Research Collaborations

Diagnostic features and checklists for using the SIAscope in the diagnosis of non-melanoma skin cancer

The SIAscope has undergone a number of trials for melanocytic lesions, but the majority of skin cancers, and skin lesions in general, are non-melanocytic. This project, led by Dr Hamid Tehrani and currently underway at Addenbrooke’s Hospital, Cambridge, and Norfolk and Norwich University Hospital, Norwich, aims to define the diagnostic criteria and rules for the identification of non-melanocytic lesions and, in particular, non-melanoma skin cancer.

The differential diagnosis of non-melanoma skin cancer is being studied using both contact and non-contact SIAscope systems to obtain SIAscans of non-melanocytic lesions presenting for excision biopsy. The project aims to obtain 700 SIAscan images. Half the SIAscans will be randomly selected, features identified from the images, and their diagnostic power assessed. A diagnostic checklist will be developed using non-linear regression analysis, and then tested against the remaining 350 SIAscans.

This research is sponsored by AKPA, the Addenbrooke’s Kidney Patients Association.

Diagnosis and management of cutaneous cancer through the use of non-contact and contact SIAscopy

Cutaneous cancers, including melanoma and non-melanoma skin cancer, are often associated with a history of change in the size or existence of a skin lesion. Transplant patients are at high risk of developing skin cancers, and require careful monitoring. This project, led by Dr Joe Walls and currently underway at Addenbrooke’s Hospital, Cambridge, and Norfolk and Norwich University Hospital, Norwich, aims to assess the use of non-contact SIAscopy to monitor skin lesions over time, and the use of both contact and non-contact SIAscopy to aid the diagnosis and referral process.

Renal transplant patients will have wide-field non-contact SIAscans taken at initial treatment and at their subsequent regular check-ups. Methodologies for comparing baseline and baseline+t images will be developed and the diagnostic power of the techniques assessed.

Because such high-risk patients will often need to have skin lesions referred to a specialist outside the regular monitoring period, the project will also collect contact and non-contact SIAscans of suspicious lesions, and any biopsy results will be recorded. Of these images, half will be randomly selected and analysed to identify diagnostic features. Non-linear regression will be used to develop a diagnostic checklist, which will then be tested against the other half of the images.

Rapid and appropriate triaging of pigmented skin lesions for excision – the SIAscope and the two-week wait for cancer

The use of the SIAscope as an effective tool in the early diagnosis of cutaneous malignant melanoma and the triage of pigmented skin lesions has so far been studied on referred populations. This project focuses on the primary care setting, and is currently underway at GP practices in the Cambridge area.

Because of the need to treat malignant melanoma quickly, a large number of suspicious lesions are referred for specialist examination. The workload of plastic surgeons and the ability of specialists to meet the Government ‘two-week wait’ target could be helped enormously if referral could be based on more accurate preliminary diagnosis. GPs, however, see few cases of malignant melanoma and consequently have limited experience upon which to base their decision to refer. It is possible that the SIAscope could greatly enhance GP decision-making when it comes to referring patients for specialist diagnosis and treatment.

Patients who present with a concern about a mole to one of the selected GP practices in this project are invited to join the study, and those recruited undergo a series of diagnostic tests, including SIAscopy, dermatoscopy, clinical photography and 7-point history. The initial GP diagnosis and SIAscope diagnosis will be compared against the diagnosis of a consultant plastic surgeon using the other diagnostic tests, and histology in a random sub-set of lesions or where clinically indicated. Results will be calculated for accuracy of GP and SIAscope diagnosis of suspicious pigmented lesions.