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Rathbone E, Fu D. Quantitative Optical Imaging of Oxygen in Brain Vasculature. J Phys Chem B 2024; 128:6975-6989. [PMID: 38991095 DOI: 10.1021/acs.jpcb.4c01277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/13/2024]
Abstract
The intimate relationship between neuronal activity and cerebral oxygenation underpins fundamental brain functions like cognition, sensation, and motor control. Optical imaging offers a noninvasive approach to assess brain oxygenation and often serves as an indirect proxy for neuronal activity. However, deciphering neurovascular coupling─the intricate interplay between neuronal activity, blood flow, and oxygen delivery─necessitates independent, high spatial resolution, and high temporal resolution measurements of both microvasculature oxygenation and neuronal activation. This Perspective examines the established optical techniques employed for brain oxygen imaging, specifically functional near-infrared spectroscopy, photoacoustic imaging, optical coherence tomography, and two-photon phosphorescent lifetime microscopy, highlighting their fundamental principles, strengths, and limitations. Several other emerging optical techniques are also introduced. Finally, we discuss key technological challenges and future directions for quantitative optical oxygen imaging, paving the way for a deeper understanding of oxygen metabolism in the brain.
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Affiliation(s)
- Emily Rathbone
- Department of Chemistry, University of Washington, Seattle, Washington 98195, United States
| | - Dan Fu
- Department of Chemistry, University of Washington, Seattle, Washington 98195, United States
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2
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Korecka K, Kwiatkowska D, Mazur E, Dańczak-Pazdrowska A, Reich A, Żaba R, Polańska A. An Update on Non-Invasive Skin Imaging Techniques in Actinic Keratosis-A Narrative Review. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:1043. [PMID: 39064472 PMCID: PMC11278531 DOI: 10.3390/medicina60071043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2024] [Revised: 06/17/2024] [Accepted: 06/24/2024] [Indexed: 07/28/2024]
Abstract
Nonmelanocytic skin cancers (NMSCs) are currently the most common group of human cancers and include all tumors that are not melanomas. Increased exposure to sunlight over the past few years, the lack of regular and proper use of sunscreen, the aging of the population, and better screening techniques are the reasons for the escalation in their diagnosis. Squamous cell carcinoma (SCC) comprises nearly 37% of the tumors in this group and can originate from actinic keratosis (AK), which usually presents as pink, often scaly plaques, usually located on the face or scalp. Advances in dermatoscopy, as well as the development of other non-invasive skin imaging modalities such as high-frequency ultrasound (HFUS), reflectance confocal microscopy (RCM), and optical coherence tomography (OCT), have allowed for greatly increased sensitivity in diagnosing these lesions and monitoring their treatment. Since AK therapy is usually local, and SCCs must be removed surgically, non-invasive imaging methods enable to correctly qualify difficult lesions. This is especially important given that they are very often located on the face, and achieving an appropriate cosmetic result after treatments in this area is very important for the patients. In this review, the authors describe the use of non-invasive skin imaging methods in the diagnosis of actinic keratosis.
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Affiliation(s)
- Katarzyna Korecka
- Department of Dermatology, Poznań University of Medical Sciences, 61-545 Poznań, Poland; (A.D.-P.); (A.P.)
| | - Dominika Kwiatkowska
- Department of Dermatology, Institute of Medical Sciences, Medical College of Rzeszow University, 35-959 Rzeszow, Poland
| | - Ewelina Mazur
- Department of Dermatology, Institute of Medical Sciences, Medical College of Rzeszow University, 35-959 Rzeszow, Poland
- Doctoral School, University of Rzeszow, 35-310 Rzeszow, Poland
| | | | - Adam Reich
- Department of Dermatology, Institute of Medical Sciences, Medical College of Rzeszow University, 35-959 Rzeszow, Poland
| | - Ryszard Żaba
- Department of Dermatology, Poznań University of Medical Sciences, 61-545 Poznań, Poland; (A.D.-P.); (A.P.)
| | - Adriana Polańska
- Department of Dermatology, Poznań University of Medical Sciences, 61-545 Poznań, Poland; (A.D.-P.); (A.P.)
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3
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Saveleva MS, Verkhovskii RA, Demina PA, Surkov YI, Anisimov RA, Prikhozhdenko ES, Pidenko PS, Serebryakova IA, Zaytsev SM, Tuchin VV, Svenskaya YI. Biodegradable calcium carbonate carriers for the topical delivery of clobetasol propionate. J Mater Chem B 2024; 12:4867-4881. [PMID: 38666451 DOI: 10.1039/d4tb00303a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/23/2024]
Abstract
Inflammatory dermatoses represent a global problem with increasing prevalence and recurrence among the world population. Topical glucocorticoids (GCs) are the most commonly used anti-inflammatory drugs in dermatology due to a wide range of their therapeutic actions, which, however, have numerous local and systemic side effects. Hence, there is a growing need to create new delivery systems for GCs, ensuring the drug localization in the pathological site, thus increasing the effectiveness of therapy and lowering the risk of side effects. Here, we propose a novel topical particulate formulation for the GC clobetasol propionate (CP), based on the use of porous calcium carbonate (CaCO3) carriers in the vaterite crystalline form. The designed carriers contain a substantially higher CP amount than conventional dosage forms used in clinics (4.5% w/w vs. 0.05% w/w) and displayed a good biocompatibility and effective cellular uptake when studied in fibroblasts in vitro. Hair follicles represent an important reservoir for the GC accumulation in skin and house the targets for its action. In this study, we demonstrated successful delivery of the CP-loaded carriers (CP-CaCO3) into the hair follicles of rats in vivo using optical coherent tomography (OCT). Importantly, the OCT monitoring revealed the gradual intrafollicular degradation of the carriers within 168 h with the most abundant follicle filling occurring within the first 48 h. Biodegradability makes the proposed system especially promising when searching for new CP formulations with improved safety and release profile. Our findings evidenced the great potential of the CaCO3 carriers in improving the dermal bioavailability of this poorly water-soluble GC.
