No Biopsy Required? Non-Invasive Skin Cancer Test May Offer Quick Diagnosis

February 14, 2017
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A new non-invasive imaging technique may accurately detect skin cancer without surgical biopsy.

Multiphoton microscopy of mitochondria accurately identified melanomas and basal cell carcinomas by detecting abnormal clusters of mitochondria in both types of skin cancer, according to researchers funded by the National Institute of Biomedical Imaging and Bioengineering (NIBIB).

“The technology developed here has the potential to make the detection of skin cancers extremely rapid and feasible at very early stages,” says Behrouz Shabestari, Ph.D., director of the NIBIB Program in Optical Imaging and Spectroscopy in Bethesda, MD, in a news release. “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.”

An international team found that mitochondria behave very differently in healthy versus cancerous tissue. They used a laser microscopy technique that takes advantage of the characteristics of a key molecule in mitochondria, nicotinamide adenine dinucleotide (NADH), that is central to energy production. NADH, which naturally fluoresces without injecting any dye or contrast agent into the individuals being screened, can be detected using multiphoton microscopy to provide diagnostically useful information about the organization of the mitochondria in skin cells, they report.

The technique was tested in 10 patients with skin cancer (melanoma or basal carcinoma) and four who did not have skin cancer. The imaging technique results were compared to the traditional biopsy results obtained from each patient. The imaging technique correctly identified skin cancer in all 10 cancer patients, and made no false diagnoses in the four individuals without skin cancer, the study showed.

This test could be routinely used in doctor’s offices within five years, although the $100,000 price tag for the laser used in this microscope could limit the medical facilities that would be able to make such an investment, the researchers note

The findings appeared in the November 2016 issue of Science Translational Medicine.

PHOTO CAPTION: 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.

PHOTO CREDIT: Credit: Irene Georgakoudi, Tufts University

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