Nevoscopy: three-dimensional computed tomography of nevi and melanomas in situ by transillumination

The thickness of a malignant nevus has been found to be an important prognostic factor for patients with melanoma. We have designed a new method of imaging nevi that permits their thickness to be measured in situ. Using fiber optics directed into the surrounding skin, we transilluminate the nevus. Three images are picked up by a digitizing TV camera: the vertical image (90 degrees ), a glancing image (180 degrees ), and one at 45 degrees , obtained by using two front-silvered mirrors held next to the nevus in a "nevoscope." The digitized images are used in a computed tomography algorithm to calculate approximate vertical cross sections of the nevus. The algorithm is one we recently developed to permit reconstruction from a very few projections. Our method is completely noninvasive. It may be used to check all the nevi on a patient. Without excisions, we could establish a baseline three-dimensional shape for each nevus, follow any changes in time, and obtain an early warning of increase in thickness and possible malignancy.