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Affiliation(s)
- Mariia S Saveleva
- Science Medical Center, Saratov State University, 410012 Saratov, Russia.
| | | | - Polina A Demina
- Science Medical Center, Saratov State University, 410012 Saratov, Russia.
| | - Yury I Surkov
- Science Medical Center, Saratov State University, 410012 Saratov, Russia.
- Institute of Physics, Saratov State University, 410012 Saratov, Russia
| | - Roman A Anisimov
- Science Medical Center, Saratov State University, 410012 Saratov, Russia.
- Institute of Physics, Saratov State University, 410012 Saratov, Russia
| | - Ekaterina S Prikhozhdenko
- Science Medical Center, Saratov State University, 410012 Saratov, Russia.
- Institute of Physics, Saratov State University, 410012 Saratov, Russia
| | - Pavel S Pidenko
- Institute of Chemistry, Saratov State University, 410012 Saratov, Russia
| | | | - Sergey M Zaytsev
- Institute of Physics, Saratov State University, 410012 Saratov, Russia
| | - Valery V Tuchin
- Science Medical Center, Saratov State University, 410012 Saratov, Russia.
- Institute of Physics, Saratov State University, 410012 Saratov, Russia
| | - Yulia I Svenskaya
- Science Medical Center, Saratov State University, 410012 Saratov, Russia.
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Akella SS, Lee J, May JR, Puyana C, Kravets S, Dimitropolous V, Tsoukas M, Manwar R, Avanaki K. Using optical coherence tomography to optimize Mohs micrographic surgery. Sci Rep 2024; 14:8900. [PMID: 38632358 PMCID: PMC11024158 DOI: 10.1038/s41598-024-53457-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Accepted: 01/31/2024] [Indexed: 04/19/2024] Open
Abstract
Mohs micrographic surgery (MMS) is considered the gold standard for treating high-risk cutaneous basal cell carcinoma (BCC), but is expensive, time-consuming, and can be unpredictable as to how many stages will be required or how large the final lesion and corresponding surgical defect will be. This study is meant to investigate whether optical coherence tomography (OCT), a highly researched modality in dermatology, can be used preoperatively to map out the borders of BCC, resulting in fewer stages of MMS or a smaller final defect. In this prospective study, 22 patients with BCC undergoing surgical excision were enrolled at a single institution. All patients had previously received a diagnostic biopsy providing confirmation of BCC and had been referred to our center for excision with MMS. Immediately prior to performing MMS, OCT was used to map the borders of the lesion. MMS then proceeded according to standard protocol. OCT images were compared to histopathology for agreement. Histopathologic analysis of 7 of 22 MMS specimens (32%) revealed a total absence of BCC, indicating resolution of BCC after previous diagnostic biopsy. This outcome was correctly predicted by OCT imaging in 6 of 7 cases (86%). Nine tumors (9/22, 41%) had true BCC and required a single MMS stage, which was successfully predicted by pre-operative OCT analysis in 7 of 9 cases (78%). The final six tumors (27%) had true BCC and required two MMS stages for complete excision; preoperative OCT successfully predicted the need for a second stage in five cases (5/6, 83.3%). Overall, OCT diagnosed BCC with 95.5% accuracy (Cohen's kappa, κ = 0.89 (p-value = < 0.01) in the center of the lesion. Following a diagnostic biopsy, OCT can be used to verify the existence or absence of residual basal cell carcinoma. When residual tumor is present that requires excision with MMS, OCT can be used to predict tumor borders, optimize surgery and minimize the need for additional surgical stages.
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Affiliation(s)
- Sruti S Akella
- Department of Dermatology, University of Illinois-Chicago, Chicago, IL, USA
- Department of Ophthalmology and Visual Sciences, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Jenna Lee
- Department of Dermatology, University of Illinois-Chicago, Chicago, IL, USA
| | - Julia Roma May
- School of Medicine, University of Illinois-Chicago, Chicago, IL, USA
| | - Carolina Puyana
- Department of Dermatology, University of Illinois-Chicago, Chicago, IL, USA
| | - Sasha Kravets
- Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois-Chicago, Chicago, IL, USA
| | | | - Maria Tsoukas
- Department of Dermatology, University of Illinois-Chicago, Chicago, IL, USA
| | - Rayyan Manwar
- Department of Biomedical Engineering, University of Illinois-Chicago, Chicago, IL, USA
| | - Kamran Avanaki
- Department of Dermatology, University of Illinois-Chicago, Chicago, IL, USA.
- Department of Biomedical Engineering, University of Illinois-Chicago, Chicago, IL, USA.
