Beatrice Martinez Zugaib Abdalla, Ofer Reiter, Kendra Godwin, Rory Gallagher, Jilliana Monnier, Ruben David Dos Reis Zuniga, Manu Jain
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引用次数: 0
Abstract
Background: Multimodal noninvasive imaging is a novel technique in dermatology. Its purpose is to overcome the limitations of unimodal techniques. This is done by combining higher resolution images with deeper imaging depth and/or tissue specificity within a single device for improvement of diagnosis and management of skin lesions.
Objective: Our aim was to systematically review multimodal imaging devices currently used in dermatology clinics and their diagnostic accuracy of skin lesions.
Methods: A comprehensive search was conducted in October 2022 for studies on multimodal imaging technologies in vivo, in human subjects, used in dermatology. An additional search was made in March 2024. Four databases were selected: MEDLINE, Embase, CENTRAL, and Web of Science. This review was registered with the international Prospective Register of Systematic Reviews (PROSPERO record number CRD42022364864). The search strategy used Medical Subject Headings (MeSH) and keywords from two concepts: Multimodal Imaging and Dermatological Conditions. Reference lists were also searched for relevant studies. Selected studies included multimodal techniques in neoplastic, inflammatory, and pigmentary skin disorders. Ex vivo imaging, non-human studies, and non-clinical settings were excluded. Data extraction and quality assessment were performed using QUADAS and STARD criteria. Data extraction was conducted by one researcher and then reviewed by an additional researcher. A third researcher resolved any disagreements. The statistical analysis involved diagnostic accuracy meta-analysis, subgroup comparisons (multimodal vs single modal, multimodal vs multimodal), and SROC curves. The primary outcomes were the diagnostic accuracy, sensitivity, and specificity of multimodal imaging devices in diagnosing dermatological conditions.
Results: The analysis included 92 studies, predominantly case reports or series (83.7%), with basal cell carcinoma (BCC) being the most frequently imaged lesion (11.8%). The studies had a moderate risk of bias (QUADAS score: 0.6) with histology as the reference test in most cases. Meta-analysis showed multimodal devices have high sensitivity and specificity for BCC diagnosis. These results indicate reliable diagnostic accuracy.
Conclusions: In a clinical setting, multimodal imaging can be useful to perform bedside diagnosis and management of skin lesions.
背景：多模态无创成像技术是皮肤科的一项新技术。其目的是克服单峰技术的局限性。这是通过将更高分辨率的图像与更深的成像深度和/或组织特异性结合在一个设备中来完成的，以改善皮肤病变的诊断和管理。目的：我们的目的是系统地回顾目前在皮肤科诊所使用的多模态成像设备及其对皮肤病变的诊断准确性。方法：于2022年10月对用于皮肤病学的人体多模态成像技术进行了全面检索。2024年3月又进行了一次搜索。选择四个数据库：MEDLINE、Embase、CENTRAL和Web of Science。本综述已在国际前瞻性系统评价注册（PROSPERO记录号CRD42022364864）注册。搜索策略使用医学主题标题（MeSH）和来自两个概念的关键词：多模态成像和皮肤病。还检索了相关研究的参考文献列表。选定的研究包括肿瘤、炎症和色素皮肤疾病的多模式技术。体外成像、非人体研究和非临床环境被排除在外。采用QUADAS和STARD标准进行数据提取和质量评估。数据提取由一名研究人员进行，然后由另一名研究人员进行审查。第三位研究人员解决了任何分歧。统计分析包括诊断准确性荟萃分析、亚组比较（多模态vs单模态、多模态vs多模态）和SROC曲线。主要结果是多模态成像设备诊断皮肤病的准确性、敏感性和特异性。结果：该分析包括92项研究，主要是病例报告或系列（83.7%），基底细胞癌（BCC）是最常见的影像学病变（11.8%）。这些研究具有中等偏倚风险（QUADAS评分：0.6），在大多数情况下以组织学作为参考试验。荟萃分析显示，多模态装置对BCC诊断具有较高的敏感性和特异性。这些结果表明诊断的准确性是可靠的。结论：在临床环境中，多模态成像可用于床边诊断和处理皮肤病变。
期刊介绍：
The American Journal of Clinical Dermatology is dedicated to evidence-based therapy and effective patient management in dermatology. It publishes critical review articles and clinically focused original research covering comprehensive aspects of dermatological conditions. The journal enhances visibility and educational value through features like Key Points summaries, plain language summaries, and various digital elements, ensuring accessibility and depth for a diverse readership.
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