BACKGROUND: Field cancerization denotes subclinical abnormalities in a tissue chronically exposed to UV radiation. These abnormalities can be found surrounding the clinically visible actinic keratoses. OBJECTIVES: The aim of this study was to test the feasibility of a hyperspectral imaging system in the detection of multiple clinical and subclinical AKs for early treatment of the affected areas. MATERIALS AND METHODS: Altogether 52 clinical AKs in 12 patients were included in this study. In six patients digital photos were taken of the naive AKs, and again after methylaminolevulinate(MAL)-fluorescence diagnosis which was used to teach HIS to find subclinical lesions. After 2-3 days when the MAL had vanished, the hyperspectral images were taken. Biopsies were taken from clinical AKs, healthy-looking skin and several suspected subclinical AKs. In the other six patients digital and hyperspectral images were taken of the naive AKs followed by one biopsy per patient. RESULTS: HIS detected all clinically visible 52 AKs and numerous subclinical lesions. The histopathology of the 33 biopsied lesions were concordant with the HIS results showing either AK (n = 28) or photodamage (n = 5). Of the 28 histopathologically confirmed AKs, 16 were subclinical. A specific diffuse reflectance spectrum of an AK and healthy skin was defined. CONCLUSION: The hyperspectral imaging system offers a new, non-invasive method for early detection of field cancerization. Lasers Surg. Med. 45:410-417, 2013.
BACKGROUND: Field cancerization denotes subclinical abnormalities in a tissue chronically exposed to UV radiation. These abnormalities can be found surrounding the clinically visible actinic keratoses. OBJECTIVES: The aim of this study was to test the feasibility of a hyperspectral imaging system in the detection of multiple clinical and subclinical AKs for early treatment of the affected areas. MATERIALS AND METHODS: Altogether 52 clinical AKs in 12 patients were included in this study. In six patients digital photos were taken of the naive AKs, and again after methylaminolevulinate(MAL)-fluorescence diagnosis which was used to teach HIS to find subclinical lesions. After 2-3 days when the MAL had vanished, the hyperspectral images were taken. Biopsies were taken from clinical AKs, healthy-looking skin and several suspected subclinical AKs. In the other six patients digital and hyperspectral images were taken of the naive AKs followed by one biopsy per patient. RESULTS: HIS detected all clinically visible 52 AKs and numerous subclinical lesions. The histopathology of the 33 biopsied lesions were concordant with the HIS results showing either AK (n = 28) or photodamage (n = 5). Of the 28 histopathologically confirmed AKs, 16 were subclinical. A specific diffuse reflectance spectrum of an AK and healthy skin was defined. CONCLUSION: The hyperspectral imaging system offers a new, non-invasive method for early detection of field cancerization. Lasers Surg. Med. 45:410-417, 2013.
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