Cancer Science & Therapy

Use of Pixel Intensity Measurements Derived from OCT Images to Differentiate Between Seborrheic Keratosis and Melanomas: A Pilot Study

Abstract

Frederick H. Silver*, Tanmay Deshmukh, Aanal Patel and Hari Nadamint

Differentiating Seborrheic Keratosis (SK) from melanoma can be difficult based on visual observations and dermoscopy since both are pigmented
lesions. While SK is considered a benign lesion that is localized, in contrast melanoma can spread to other tissues and lead to death if it
metastasizes. Therefore, it is important to be able to noninvasively differentiate between SK and melanoma to limit the number of unnecessary
biopsies performed. We have measured the pixel intensity of Optical Coherence Tomography (OCT) images of normal skin, SK, and melanoma
by breaking OCT images into low (green), medium (blue) and high (red) pixel intensity vs. depth images. Normal skin and SK are characterized
by higher green scale pixel intensity vs. depth plots while melanoma has a lower green scale pixel intensity vs. depth plot. Melanoma also
has lower red scale pixel intensity vs. depth plot compared to SK and normal skin. Our results show that a decreased pixel intensity of the
superficial epidermis that is observed in melanomas is likely due to formation of melanin aggregates that approach the wavelength of light in
size. The decreased pixel intensity of melanoma is likely a result of increased amounts of melanin particles in melanocytes and keratinocytes.
The specificity and sensitivity of differentiating SK and melanoma and normal skin from melanoma based on quantitative pixel intensity vs. depth
are about 85% to 100%, respectively. The sensitivity and specificity of differentiating normal skin from SK is 60% and 100%, respectively. These
results suggest that color-coded OCT images can be used to noninvasively screen for melanomas along with dermoscopy and visual inspection.
The ability to collect OCT lesion data noninvasively in concert with remote data acquisition will allow rapid patient screening for melanomas in
areas where dermatologist visits are difficult to schedule.