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Vélez González JJ, Berger M, Schiele S, Rubeck A, Müller G, Welzel J, Schuh S. Dynamic optical coherence tomography of chronic venous ulcers. J Eur Acad Dermatol Venereol 2024; 38:223-231. [PMID: 37669869 DOI: 10.1111/jdv.19496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Accepted: 08/11/2023] [Indexed: 09/07/2023]
Abstract
BACKGROUND Chronic ulcers, especially venous leg ulcers, are a major burden on the healthcare system. To date there are only few non-invasive established procedures for evaluation of blood perfusion in wounds. Dynamic optical coherence tomography (D-OCT) provides images of the skin's superficial vascularisation. OBJECTIVES This study aims to investigate if and how the D-OCT measurement of chronic wounds can provide new information about the vascularisation during the healing process. METHODS We examined 16 venous ulcers over 16 weeks and evaluated the vessel morphology and density using D-OCT at the wound bed, borders, two centimetres adjacent to the wound und at non-ulcerated skin on the contralateral leg. RESULTS In D-OCT scans clumps were unique and the most common vessel type in the wound area of venous ulcers, whereas lines and serpiginous vessels were the most common in non-ulcerated skin. At the wound border mottle and cluster patterns occurred more frequently. Healthy skin showed a significant increase of mesh pattern. Vessel density significantly increased at the wound area compared to non-ulcerated skin. During the healing process the wound border showed the most vascular changes while only an increase in curves was observed in the wound centre. Non-healing wounds had fewer dots and blobs at the borders, fewer dots, coils, clumps, lines and serpiginous vessels at the centre and fewer dots in adjacent skin. Temperature analysis showed higher temperatures in non-ulcerated skin, followed by the wound margin and centre. Non-healing wounds showed the lowest temperatures in the wound centre. CONCLUSIONS These results highlight the non-invasive use of D-OCT for the examination and monitoring of wound healing in chronic venous ulcers. D-OCT imaging of blood vessels may offer the potential to detect disorders of wound healing at an early stage, differentiate ulcers of different genesis and to tailor more individualized, patient-oriented therapy.
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Affiliation(s)
| | - Maximilian Berger
- Department of Dermatology and Allergology, University Hospital Augsburg, Augsburg, Germany
| | - Stefan Schiele
- Institute of Mathematics, University of Augsburg, Augsburg, Germany
| | - Anna Rubeck
- Institute of Mathematics, University of Augsburg, Augsburg, Germany
| | - Gernot Müller
- Institute of Mathematics, University of Augsburg, Augsburg, Germany
| | - Julia Welzel
- Department of Dermatology and Allergology, University Hospital Augsburg, Augsburg, Germany
| | - Sandra Schuh
- Department of Dermatology and Allergology, University Hospital Augsburg, Augsburg, Germany
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Wolswijk T, Adan F, Nelemans PJ, Defauwes A, Mosterd K. Optical coherence tomography for diagnosing recurrent or residual basal cell carcinoma after topical treatment: A diagnostic cohort study. J Am Acad Dermatol 2023; 89:728-733. [PMID: 37391069 DOI: 10.1016/j.jaad.2023.06.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 05/26/2023] [Accepted: 06/09/2023] [Indexed: 07/02/2023]
Abstract
BACKGROUND Recurrent/residual basal cell carcinoma (BCC) after topical treatment may not be visible during clinical and dermatoscopic examination (CDE). Optical coherence tomography (OCT) may detect these subclinical recurrences or residues. OBJECTIVE To compare the diagnostic accuracy of CDE with that of CDE combined with OCT (CDE-OCT) for detecting recurrent/residual BCC after topical treatment of superficial BCC. METHODS In this diagnostic cohort study, the suspicion level for recurrence or residue was recorded on a 5-point confidence scale. All patients with high suspicion of recurrence or residue based on CDE and/or CDE-OCT were referred for punch biopsy. Patients with a low suspicion on CDE and CDE-OCT were asked to (voluntarily) undergo a control biopsy. Histopathologic results of the biopsy were used for verification of CDE and CDE-OCT diagnoses (gold standard). RESULTS This study included 100 patients. A histopathologic recurrent/residual BCC was found in 20 patients. For recurrence or residue detection, sensitivity was 100% (20 of 20) for CDE-OCT and 60% (12 of 20) for CDE (P = .005) and specificity was 95% for CDE-OCT and 96.3% for CDE (P = .317). The area under the curve for CDE-OCT (0.98) was significantly higher than that for CDE (0.77) (P = .001). LIMITATIONS Results are based on 2 OCT assessors. CONCLUSION Compared with CDE alone, CDE-OCT results in a significantly higher ability to detect recurrent/residual BCCs after topical treatment.
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Affiliation(s)
- Tom Wolswijk
- Department of Dermatology, Maastricht University Medical Center, Maastricht, the Netherlands; GROW Research Institute for Oncology and Reproduction, Maastricht University, Maastricht, the Netherlands.
| | - Fieke Adan
- Department of Dermatology, Maastricht University Medical Center, Maastricht, the Netherlands; GROW Research Institute for Oncology and Reproduction, Maastricht University, Maastricht, the Netherlands
| | | | - Aniek Defauwes
- Maastricht University, Faculty of Health Medicine and Life Sciences, Maastricht, the Netherlands
| | - Klara Mosterd
- Department of Dermatology, Maastricht University Medical Center, Maastricht, the Netherlands; GROW Research Institute for Oncology and Reproduction, Maastricht University, Maastricht, the Netherlands
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Schuh S, Sattler EC, Rubeck A, Schiele S, De Carvalho N, Themstrup L, Ulrich M, Jemec GBE, Holmes J, Pellacani G, Welzel J. Dynamic Optical Coherence Tomography of Blood Vessels in Cutaneous Melanoma-Correlation with Histology, Immunohistochemistry and Dermoscopy. Cancers (Basel) 2023; 15:4222. [PMID: 37686502 PMCID: PMC10487152 DOI: 10.3390/cancers15174222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 07/28/2023] [Accepted: 08/15/2023] [Indexed: 09/10/2023] Open
Abstract
Dermoscopy adds important information to the assessment of cutaneous melanoma, but the risk of progression is predicted by histologic parameters and therefore requires surgery and histopathologic preparation. Neo-vascularization is crucial for tumor progression and worsens prognosis. The aim of this study was the in vivo evaluation of blood vessel patterns in melanoma with dynamic optical coherence tomography (D-OCT) and the correlation with dermoscopic and histologic malignancy parameters for the risk assessment of melanoma. In D-OCT vessel patterns, shape, distribution and presence/type of branching of 49 melanomas were evaluated in vivo at three depths and correlated with the same patterns in dermoscopy and with histologic parameters after excision. In D-OCT, blood vessel density and atypical shapes (coils and serpiginous vessels) increased with higher tumor stage. The histologic parameters ulceration and Hmb45- and Ki67-positivity increased, whereas regression, inflammation and PD-L1-positivity decreased with risk. CD31, VEGF and Podoplanin correlated with D-OCT vasculature findings. B-RAF mutation status had no influence. Due to pigment overlay and the summation effect, the vessel evaluation in dermoscopy and D-OCT did not correlate well. In summary, atypical vessel patterns in melanoma correlate with histologic parameters for risk for metastases. Tumor vasculature can be noninvasively assessed using D-OCT before surgery.
