PDT of AK by continuous activation of porphyrins by daylight proved to be as effective as conventional PDT. PDT using daylight activation will make the treatment of these extremely common premalignant tumours more time and cost effective, and more convenient for the patient.
Melanoma is the most aggressive skin cancer. The specificity and sensitivity of clinical diagnosis varies from around 40% to 80%. Here, we investigated whether the chemical changes in the melanoma tissue detected by Raman spectroscopy and neural networks can be used for diagnostic purposes. Near-infrared Fourier transform Raman spectra were obtained from samples of melanoma (n=22) and other skin tumors that can be clinically confused with melanoma: pigmented nevi (n=41), basal cell carcinoma (n=48), seborrheic keratoses (n=23), and normal skin (n=89). A sensitivity analysis of spectral frequencies used by a neural network was performed to determine the importance of the individual components in the Raman spectra. Visual inspection of the Raman spectra suggested that melanoma could be differentiated from pigmented nevi, basal cell carcinoma, seborrheic keratoses, and normal skin due to the decrease in the intensity of the amide I protein band around 1660 cm-1. Moreover, melanoma and basal cell carcinoma showed an increase in the intensity of the lipid-specific band peaks around 1310 cm-1 and 1330 cm-1, respectively. Band alterations used in the visual inspection were also independently identified by a neural network for melanoma diagnosis. The sensitivity and specificity for diagnosis of melanoma achieved by neural network analysis of Raman spectra were 85% and 99%, respectively. We propose that neural network analysis of near-infrared Fourier transform Raman spectra could provide a novel method for rapid, automated skin cancer diagnosis on unstained skin samples.
Daylight-mediated MAL-PDT is an effective, convenient and nearly pain-free treatment for patients with multiple thin AKs. Daylight-mediated PDT procedures were easily performed and 2 h of daylight exposure resulted in uniformly high response rates when conducted in the period from June to October in Nordic countries.
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