Dermatoscopes are commonly used by professionals to aid the diagnosis of skin lesions, particularly where these are more complex. Tom Kimpe, Vice President Technology & Innovation at Barco Healthcare shares his vision for the dermoscopy market.
Skin cancer is one of only a few cancers whose prevalence is rising. Currently, between two and three million non-melanoma skin cancers and 132,000 melanoma skin cancers occur each year. According to the World Health Organisation, one in every three cancers diagnosed is a skin cancer, and one in every five Americans will develop skin cancer within their lifetime.1
As the challenge grows, advanced technology can not only improve the levels of correct diagnosis, but also play a part in changing clinical workflows to increase the feasibility of such cancers being detected more quickly. Where skin cancer is identified at an early stage, it is relatively straightforward and low cost to treat, with excision the most effective method.
The answer lies in enabling early diagnosis. First line clinicians may not have the equipment or experience to diagnose skin cancers, and referral times to dermatologists globally are running at months, rather than days and weeks. Also, not all dermatologists are specialists in complex skin cancer, and a further referral may be required in this case.
With some particularly aggressive cancers capable of growing in depth at 0.1mm per month and quickly spreading throughout the body, a ‘watch and wait’ approach can result in much more complex care being required, or in some cases resulting in a fatality. In addition, patients undergo significant emotional distress.
State of the market
Polarized dermatoscopes have been in common use for around twenty years, and in their most basic form consist of a magnifying glass and a polarized light. More recently, digital dermatoscopes have become available, which enable professionals to not only view lesions in far greater detail, but to photograph them and store the images for later review and follow-up.
Despite the advantages of digital dermoscopy, any kind of dermatoscope requires training and experience to be used effectively to distinguish the sometimes subtle differences between benign and malignant lesions, as well as between types of malignancy. And there are some digital devices which although offering additional insight are prohibitively expensive, clumsy to use and, despite requiring substantial initial investment, can become outdated relatively quickly.
A new approach
Barco has a proven track record in healthcare innovation. Its radiology displays make up approximately half of all those sold globally each year. It is also a leader in surgical imagery, with many years of experience in producing standards compliant medical devices. Combined with its best in class visualization, optics and imagery technology, this makes Barco the obvious choice to take dermatologic imaging technology to the next level.
We began our development process with an intensive period of stakeholder engagement, talking to doctors, patients, first line clinicians and dermatologists about what they wanted, what their challenges were and how they saw the solution. We then developed various prototypes, at each stage referring to our stakeholders to ensure we were progressing along the best path.
The output was Demetra, which is not just a high quality digital dermatoscope, but a unique skin imaging platform. It uses multispectral imaging technology, which provides detail on tissue composition, blood flow and pigmentation to enable clinical decision making based on a deeper level of information and understanding. Demetra’s Skin Parameter Mapping reveals vasculature and pigment structures in a way that is simply not possible with traditional white light dermoscopy.
Images can be instantly and securely stored in the patient’s record in the cloud, so are readily available to any clinician with relevant access. This also means images can be viewed over time and any changes easily identified. All data is managed inline with General Data Protection Regulations.
Demetra enables dermatologists to view high quality images and series of images in the cloud, enabling them to consult with other stakeholders referring to clinical evidence. Demetra can support ongoing learning about skin cancer, as over time it’s possible to create an image bank which clearly records each patient journey and can offer insight into which kinds of lesions were proven to be benign or malignant.
Demetra is a service, not a product. Users will always have the latest technology, as software updates are automatically pushed to devices whilst they are on charge and not in use. Any faulty hardware will be replaced free of charge. We continue to innovate, and Demetra will offer new features and services, becoming more complete, not obsolete. For example, additional analytics algorithms are currently in clinical trial, which will guide diagnoses.
Ultimately the aim is to streamline the clinical workflow for skin cancer detection. We want to make it easier for first line practitioners, such as family doctors, pharmacists and nurses to be able to confidently triage skin lesions, giving them guidance on whether a patient should be reviewed again in a few weeks or referred urgently, for example.
In time, we may be able to screen for skin cancers in the same way we do for other cancers such as breast, prostate and colon cancer using the imagery collected by Demetra along with interrelated risk factors.
Barco has a clear vision of how we can use technology to change the paradigm in dermoscopy. We are committed to investing in a strategy which will improve patient flow, make best use of resources, and deliver better outcomes for patients.