SKINSPECTION – Hybrid Imaging for Skin Diagnosis

The incidence of skin cancer in Europe, US, and Australia is rising rapidly. One in five will develop some form of skin cancer during the lifetime. A person has a 1:33 chance to develop melanoma, the most aggressive skin cancer. Melanoma is the second most common cancer in women aged 20-29, and the sixth most common cancer in men and women. In 2007, more than 1 million new cases were diagnosed in the US alone. About 90% of skin cancers are caused by ultraviolet (UV) sunlight. A significant improvement of the current diagnostic tools of dermatologists is required in order to identify dermal disorders at a very early stage as well as to monitor directly the effects of treatment.

The SKINSPECTION consortium consists of six European partners from United Kingdom, Italy and Germany. The concept is based on a multimodal imaging approach combining multiphoton tomography, fluorescence lifetime imaging, optoacoustic imaging and high resolution ultrasound. The combination of theses modalities allows in-vivo non-invasive imaging of skin lesions both on the macroscopic and the microscopic level. Ultrasound and optoacoustic imaging allow a wide-field view of structures with special focus to subcutaneous microvasculature and morphology of lesions. These modalities provide images down to 3 mm in depth with a sub-100µm resolution. In addition, multiphoton tomography and FLIM give access to subcellular structures from the upper skin layers. Imperial College London has developed a FLIM module for integration in a multiphoton tomograph from the german company JenLab GmbH. The ultrasound based modalities are implemented by the german partners kibero GmbH and Fraunhofer IBMT. After 3 years of development and certification for clinical testing, the evaluation of the platform was performed in a bicentric clinical study at Hammersmith Hospital London and Universita di Modena.

While high resolution ultrasound is established in diagnosis of skin diseases, the optoacoustic imaging module developed by Fraunhofer IBMT and kibero has allowed the first evaluation of optoacoustic technology for investigation of skin lesions under clinical conditions. Further, the optical SKINSPECTION modalities give access to in-vivo 3D biopsies of skin with ultrahigh subcellular resolution. The award-winning multiphoton technology from Jenlab in combination with Imperial’s FLIM module have allowed to provide clinicians with a whole range of new diagnostic parameters, allowing to identify specific morphological features from cells that can be associated to defined skin diseases.