Diagnostic Efficacy of Electrical Impedance Spectroscopy Versus Dermoscopy for Pigmented Skin Lesions: A Pilot Study
Main Article Content
skin cancer, melanoma, dysplastic nevi, diagnostic efficacy, electrical impedance spectroscopy
Introduction: Electrical impedance spectroscopy (EIS) is a non-invasive diagnostic device that measures the electrical impedance of skin lesions to assist in the detection of melanoma. While this tool has been shown to have a high sensitivity for melanoma diagnosis, data on its impact on clinical decision-making for pigmented skin lesions (PSLs) compared to other diagnostic tools is lacking. To gain further insight into its clinical utility, we conducted a pilot study to evaluate how this technology – specifically, the effect it has on clinical decisions for PSLs – compares to traditional dermoscopy.
Methods: Dermatologists, dermatology residents, and medical students completed an online survey eliciting their biopsy decisions for 24 PSLs of varying histopathological diagnoses. Half of the lesions from each diagnosis group were presented as a clinical image with associated dermoscopic image and the other half as a clinical image with the corresponding EIS score.
Results: Decisions made with EIS demonstrated a mean sensitivity of 75% for melanomas/severely dysplastic nevi vs. 66% for decisions made with dermoscopy (p=.008). While dermatologists biopsied with similar sensitivities when using EIS or dermoscopy (81% vs. 81%), residents and medical students biopsied with significantly greater sensitivity when using EIS. Respondents who reported rarely using dermoscopy showed the greatest improvement in sensitivity and specificity when using EIS compared to dermoscopy.
Conclusion: Given that not all providers are trained in dermoscopy, and our finding that EIS particularly benefits those who infrequently use dermoscopy, EIS may complement dermoscopy by helping a broader range of providers make improved PSL diagnostic decisions.
2. Terushkin V, Halpern AC. Melanoma early detection. Hematol Oncol Clin North Am. 2009 Jun;23(3):481-500, viii.
3. Leachman SA, Cassidy PB, Chen SC, Curiel C, Geller A, Gareau D, Pellacani G, Grichnik JM, Malvehy J, North J, Jacques SL, Petrie T, Puig S, Swetter SM, Tofte S, Weinstock MA. Methods of Melanoma Detection. Cancer Treat Res. 2016;167:51-105.
4. Papageorgiou V, Apalla Z, Sotiriou E, et al. The limitations of dermoscopy: false-positive and false-negative tumours. J Eur Acad Dermatol Venereol. 2018;32(6):879-888.
5. Chiaravalloti AJ, Laduca JR. Melanoma screening by means of complete skin exams for all patients in a dermatology practice reduces the thickness of primary melanomas at diagnosis. J Clin Aesthet Dermatol. 2014 Aug;7(8):18-22.
6. Malvehy J, Hauschild A, Curiel-Lewandrowski C, et al. Clinical performance of the Nevisense system in cutaneous melanoma detection: an international, multicentre, prospective and blinded clinical trial on efficacy and safety. Br J Dermatol. 2014;171(5):1099-1107.
7. Litchman GH, Teplitz RW, Marson JW, Rigel DS. Impact of electrical impedance spectroscopy on dermatologists' number needed to biopsy metric and biopsy decisions for pigmented skin lesions. J Am Acad Dermatol. 2021 Oct;85(4):976-979.
8. Svoboda RM, Prado G, Mirsky RS, Rigel DS. Assessment of clinician accuracy for diagnosing melanoma on the basis of electrical impedance spectroscopy score plus morphology versus lesion morphology alone. J Am Acad Dermatol. 2019 Jan;80(1):285-287.
9. Rastrelli M, Tropea S, Rossi CR, Alaibac M. Melanoma: epidemiology, risk factors, pathogenesis, diagnosis and classification. In Vivo. 2014 Nov-Dec;28(6):1005-11.
10. Guitera P, Menzies SW. State of the art of diagnostic technology for early-stage melanoma. Expert Rev Anticancer Ther. 2011 May;11(5):715-23.