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Affiliation(s)
- Sandra Schuh
- Department of Dermatology, University Hospital Augsburg, 86179 Augsburg, Germany;
| | - Elke Christina Sattler
- Department of Dermatology and Allergy, University Hospital, Ludwig Maximilian University of Munich, 80337 Munich, Germany;
| | - Anna Rubeck
- Institute of Mathematics, University of Augsburg, 86159 Augsburg, Germany; (A.R.); (S.S.)
| | - Stefan Schiele
- Institute of Mathematics, University of Augsburg, 86159 Augsburg, Germany; (A.R.); (S.S.)
| | - Nathalie De Carvalho
- Department of Dermatology, University of Modena and Reggio Emilia, 41124 Modena, Italy; (N.D.C.); (G.P.)
| | - Lotte Themstrup
- Department of Dermatology, Roskilde Hospital, Health Science Faculty, University of Copenhagen, 4000 Roskilde, Denmark; (L.T.); (G.B.E.J.)
| | | | - Gregor B. E. Jemec
- Department of Dermatology, Roskilde Hospital, Health Science Faculty, University of Copenhagen, 4000 Roskilde, Denmark; (L.T.); (G.B.E.J.)
| | - Jon Holmes
- Michelson Diagnostics, Maidstone ME14 5FY, UK;
| | - Giovanni Pellacani
- Department of Dermatology, University of Modena and Reggio Emilia, 41124 Modena, Italy; (N.D.C.); (G.P.)
| | - Julia Welzel
- Department of Dermatology, University Hospital Augsburg, 86179 Augsburg, Germany;
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Atak MF, Farabi B, Navarrete-Dechent C, Rubinstein G, Rajadhyaksha M, Jain M. Confocal Microscopy for Diagnosis and Management of Cutaneous Malignancies: Clinical Impacts and Innovation. Diagnostics (Basel) 2023; 13:diagnostics13050854. [PMID: 36899999 PMCID: PMC10001140 DOI: 10.3390/diagnostics13050854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 02/10/2023] [Accepted: 02/20/2023] [Indexed: 02/25/2023] Open
Abstract
Cutaneous malignancies are common malignancies worldwide, with rising incidence. Most skin cancers, including melanoma, can be cured if diagnosed correctly at an early stage. Thus, millions of biopsies are performed annually, posing a major economic burden. Non-invasive skin imaging techniques can aid in early diagnosis and save unnecessary benign biopsies. In this review article, we will discuss in vivo and ex vivo confocal microscopy (CM) techniques that are currently being utilized in dermatology clinics for skin cancer diagnosis. We will discuss their current applications and clinical impact. Additionally, we will provide a comprehensive review of the advances in the field of CM, including multi-modal approaches, the integration of fluorescent targeted dyes, and the role of artificial intelligence for improved diagnosis and management.
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Affiliation(s)
- Mehmet Fatih Atak
- Department of Dermatology, New York Medical College, Metropolitan Hospital, New York, NY 10029, USA
| | - Banu Farabi
- Department of Dermatology, New York Medical College, Metropolitan Hospital, New York, NY 10029, USA
| | - Cristian Navarrete-Dechent
- Department of Dermatology, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago 8331150, Chile
| | | | - Milind Rajadhyaksha
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Manu Jain
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
- Dermatology Service, Department of Medicine, Weill Cornell Medicine, New York, NY 10021, USA
- Correspondence: ; Tel.: +1-(646)-608-3562
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Rapid On-Site Microscopy and Mapping of Diagnostic Biopsies for See-And-Treat Guidance of Localized Prostate Cancer Therapy. Cancers (Basel) 2023; 15:cancers15030792. [PMID: 36765751 PMCID: PMC9913800 DOI: 10.3390/cancers15030792] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 01/25/2023] [Accepted: 01/25/2023] [Indexed: 01/31/2023] Open
Abstract
Prostate cancer continues to be the most diagnosed non-skin malignancy in men. While up to one in eight men will be diagnosed in their lifetimes, most diagnoses are not fatal. Better lesion location accuracy combined with emerging localized treatment methods are increasingly being utilized as a treatment option to preserve healthy function in eligible patients. In locating lesions which are generally <2cc within a prostate (average size 45cc), small variance in MRI-determined boundaries, tumoral heterogeneity, patient characteristics including location of lesion and prostatic calcifications, and patient motion during the procedure can inhibit accurate sampling for diagnosis. The locations of biopsies are recorded and are then fully processed by histology and diagnosed via pathology, often days to weeks later. Utilization of real-time feedback could improve accuracy, potentially prevent repeat procedures, and allow patients to undergo treatment of clinically localized disease at earlier stages. Unfortunately, there is currently no reliable real-time feedback process for confirming diagnosis of biopsy samples. We examined the feasibility of implementing structured illumination microscopy (SIM) as a method for on-site diagnostic biopsy imaging to potentially combine the diagnostic and treatment appointments for prostate cancer patients, or to confirm tumoral margins for localized ablation procedures. We imaged biopsies from 39 patients undergoing image-guided diagnostic biopsy using a customized SIM system and a dual-color fluorescent hematoxylin & eosin (H&E) analog. The biopsy images had an average size of 342 megapixels (minimum 78.1, maximum 842) and an average imaging duration of 145 s (minimum 56, maximum 322). Comparison of urologist's suspicion of malignancy based on MRI, to pathologist diagnosis of biopsy images obtained in real time, reveals that real-time biopsy imaging could significantly improve confirmation of malignancy or tumoral margins over medical imaging alone.
