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Noninvasive diagnosis of suspect lesions possible with handheld device


Using confocal imaging (or reflectance confocal microscopy, RCM), the VivaScope (Lucid) is proving to be a useful tool in the differentiation and diagnosis of cutaneous lesions.

Key Points

The new handheld VivaScope 3000, the next generation in the product line using RCM technology, was presented at the 68th Annual Meeting of the American Academy of Dermatology.


"This is not meant to be a screening tool; it is more an adjunct diagnostic tool for those lesions that remain questionable after both clinical and dermoscopic examinations," Dr. Rabinovitz says.

The VivaScope 1500 has an imaging head about the size of a dental X-ray unit mounted on a pivoting arm, allowing the physician to capture images from most locations on the body. Using the VivaScope 1500, up to an 8 mm square area is captured at multiple levels within the skin.

"VivaNet is a unique Internet-based server that enables dermatologists to securely transfer high-resolution VivaScope images to dermatopathologists in near-real time," Mr. Eastman says. "This is an extremely efficient way of getting a diagnostic interpretation of the images, and also enables rapid second opinions from appropriate specialists, thus helping the dermatologist make an informed clinical judgment on questionable lesions.

"Many physicians in private practice prefer to have the images read by a pathologist or a dermatopathologist. The rapid acquisition of confocal images and the ability to immediately share them with appropriate specialists is key as we bring this technology into private practice," he says.

A noninvasive option

According to Mr. Eastman, statistics show that on average in the United States, 28 biopsies are performed for each melanoma found. Although histopathology remains the gold standard in diagnosis, taking a biopsy may be a less-than-optimal diagnostic approach for young children, patients apprehensive of surgery or in problematic anatomic sites. In such cases, the VivaScope can prove helpful in reaching a diagnosis.

"With all of the noninvasive imaging technology and devices currently used in medicine, such as MRI and CT scans, this device simply follows suit by offering a noninvasive way of evaluating tissues without the need of a biopsy, something our market survey data indicates patients will prefer and demand," Mr. Eastman says.

For physicians who use Lucid's VivaNet, the company recently implemented a monthly leasing program for its VivaScope confocal imagers.

Disclosures: Dr. Rabinovitz is a clinical investigator for Lucid.

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