Alexander D.
Mickan, Sharon
Mallett, Susan
Ayya, Mekhala
author_sort Stevenson, Alexander D.
collection PubMed
description BACKGROUND: Melanoma is a cancer of the skin and is increasing in incidence in the UK and Europe. Melanoma is a condition that is often curable if detected at an early stage, which makes accurate diagnosis vital. Reflectance confocal microscopy (RCM) is a tool used to image the skin. It gives high magnification images of the skin, which may provide more accurate diagnosis of lesions that are equivocal on clinical examination and dermoscopy. OBJECTIVE: To determine the diagnostic accuracy of reflectance confocal microscopy (RCM), for melanoma diagnosis, as an add-on test to clinical examination and dermoscopy in the diagnosis of equivocal pigmented skin lesions using histopathology as the reference standard. METHODS: A search was conducted of MEDLINE, EMBASE and six other electronic databases from inception to present. Forward citation searching and hand searching of reference lists were also conducted. Diagnostic accuracy studies that assess RCM in the diagnosis of melanoma were included in the review. Two contributors conducted the search, data extraction and assessment of methodological quality using QUADAS-2. Statistical analysis was performed using hierarchical bivariate random effects meta-analysis. RESULTS: 951 titles and abstracts were screened. Five studies comprising 909 lesions were eligible for meta-analysis. Meta-analysis returned a per lesion sensitivity of 93% [95% CI 89–96] and a specificity of 76% [95% CI 68–83]. CONCLUSIONS: The utility of reflectance confocal microscopy (RCM) as an add-on test for the diagnosis of melanoma depends on the trade off between over-excising benign lesions and misdiagnosing melanoma as benign. This becomes important when considering lesions on surgically difficult or cosmetically important areas of the body.
format Online
Article
Text
id pubmed-3839827
institution National Center for Biotechnology Information
language English
publishDate 2013
publisher Derm101.com
record_format MEDLINE/PubMed
spelling pubmed-38398272013-11-26 Systematic review of diagnostic accuracy of reflectance confocal microscopy for melanoma diagnosis in patients with clinically equivocal skin lesions Stevenson, Alexander D. Mickan, Sharon Mallett, Susan Ayya, Mekhala Dermatol Pract Concept Articles BACKGROUND: Melanoma is a cancer of the skin and is increasing in incidence in the UK and Europe. Melanoma is a condition that is often curable if detected at an early stage, which makes accurate diagnosis vital. Reflectance confocal microscopy (RCM) is a tool used to image the skin. It gives high magnification images of the skin, which may provide more accurate diagnosis of lesions that are equivocal on clinical examination and dermoscopy. OBJECTIVE: To determine the diagnostic accuracy of reflectance confocal microscopy (RCM), for melanoma diagnosis, as an add-on test to clinical examination and dermoscopy in the diagnosis of equivocal pigmented skin lesions using histopathology as the reference standard. METHODS: A search was conducted of MEDLINE, EMBASE and six other electronic databases from inception to present. Forward citation searching and hand searching of reference lists were also conducted. Diagnostic accuracy studies that assess RCM in the diagnosis of melanoma were included in the review. Two contributors conducted the search, data extraction and assessment of methodological quality using QUADAS-2. Statistical analysis was performed using hierarchical bivariate random effects meta-analysis. RESULTS: 951 titles and abstracts were screened. Five studies comprising 909 lesions were eligible for meta-analysis. Meta-analysis returned a per lesion sensitivity of 93% [95% CI 89–96] and a specificity of 76% [95% CI 68–83]. CONCLUSIONS: The utility of reflectance confocal microscopy (RCM) as an add-on test for the diagnosis of melanoma depends on the trade off between over-excising benign lesions and misdiagnosing melanoma as benign. This becomes important when considering lesions on surgically difficult or cosmetically important areas of the body. Derm101.com 2013-10-31 /pmc/articles/PMC3839827/ /pubmed/24282659 http://dx.doi.org/10.5826/dpc.0304a05 Text en Copyright © 2013 Stevenson et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Articles
Stevenson, Alexander D.
Mickan, Sharon
Mallett, Susan
Ayya, Mekhala
Systematic review of diagnostic accuracy of reflectance confocal microscopy for melanoma diagnosis in patients with clinically equivocal skin lesions
title Systematic review of diagnostic accuracy of reflectance confocal microscopy for melanoma diagnosis in patients with clinically equivocal skin lesions
title_full Systematic review of diagnostic accuracy of reflectance confocal microscopy for melanoma diagnosis in patients with clinically equivocal skin lesions
title_fullStr Systematic review of diagnostic accuracy of reflectance confocal microscopy for melanoma diagnosis in patients with clinically equivocal skin lesions
title_full_unstemmed Systematic review of diagnostic accuracy of reflectance confocal microscopy for melanoma diagnosis in patients with clinically equivocal skin lesions
title_short Systematic review of diagnostic accuracy of reflectance confocal microscopy for melanoma diagnosis in patients with clinically equivocal skin lesions
title_sort systematic review of diagnostic accuracy of reflectance confocal microscopy for melanoma diagnosis in patients with clinically equivocal skin lesions
topic Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3839827/
https://www.ncbi.nlm.nih.gov/pubmed/24282659
http://dx.doi.org/10.5826/dpc.0304a05
work_keys_str_mv AT stevensonalexanderd systematicreviewofdiagnosticaccuracyofreflectanceconfocalmicroscopyformelanomadiagnosisinpatientswithclinicallyequivocalskinlesions
AT mickansharon systematicreviewofdiagnosticaccuracyofreflectanceconfocalmicroscopyformelanomadiagnosisinpatientswithclinicallyequivocalskinlesions
AT mallettsusan systematicreviewofdiagnosticaccuracyofreflectanceconfocalmicroscopyformelanomadiagnosisinpatientswithclinicallyequivocalskinlesions
AT ayyamekhala systematicreviewofdiagnosticaccuracyofreflectanceconfocalmicroscopyformelanomadiagnosisinpatientswithclinicallyequivocalskinlesions