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Cioabla A, Duma VF, Mnerie C, Erdelyi RA, Dobre GM, Bradu A, Podoleanu A. Effect of an Anaerobic Fermentation Process on 3D-Printed PLA Materials of a Biogas-Generating Reactor. MATERIALS (BASEL, SWITZERLAND) 2022; 15:8571. [PMID: 36500067 PMCID: PMC9735893 DOI: 10.3390/ma15238571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Revised: 11/19/2022] [Accepted: 11/27/2022] [Indexed: 06/17/2023]
Abstract
3D-printed materials are present in numerous applications, from medicine to engineering. The aim of this study is to assess their suitability for an application of interest today, that of testing of 3D-printed polylactic acid (PLA)-based reactors for biogas production using anaerobic digestion. The impact of temperature, pH, and aqueous phase on the tested bioreactor is investigated, together with the effect of the gaseous phase (i.e., produced biogas). Two batches of materials used separately, one after another inside the bioreactor were considered, in a realistic situation. Two essential parameters inside the reactor (i.e., pH and temperature) were continuously monitored during a time interval of 25 to 30 days for each of the two biogas-generating processes. To understand the impact of these processes on the walls of the bioreactor, samples of 3D-printed material were placed at three levels: at the top (i.e., outside the substrate), in the middle, and at the bottom of the bioreactor. The samples were analyzed using a non-destructive imaging method, Optical Coherence Tomography (OCT). An in-house developed swept-source (SS) OCT system, master-slave (MS) enhanced, operating at a central wavelength of 1310 nm was utilized. The 3D OCT images related to the degradation level of the material of the PLA samples were validated using Scanning Electron Microscopy (SEM). The differences between the impact of the substrate on samples situated at the three considered levels inside the reactor were determined and analyzed using their OCT B-scans (optical cross-section images). Thus, the impact of the biogas-generating process on the interior of the bioreactor was demonstrated and quantified, as well as the capability of OCT to perform such assessments. Therefore, future work may target OCT for in situ investigations of such bioreactors.
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Affiliation(s)
- Adrian Cioabla
- Faculty of Mechanics, Polytechnic University of Timisoara, 1 Mihai Viteazu Ave., 300222 Timisoara, Romania
| | - Virgil-Florin Duma
- 3OM Optomechatronics Group, Faculty of Engineering, “Aurel Vlaicu” University of Arad, Str. Elena Dragoi No. 2, 310177 Arad, Romania
- Doctoral School, Polytechnic University of Timisoara, 1 Mihai Viteazu Ave., 300222 Timisoara, Romania
| | - Corina Mnerie
- 3OM Optomechatronics Group, Faculty of Engineering, “Aurel Vlaicu” University of Arad, Str. Elena Dragoi No. 2, 310177 Arad, Romania
| | - Ralph-Alexandru Erdelyi
- 3OM Optomechatronics Group, Faculty of Engineering, “Aurel Vlaicu” University of Arad, Str. Elena Dragoi No. 2, 310177 Arad, Romania
- Doctoral School, Polytechnic University of Timisoara, 1 Mihai Viteazu Ave., 300222 Timisoara, Romania
| | - George Mihai Dobre
- Applied Optics Group, School of Physics, University of Kent, Canterbury CT2 7NR, UK
| | - Adrian Bradu
- Applied Optics Group, School of Physics, University of Kent, Canterbury CT2 7NR, UK
| | - Adrian Podoleanu
- Applied Optics Group, School of Physics, University of Kent, Canterbury CT2 7NR, UK
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11
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Szczepanik M, Balicki I, Śmiech A, Szadkowski M, Gołyński M, Osęka M, Zwolska J. The use of optical coherence tomography for skin evaluation in healthy rats – A pilot study. Vet Dermatol 2022; 33:296-e69. [DOI: 10.1111/vde.13071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Revised: 12/09/2021] [Accepted: 01/23/2022] [Indexed: 11/27/2022]
Affiliation(s)
- Marcin Szczepanik
- Subdepartment of Clinical Diagnostics and Veterinary Dermatology Department and Clinic of Internal Animal Diseases Faculty of Veterinary Medicine University of Life Sciences in Lublin Lublin Poland
| | - Ireneusz Balicki
- Department and Clinic of Animal Surgery Department and Clinic of Internal Animal Diseases Faculty of Veterinary Medicine University of Life Sciences in Lublin Lublin Poland
| | - Anna Śmiech
- Subdepartment of Pathomorphology and Forensic Veterinary Medicine, Department and Clinic of Internal Animal Diseases, Faculty of Veterinary Medicine University of Life Sciences in Lublin Lublin Poland
| | - Mateusz Szadkowski
- Department and Clinic of Animal Surgery Department and Clinic of Internal Animal Diseases Faculty of Veterinary Medicine University of Life Sciences in Lublin Lublin Poland
| | - Marcin Gołyński
- Nicolaus Copernicus University in Torun Faculty of Biological and Veterinary Sciences Toruń Poland
| | | | - Jowita Zwolska
- Department and Clinic of Animal Surgery Department and Clinic of Internal Animal Diseases Faculty of Veterinary Medicine University of Life Sciences in Lublin Lublin Poland
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12
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Yuan Z, Yang D, Yang Z, Zhao J, Liang Y. Digital refocusing based on deep learning in optical coherence tomography. BIOMEDICAL OPTICS EXPRESS 2022; 13:3005-3020. [PMID: 35774338 PMCID: PMC9203092 DOI: 10.1364/boe.453326] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 03/18/2022] [Accepted: 03/18/2022] [Indexed: 06/15/2023]
Abstract
We present a deep learning-based digital refocusing approach to extend depth of focus for optical coherence tomography (OCT) in this paper. We built pixel-level registered pairs of en face low-resolution (LR) and high-resolution (HR) OCT images based on experimental data and introduced the receptive field block into the generative adversarial networks to learn the complex mapping relationship between LR-HR image pairs. It was demonstrated by results of phantom and biological samples that the lateral resolutions of OCT images were improved in a large imaging depth clearly. We firmly believe deep learning methods have broad prospects in optimizing OCT imaging.
