“There are known knowns. These are things we know that we know. There are known unknowns. That is to say, there are things that we know we don’t know. But there are also unknown unknowns. There are things we don’t know we don’t know.”
This classic quote by Donald Rumsfeld was given in response to questions about terrorism intelligence, but it's also a useful one in the context of developing new medical technology. In essence, he is saying that while we spend most of our time on “known” and “known unknown” qualities; it’s the ones that we haven’t even considered yet that will be the most disruptive. In other words, ”you don’t know what you don’t know.”
Evolution of dermoscopy
The first use of skin microscopy is attributed to Kolhaus back in 1663 to examine vessels in the nail matrix. Since that time, we have seen incremental improvements in the way those images are obtained: from the use of liquid medium, to the first dedicated dermatoscopes, to utilising polarised light and more recently to the digital capture of dermoscopic images.
The introduction of multi-spectral imaging
What all these developments have in common is the use of white light to illuminate, magnify and visualize the subsurface structures of skin lesions. However, white light imaging has its limitations, such as being able to see the inner structures of those lesions.
This is what makes the introduction of multi-spectral imaging so exciting. By using different wavelengths of light to illuminate the lesion, multi-spectral imaging is able to decompose the dermoscopic image into individual maps that allow us to more clearly visualize specific skin structures such as pigment distribution and blood vessels (vasculature).
These visualizations are called Skin Parameter Maps (SPM) and allow us to provide new insights that support the clinician’s decisions on management strategies, diagnosis, treatments and follow-ups for their patients.
You don’t know what you don’t know
What’s most exciting is that we are still in the exploration phase on the application of this technology. While you can see the clinical application of SPM in pigmented Basal Cell Carcinoma here, its application for other types of skin conditions are being researched and tested and promise to unlock new, unknown ways in which it can aid clinicians.
Stay connected with Barco Demetra as we further explore this exciting new technology over the coming weeks and you can find more information on the Barco Demetra website.
About Barco Demetra
Barco Demetra® is a revolutionary skin imaging platform co-developed with leading dermatologists. It combines the best of analogue and digital skin imaging in a flexible, wireless handheld device. It allows dermatologists to take any kind of picture and makes mapping, follow-up and comparison of skin images smoother and smarter. Demetra is a platform that will evolve over time. We are continuously working on new groundbreaking capabilities, including deep learning algorithms, all developed to improve the quality of skin diagnoses.
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