Nevisense – A secure and innovative method for the detection of malignant melanoma
User experience case: Dr. Isabel Gahlen, Ludwigsburg, Germany
Even the most experienced physician sometimes find it challenging when dealing with malignant melanoma (MM) as, especially in early stages, the clinical signs can be vague, making these very difficult to diagnose accurately. We introduced Nevisense into our clinic to broaden our skin check services to patients – with a tool that provides high diagnostic accuracy and improves our means of early detection even further.
As a dermatologist, my objective is to detect skin cancer as early as possible on my patients, especially when it comes to malignant melanoma (MM). I have been using dermatoscope for about 15 years. I am therefore well aware of the usefulness of dermoscopy but also the limitations it sometimes has. When I heard about the Nevisense-method at the Frankenthal Congress, I became immediately interested in the technology and the method. Was there an additional diagnostic support tool that could improve the accuracy ever further and complement my dermatoscopic evaluations?
As a private clinician my patients demand a high level of service. That includes everything from the location of my clinic, the employees that work here, the access to the latest technology, but most of all – the best possible clinical care.
Due to my background of having worked at the Fachklinikum Hornheide in Münster for two years, (which specializes in skin cancer only), I have of course a special interest in the topic. Today we have around 20 patients a day that come to have a skin check, and with over 20 years in the field of dermatology, many lesions can be quickly and adequately evaluated with the help of standard visual examination combined with dermoscopy.
However, even after so many years there are, and will always be, lesions that are harder to evaluate even for a skilled dermatologist, and where Nevisense has proven to be a good support tool.
My clinical experience with Nevisense
We use Nevisense after evaluating the suspicious lesions with dermoscopy, and where question-marks remain as to whether the lesion is malignant or not. In these cases, Nevisense provides us with a risk score that we take into consideration in our clinical decision making, together with the result of the visual examination.
Nevisense has proven to be a good support tool in many patient cases. For example, for a patient that has many irregular lesions that all seem rather suspicious, Nevisense gives me additional information, to identify the right lesions that need to be excised. Some patients have lesions located in sites where they don’t want any scar tissue, predominantly in the face, and in those cases unnecessary excisions can be avoided as well.
In our clinic, we perform an examination with Nevisense in about half of the cases and on each patient we measure around one to three lesions. In order to increase efficiency, a medical assistant performs the three to five minute measurements. Nevisense provides an output with a so called EIS-score between 0 and 10, which indicates the risk of malignancy, and if the EIS-score is high, we usually excise the lesion straight away.
According to published clinical studies*, benign lesions are identified with 98% NPV (negative predictive value) accuracy with Nevisense (an EIS-score of 0-3) so these we don’t excise. According to the study there was a possible reduction of unnecessary excision with 34%. To effeciently rule out benign lesions improves our diagnostic accurency and thereby patient care. This course only on lesions with a certain level of suspicion. In cases where the clinical signs after dermoscopy strongly indicates melanoma we do not measure with Nevisense, instead we excise the lesion directly.
The number one advantage regarding Nevisense is that it backs up my decision and provides me with more certainty in whether or not to excise a lesion. At the same time, it provides confidence that melanomas are not missed, and maximizes the chances of detecting malignant melanoma in an early stage.
Another advantage is that the method is applicable for patients with all skin types. In a majority of the cases the examination with both dermoscopy and Nevisense provides us with enough information in order to make the right decision in whether to excise or not, and thereby increase our patient care to the best one possible.
* Clinical performance of the Nevisense system in cutaneous melanoma detection: an international, multi-centre, prospective and blinded clinical trial on efficacy and safety.
British Journal of Dermatology, 2014 Nov; 171(5): 1099±1107