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Affiliation(s)
- Zhuoqun Yuan
- Institute of Modern Optics, Nankai University, Tianjin Key Laboratory of Micro-scale Optical Information Science and Technology, Tianjin 300350, China
- Contributed equally
| | - Di Yang
- Institute of Modern Optics, Nankai University, Tianjin Key Laboratory of Micro-scale Optical Information Science and Technology, Tianjin 300350, China
- Contributed equally
| | - Zihan Yang
- Institute of Modern Optics, Nankai University, Tianjin Key Laboratory of Micro-scale Optical Information Science and Technology, Tianjin 300350, China
| | - Jingzhu Zhao
- Department of Thyroid and Neck Tumor, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin 300060, China
| | - Yanmei Liang
- Institute of Modern Optics, Nankai University, Tianjin Key Laboratory of Micro-scale Optical Information Science and Technology, Tianjin 300350, China
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13
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Yow AP, Lee WZ, Wong DWK, Tey HL. Subsurface detection of hair follicles in alopecia areata using optical coherence tomography. Skin Res Technol 2022; 28:379-381. [PMID: 35020967 PMCID: PMC9907577 DOI: 10.1111/srt.13138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 12/18/2021] [Indexed: 12/01/2022]
Affiliation(s)
- Ai Ping Yow
- Singapore Centre for Environmental Life Sciences Engineering, Singapore, Singapore
| | | | - Damon Wing Kee Wong
- School of Chemical and Biomedical Engineering, Nanyang Technological University, Singapore, Singapore
| | - Hong Liang Tey
- National Skin Centre, Singapore, Singapore.,Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore.,Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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14
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Abstract
During the past decade, noninvasive imaging has emerged as a valuable tool in clinical dermatology and dermatologic research. Optical coherence tomography (OCT) is one such type of noninvasive imaging. OCT uses the principle of interferometry to produce real-time images. A low-power diode laser shines infrared light onto tissues, which reflects back to an optical fiber interferometer. Using time delay and the backscattered light intensity, a two-dimensional image akin to an ultrasound is rendered. We review the history, types, and modalities of OCT, plus the many applications of frequency domain, high definition, and dynamic OCT in practice, including its utility in diagnosis, monitoring, and grading disease severity in a variety of cutaneous conditions.
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Affiliation(s)
- Corinna E Psomadakis
- Department of Medicine, Mount Sinai West and Morningside, New York, New York, USA
| | - Nadeem Marghoob
- University of Vermont Medical Center, Department of Dermatology, Burlington, VT
| | - Brady Bleicher
- Department of Dermatology, SUNY Downstate Medical Center, Brooklyn, New York, USA
| | - Orit Markowitz
- Department of Dermatology, SUNY Downstate Medical Center, Brooklyn, New York, USA.
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15
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Chaturvedi P, Worsley PR, Zanelli G, Kroon W, Bader DL. Quantifying skin sensitivity caused by mechanical insults: A review. Skin Res Technol 2021; 28:187-199. [PMID: 34708455 PMCID: PMC9298205 DOI: 10.1111/srt.13104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 08/21/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Skin sensitivity (SS) is a commonly occurring response to a range of stimuli, including environmental conditions (e.g., sun exposure), chemical irritants (e.g., soaps and cosmetics), and mechanical forces (e.g., while shaving). From both industry and academia, many efforts have been taken to quantify the characteristics of SS in a standardised manner, but the study is hindered by the lack of an objective definition. METHODS A review of the scientific literature regarding different parameters attributed to the loss of skin integrity and linked with exhibition of SS was conducted. Articles included were screened for mechanical stimulation of the skin, with objective quantification of tissue responses using biophysical or imaging techniques. Additionally, studies where cohorts of SS and non-SS individuals were reported have been critiqued. RESULTS The findings identified that the structure and function of the stratum corneum and its effective barrier properties are closely associated with SS. Thus, an array of skin tissue responses has been selected for characterization of SS due to mechanical stimuli, including: transepidermal water loss, hydration, redness, temperature, and sebum index. Additionally, certain imaging tools allow quantification of the superficial skin layers, providing structural characteristics underlying SS. CONCLUSION This review proposes a multimodal approach for identification of SS, providing a means to characterise skin tissue responses objectively. Optical coherence tomography (OCT) has been suggested as a suitable tool for dermatological research with clinical applications. Such an approach would enhance the knowledge underlying the multifactorial nature of SS and aid the development of personalised solutions in medical and consumer devices.
