Researchers from the European project ‘Automatic Detection of VAscular Networks for Cancer Evaluation’ (ADVANCE) have developed the world’s first scanner that detects blood vessels grown by a malignant melanoma with an infrared laser beam in 30 seconds.
Using the new device, called ‘VivoSight,’ a specialist can actually see under your skin at depths of 1 mm by creating a 3D color image of the microscopic blood vessels in a process that takes around 30 seconds.
Employing a new and advanced version of Optical Coherence Tomography(OCT), a photonics technique more commonly used in retina scans, the scanner captures 3D images of the micro structures under the skin with a harmless infrared laser beam.
Since melanomas need oxygen to grow and survive, they grow their own blood vessels. As the cancer develops and becomes more malignant, they become increasingly distorted and malformed, differing in appearance from healthy vessels.
Being able to detect and see these vessels in a suspicious lesion in real time has never been possible, until now, opening the possibility for dermatologists to make treatment decisions in an unrivalled timeframe.
“At present, all patients with such melanomas have to wait for a sentinel lymph node biopsy performed in a hospital under general anesthesia to find out if it is spreading. This can take weeks to perform, is very expensive and can be debilitating for the patient.”
“About 80% of the time, the biopsy produces a negative result with no sign of the cancer spreading,” Holmes said.
“There has to be a better way: our scanner may radically improve the abilities of dermatologists to decide whether a melanoma is in the less malignant, non-spreading, early stage, or if it has already developed and requires immediate aggressive therapy. Further clinical trials will be needed to conclusively prove the technology.”
In their scanner, the scientists used a variant of OCT called ‘Speckle-Variance’ OCT, or dynamic OCT (D-OCT).
Studying the ‘speckle’ or flicker of light patterns created by moving blood cells, the imaging device takes around four frames per second and compiles the images so that a clinician may tell where something has moved on the image from frame to frame.
“Using D-OCT we can see movement of blood against the solid tissue structures, something we have never been able to do before in a clinical setting. It’s like looking out at night and seeing cars’ headlights flowing along a motorway, only at depths of nanometers under the skin,” Holmes said.
“But it appears cancers don’t take the direct route! Their vessels are like twisty, branching country lanes that get narrower and wider. Our clinical team thinks that these ‘shapes’ are key to understanding the cancer. Our scanner shows these vessels in gorgeous detail.”
As well as the profound use in skin cancer diagnosis, the ability to see blood vessel networks with the new device creates a number of useful spin-off benefits.
“The scanner can image the blood vessels in healing wounds. This may have application for treatment of leg and foot chronic ulcers, when doctors want to know whether a wound is healing or requires a change in treatment, potentially reducing the number of amputations,” Holmes said.
“Our technology may also help with burn victims, being able to give a doctor a quicker response time than the standard 15 days to determine whether a patient’s skin is healing and whether or not to give a skin graft.”
“Ultimately with our scanner, not only can thousands of lives be saved and many millions of Euros in cost savings be made annually worldwide, but there is no price we can put on a patient not having to go through an unnecessary operation with potential long term debilitating side effects or wait an unnecessary amount of time for treatment.”