Delineating margins of lentigo maligna using a hyperspectral imaging system

Area of Science:

• Dermatology
• Medical Imaging
• Oncology

Background:

• Lentigo maligna (LM) is an early melanoma stage that can advance to invasive lentigo maligna melanoma (LMM).
• Assessing the precise borders of pigmented LM/LMM lesions is difficult due to variable pigmentation and visibility.
• Accurate margin delineation is crucial for effective surgical treatment and preventing recurrence.

Purpose of the Study:

• To evaluate the efficacy of a hyperspectral imaging system (HIS) for in vivo preoperative delineation of LM and LMM margins.
• To compare HIS-delineated lesion margins with clinically estimated margins and histological confirmation.

Main Methods:

• A prospective study involving 19 patients with 14 LMs and 5 LMMs.
• Hyperspectral imaging was used for preoperative margin assessment.
• Margins identified by HIS were compared against clinical assessment and subsequent histopathological analysis.

Main Results:

• HIS analysis demonstrated high concordance with histopathology, matching in 94.7% of cases (18/19).
• HIS identified subclinical lesion extension in one case (5.3%), which was not confirmed by histopathology (false positive).
• HIS provided more accurate margin delineation than clinical examination in 52.6% of cases (10/19), identifying wider or smaller margins.

Conclusions:

• Hyperspectral imaging system (HIS) is a valuable tool for detecting subclinical borders of lentigo maligna and lentigo maligna melanoma.
• HIS enhances preoperative margin assessment, potentially improving surgical outcomes for these melanoma subtypes.
• Further investigation may refine HIS use to minimize false positives and optimize its clinical application.