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Affiliation(s)
- Pakhi Chaturvedi
- Philips Consumer Lifestyle B.V., Drachten, The Netherlands.,School of Health Sciences, University of Southampton, Southampton, UK
| | - Peter R Worsley
- School of Health Sciences, University of Southampton, Southampton, UK
| | - Giulia Zanelli
- Philips Consumer Lifestyle B.V., Drachten, The Netherlands
| | - Wilco Kroon
- Philips Consumer Lifestyle B.V., Drachten, The Netherlands
| | - Dan L Bader
- School of Health Sciences, University of Southampton, Southampton, UK
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16
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Jartarkar SR, Patil A, Wollina U, Gold MH, Stege H, Grabbe S, Goldust M. New diagnostic and imaging technologies in dermatology. J Cosmet Dermatol 2021; 20:3782-3787. [PMID: 34652880 DOI: 10.1111/jocd.14499] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 09/17/2021] [Indexed: 12/19/2022]
Abstract
INTRODUCTION Diagnosis of dermatological disorders is primarily based on clinical examination in combination with histopathology. However, clinical findings alone may not be sufficient for accurate diagnosis and cutaneous biopsies are being associated with morbidity. OBJECTIVE The objective of this article is to review the newer technologies along with their applications, limitation and future prospectus. METHODOLOGY Comprehensive literature search was performed using electronic online databases "PubMed" and "Google Scholar". Articles published in English language were considered for the review. RESULTS In order to improve and/or widen the armamentarium in dermatologic disease diagnosis and therapy, newer emerging technologies are being made available which aid in diagnosis and management. New emerging technologies include confocal microscopy, digital photographic imaging, optical coherence tomography, high frequency ultrasonography, and artificial intelligence. There have been advancements in the dermoscopes. CONCLUSION Significant progress is seen in the diagnostic methods and imaging technologies in dermatology, each having its advantages and limitations. Artificial intelligence/machine-based learning software may have a great scope to influence the dermatological practice.
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Affiliation(s)
- Shishira R Jartarkar
- Department of Dermatology, Vydehi Institute of Medical Sciences and Research Centre, Bangalore, India
| | - Anant Patil
- Department of Pharmacology, Dr. DY Patil Medical College, Navi Mumbai, India
| | - Uwe Wollina
- Department of Dermatology and Allergology, Städtisches Klinikum Dresden, Academic Teaching Hospital of the Technical University of Dresden, Dresden, Germany
| | - Michael H Gold
- Gold Skin Care Center, Tennessee Clinical Research Center, Nashville, Tennessee, USA
| | - Henner Stege
- Department of Dermatology, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Stephan Grabbe
- Department of Dermatology, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Mohamad Goldust
- Department of Dermatology, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
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17
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Jung JM, Cho JY, Lee WJ, Chang SE, Lee MW, Won CH. Emerging Minimally Invasive Technologies for the Detection of Skin Cancer. J Pers Med 2021; 11:951. [PMID: 34683091 PMCID: PMC8538732 DOI: 10.3390/jpm11100951] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 09/23/2021] [Accepted: 09/23/2021] [Indexed: 12/23/2022] Open
Abstract
With the increasing incidence of skin cancer, many noninvasive technologies to detect its presence have been developed. This review focuses on reflectance confocal microscopy (RCM), optical coherence tomography (OCT), high-frequency ultrasound (HFUS), electrical impedance spectroscopy (EIS), pigmented lesion assay (PLA), and Raman spectroscopy (RS) and discusses the basic principle, clinical applications, advantages, and disadvantages of each technology. RCM provides high cellular resolution and has high sensitivity and specificity for the diagnosis of skin cancer. OCT provides lower resolution than RCM, although its evaluable depth is deeper than that of RCM. RCM and OCT may be useful in reducing the number of unnecessary biopsies, evaluating the tumor margin, and monitoring treatment response. HFUS can be mainly used to delineate tumor depths or margins and monitor the treatment response. EIS provides high sensitivity but low specificity for the diagnosis of skin malignancies. PLA, which is based on the genetic information of lesions, is applicable for the detection of melanoma with high sensitivity and moderate-to-high specificity. RS showed high accuracy for the diagnosis of skin cancer, although more clinical studies are required. Advances in these technologies for the diagnosis of skin cancer can lead to the realization of optimized and individualized treatments.
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Affiliation(s)
- Joon Min Jung
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea; (J.M.J.); (W.J.L.); (S.E.C.); (M.W.L.)
| | - Ji Young Cho
- Department of Medical Science, Asan Medical Institute of Convergence Science and Technology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea;
| | - Woo Jin Lee
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea; (J.M.J.); (W.J.L.); (S.E.C.); (M.W.L.)
| | - Sung Eun Chang
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea; (J.M.J.); (W.J.L.); (S.E.C.); (M.W.L.)
| | - Mi Woo Lee
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea; (J.M.J.); (W.J.L.); (S.E.C.); (M.W.L.)
| | - Chong Hyun Won
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea; (J.M.J.); (W.J.L.); (S.E.C.); (M.W.L.)
