PDF(Pubmed)
Abstract：
Melanomas arise de novo or in the context of a precursor lesion. Lesions typically grow radially and then undergo a vertical growth phase proceeding to local invasion and metastasis. This review describes the utility of different imaging modalities in diagnosis and melanocytic lesion monitoring. A literature search was performed in November 2023 utilizing EMBASE, Medline, and PubMed. The PRISMA diagram demonstrates the review process. Reflectance confocal microscopy (RCM) utilizes near-infrared light to help diagnose dermatologic lesions. RCM was found to demonstrate nearly two times the positive predictive value compared to dermoscopy. The introduction of the Berlin Ultrasound (US) Morphology Criteria permitted a 65-80% improvement in diagnostic sensitivity. US with fine-needle aspiration cytology (FNAC) accurately predicts the necessity for sentinel lymph node biopsy and lymphadenectomy, sparing patients with metastasis and prompting biopsy for equivocal lesions. Single-photon emission computed tomography/computed tomography (SPECT/CT) is an adjunctive tool to anatomically and functionally assess lymphatic invasion. SPECT/CT improves the detection of sentinel nodes while decreasing operating time and improving cosmetic outcomes. 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) with small voxel reconstruction demonstrated increased specificity and sensitivity for detecting in-transit metastases of melanomas, specifically in the limbs. Dermoscopy allows providers to cost-effectively recognize common lesion patterns. Multiphoton microscopy assigns a weight-based score based on malignant features. Optical coherence angiography captures images of vessels to help diagnose equivocal lesions. Utilization of imaging techniques may increase diagnostic accuracy, reduce unnecessary procedures, and help guide treatment plans. Additional research is needed to further characterize the utility of these techniques in order to improve the diagnosis and treatment of melanomas.
摘要：
黑色素瘤从头出现或在前体病变的背景下出现。病变通常呈放射状生长，然后经历垂直生长阶段，直至局部浸润和转移。这篇综述描述了不同成像方式在诊断和黑素细胞病变监测中的应用。2023年11月，利用EMBASE进行了文献检索，Medline,和PubMed。PRISMA图展示了审查过程。反射共聚焦显微镜（RCM）利用近红外光来帮助诊断皮肤病变。与皮肤镜检查相比，发现RCM显示出将近两倍的阳性预测值。柏林超声（US）形态学标准的引入使诊断灵敏度提高了65-80％。美国细针穿刺细胞学（FNAC）准确预测前哨淋巴结活检和淋巴结清扫的必要性，保留转移患者并提示活检模棱两可的病变。单光子发射计算机断层扫描/计算机断层扫描（SPECT/CT）是在解剖学和功能上评估淋巴侵入的辅助工具。SPECT/CT可改善前哨淋巴结的检测，同时减少手术时间并改善美容效果。具有小体素重建的18F-氟脱氧葡萄糖（18F-FDG）正电子发射断层扫描/计算机断层扫描（PET/CT）显示出检测黑色素瘤在途转移的特异性和敏感性增加。特别是四肢。皮肤镜检查允许提供者经济有效地识别常见的病变模式。多光子显微镜根据恶性特征分配基于权重的评分。光学相干血管造影捕获血管图像以帮助诊断模棱两可的病变。成像技术的利用可以提高诊断的准确性，减少不必要的程序，并帮助指导治疗计划。需要额外的研究来进一步表征这些技术的实用性,以改善黑素瘤的诊断和治疗。
