Nevisense – An innovative, accurate and secure new method of diagnosing malignant melanoma
Even today, the exact diagnosis of malignant melanoma remains a challenge for dermatologists. Although dermoscopy offers support during the visual clinical assessment, unclear cases still leave physicians and patients with a degree of uncertainty – and ultimately the risk of misdiagnosis. Nevisense makes it possible to use an additional objective measurement method to increase diagnostic accuracy.
As a doctor, one of my goals is to provide early skin cancer detection, especially of malignant melanoma (MM), in order to improve the patient’s prognosis.
Due to numerous factors including changing leisure habits, the incidence of MM is continually increasing. Despite this, the mortality rate remains constant because of a growing risk awareness and especially due to the unique preventive and specialized medical care structures in Germany.
A Diagnostic Challenge
While diagnostic capabilities have improved over time, a doctor’s clinical experience and his or her trained eye are still the most important diagnostic tools. Dermatoscopy has established itself as an important tool in confirming a suspicion or examining the unclear presentation of a nevus. For deeper optical structure analysis and the documentation of changes over time, digital tools such as video dermatoscopy have become available. Essentially, technical aids for the assessment of suspicious pigment structures are based on optical support.
Uncertainty – suspect cases in the “gray area”
Despite the aid provided in the analysis of suspicious pigment structures through technical means, in many cases an uncertainty remains. An unambiguous assessment is particularly difficult in early, usually treatable stages. A clear diagnostic decision is also often difficult in the case of atypical, dysplastic nevi. Even the use of optical aids can often not completely eliminate the uncertainty of a misdiagnosis, i.e. overlooking a malignant structure or unnecessarily surgically removing a benign lesion. Often the self-assessment and mindset of the physician play a large role in the decision of whether to opt for or against an immediate excision or, rather, to opt for close observation and further diagnostic measures.
The psyche of the patient and family
The psychological state of the patient should not be disregarded within the context of any medical treatment. Patients who are given an unclear diagnosis are left very stressed. This is particularly true for the parents of children. They want immediate certainty and clarity. In uncertain cases, it is particularly important to explore all diagnostic routes in order to relieve the worries of those affected and their loved ones.
”Overall, there is only a narrow corridor of uncertain cases in skin cancer diagnosis. However, this makes it even more important to exhaust all diagnostic possibilities in order to exclude false-negative diagnoses as well as unnecessary surgery. It is also important to ensure as much clarity as possible – for the relief of the unsettled patient.”
My clinical experience with Nevisense
A patient with an unclear birthmark can be offered a Nevisense check as an alternative to immediate excision and histological diagnosis. Experience shows that the additional diagnosis with Nevisense is usually preferred. This generally leads to a clearer decision.
According to studies, benign lesions are recognized as such with about 98% certainty (a Nevisense score of 1–3). The incidence of identification for non-malignant skin changes is significantly increased, and many unnecessary excisions performed simply to clarify the diagnosis can be avoided.
Should the analysis of a malignancy be corroborated (Nevisense score of 4–10), a decision for or against an immediate excision can be made in a doctor-patient consultation.
Nevisense is particularly helpful in cases where doctor and patient are uncertain and a third “objective party” is required. The attitude and feelings of the patient are of highest importance. If the patient demands clarity quickly, Nevisense provides robust additional objective evaluation criteria. For many patients, the ability of this “neutral party“ to provide an additional measure of security is of great importance.
It is particularly advantageous that the device is approved for use on children. A quick decision contributes decisively in calming worried parents. Parents receive clarity and certainty quickly, and unnecessary additional visits to other doctors for a second opinion can be avoided. An additional advantage is its use on skin type IV or colored skin. Other diagnostic methods are of limited significance with more pigmented skin. Here the impedance measurement through Nevisense can provide crucial information.