Utilizing Data from Electrical Impedance Spectroscopy Significantly Improves the Decision to Biopsy Pigmented Skin Lesions Beyond Clinical Evaluation and Dermoscopy

Background: Even the most experienced dermatologists may forego a biopsy on as many as one-third of malignant melanomas (MMs). Electrical impedance spectroscopy (EIS) is a noninvasive technology that send a painless, very low voltage electrical current through a pigmented lesion to determine if it is benign or malignant. This study aimed to determine if EIS data can improve the decision to biopsy a pigmented lesion even beyond dermoscopy. Methods: A survey with 49 images of MMs, severe dysplastic nevi (SDNs), and benign pigmented skin lesions (PSLs) was shown to dermatologists at a national conference. They were asked if they would biopsy the lesion after first seeing the clinical image, then again after seeing the dermoscopic image, and again after receiving the EIS score. Results: 151 dermatologists completed the survey. Respondents significantly increased correct biopsy decisions (biopsy MMs and SDNs and forego biopsy of benign PSLs) with the addition of dermoscopy versus clinical image alone for MM (78.5% vs. 56.2%, p<0.01) and SDN (62.7% vs. 43.8%, p<0.01). Participants also demonstrated a statistically significant increase in correct biopsy decisions beyond the dermoscopic evaluation when integrating the EIS score for MM (86.2% vs. 78.9%, p<0.01), SDN (68.1% vs. 62.7%, p<0.05) and benign lesions (58.7% vs. 48.0% vs, p<0.01). Conclusion: EIS was able to further improve the rate of correct biopsy choice for MMs and SDNs even beyond dermoscopic evaluation. While dermoscopy worsened diagnostic accuracy for benign PSLs, EIS results were able to significantly improve decision making for these lesions as well. This study demonstrates the clinical utility of EIS technology for improving melanoma diagnosis.