An international team of researchers has proven that dynamic optical coherence tomography (D-OCT) imaging of melanoma reveals changes to the blood vessels that correlate with the depth of its invasion, which could lead to a faster method of rapidly assessing the severity of a melanoma. Nathalie de Carvalho, of the University of Modena and Reggio Emilia, explained that cancers grow their own blood vessel network to supply oxygen and nutrients. “We analyzed the shapes of the vessels in the OCT images of melanomas and correlated the frequency of different shapes with the Breslow depths [the thickness of the tumors, measured from biopsy samples],” de Carvalho said. “We found that certain vessel shapes appeared much more frequently in thicker tumors. The vessels grown by the tumor seem to grow more chaotically and become more malformed as the cancer progresses.” A quicker diagnosis and assessment would allow patients with more serious invasive disease access the right treatment earlier, ending delays that occur in the traditional diagnosis method. The technique may also lead to reducing the number of patients with less aggressive tumors receiving sentinel lymph node biopsies, an expensive in-patient procedure that sometimes results in unpleasant long-term side effects. The clinical study, published in Experimental Dermatology, examined blood vessel shapes in OCT images of 127 melanomas at various stages of disease progression. The study samples were collected at four leading European dermatology groups (University of Modena and Reggio Emilia, General Hospital Augsburg, University of Copenhagen, and Collegium Medicum Berlin). The research team used Michelson Diagnostics’ VivoSight OCT scanner, which has regulatory clearance in Europe, the U.S., and Australia for clinical use in imaging skin. The scanner was equipped with dynamic OCT software that detects and displays the tiny blood vessels in the skin and the tumor. Although the Breslow depth is already used to assess the progress of the disease from early stages to serious metastatic disease, it takes time for the biopsy results to come back from the laboratory. This new imaging approach may provide a shortcut to more quickly identify advanced metastatic melanomas so that patients can be fast-tracked to the right treatment. Julia Welzel, of General Hospital Augsburg, said the research team’s goal is to help develop and quicker, more efficient, and less invasive diagnostic and treatment plan for melanoma. “Patients with advanced disease should get aggressive treatment as quickly as possible,” Welzel said. “Those with early-stage melanomas should not have to undergo expensive invasive sentinel lymph node biopsy operations if their melanoma is reliably confirmed as very low risk. We believe dynamic OCT imaging could help with these goals, and the results of this study are very encouraging. The next stage of our work is to analyze the link between vessel shapes and the actual degree of metastasis of the melanomas in a larger cohort, and not just the Breslow depth.”