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18
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Tarek E, Mostafa WZ, Allam RSHM, El-Samanoudy SI, Saadi DG. Short-pulsed and Q-switched ND-YAG laser with topical carbon versus fractional CO 2 laser in the treatment of enlarged facial pores: A split-face comparative study. Lasers Surg Med 2021; 54:237-244. [PMID: 34255869 DOI: 10.1002/lsm.23454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/28/2021] [Indexed: 11/09/2022]
Abstract
OBJECTIVES To assess and compare the efficacy and safety of topical carbon plus short-pulsed and Q-switched Nd-YAG laser to fractional carbon dioxide (CO2 ) laser in improving the appearance of wide facial pores. MATERIALS AND METHODS Thirty Egyptian patients with wide facial pores were treated in a split-face manner with two sessions of fractional CO2 laser on one side of the face and topical carbon followed by short-pulsed and Q-switched Nd-YAG laser on the other side at 4-week intervals. Clinical evaluation by Investigator Global Assessment (IGA), patient satisfaction level, and photography before treatment and 1 month after the second laser session was performed and adverse effects were monitored. Dermoscopic evaluation by dermoscopy pore score and optical coherence tomography (OCT) evaluation by surface irregularities score were performed at baseline and 1-month posttreatment. RESULTS One month after treatment, both modalities produced significant reduction in IGA score, dermoscopy pore score, and surface irregularities by OCT (p < 0.001, p < 0.001). Both procedures were well-tolerated. There was no significant difference in IGA, dermoscopy pore score, surface irregularities score by OCT, adverse effects or patient satisfaction level between both treated sides. CONCLUSION Fractional CO2 laser and topical carbon application followed by short-pulsed and Q-switched Nd-YAG laser can be safely and effectively used to improve the appearance of wide facial pores.
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Affiliation(s)
- Eman Tarek
- Department of Dermatology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Wedad Z Mostafa
- Department of Dermatology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Riham S H M Allam
- Department of Ophthalmology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | | | - Dina G Saadi
- Department of Dermatology, Faculty of Medicine, Cairo University, Cairo, Egypt
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19
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Optimization of X-ray Investigations in Dentistry Using Optical Coherence Tomography. SENSORS 2021; 21:s21134554. [PMID: 34283107 PMCID: PMC8271642 DOI: 10.3390/s21134554] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 06/30/2021] [Accepted: 07/01/2021] [Indexed: 12/16/2022]
Abstract
The most common imaging technique for dental diagnoses and treatment monitoring is X-ray imaging, which evolved from the first intraoral radiographs to high-quality three-dimensional (3D) Cone Beam Computed Tomography (CBCT). Other imaging techniques have shown potential, such as Optical Coherence Tomography (OCT). We have recently reported on the boundaries of these two types of techniques, regarding. the dental fields where each one is more appropriate or where they should be both used. The aim of the present study is to explore the unique capabilities of the OCT technique to optimize X-ray units imaging (i.e., in terms of image resolution, radiation dose, or contrast). Two types of commercially available and widely used X-ray units are considered. To adjust their parameters, a protocol is developed to employ OCT images of dental conditions that are documented on high (i.e., less than 10 μm) resolution OCT images (both B-scans/cross sections and 3D reconstructions) but are hardly identified on the 200 to 75 μm resolution panoramic or CBCT radiographs. The optimized calibration of the X-ray unit includes choosing appropriate values for the anode voltage and current intensity of the X-ray tube, as well as the patient’s positioning, in order to reach the highest possible X-rays resolution at a radiation dose that is safe for the patient. The optimization protocol is developed in vitro on OCT images of extracted teeth and is further applied in vivo for each type of dental investigation. Optimized radiographic results are compared with un-optimized previously performed radiographs. Also, we show that OCT can permit a rigorous comparison between two (types of) X-ray units. In conclusion, high-quality dental images are possible using low radiation doses if an optimized protocol, developed using OCT, is applied for each type of dental investigation. Also, there are situations when the X-ray technology has drawbacks for dental diagnosis or treatment assessment. In such situations, OCT proves capable to provide qualitative images.
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20
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Phan TL, Hieu NV, Li TS, Tsao KC, Ching CTS. Noninvasive and real-time in vivo characterization of Inflammation skin. A feasibility of animal study. Skin Res Technol 2021; 27:846-853. [PMID: 33890700 DOI: 10.1111/srt.13030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 03/11/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Inflammatory skin diseases were the most common problem in dermatology. This study aimed to develop a circuit by using a simple method for noninvasive, objective, and real-time skin inflammation screening. MATERIALS AND METHODS Sprague-Dawley rats were used in this study. The rats were chemically induced to suffer from skin inflammation at the back of their left-hand side while the right-hand side of their back remained untreated serving as a control. Impedance (Z) spectrum of the rat's skin was recorded. RESULTS Two characteristic frequencies (4.5 and 48.3 kHz) were found. At the two frequencies, the impedance of inflammatory skin tissue (ZIST ) was found to be significantly (P < .05) smaller than that of normal healthy skin tissue (ZNHST ). Moreover, the ratio of the impedance measured at 4.5 kHz (Zf = 4 .5 kHz ) to the impedance measured at 48.3 kHz (Zf = 48.3 kHz ), that is, Zf = 4.5 kHz /Zf = 48.3 kHz , was capable of skin inflammation screening. It was observed that the inflammatory skin tissue (IST) had the smaller value of Zf = 4 .5 kHz /Zf = 48.3 kHz (value < 8.5) and normal healthy skin tissue (NHST) had the higher value of Zf = 4 .5 kHz /Zf = 48.3 kHz (value ≈ 10) which almost remained constant. CONCLUSION A circuit was developed which was used for measuring the skin impedance accurately at the two characteristic frequencies for skin inflammation screening.
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Affiliation(s)
- Thien Luan Phan
- Graduate Institute of Biomedical Engineering, National Chung Hsing University, Taichung City, Taiwan.,Department of Physics and Electronic Engineering, University of Science (Vietnam National University of Hochiminh City), Ho Chi Minh City, Vietnam
| | - Nguyen Van Hieu
- Department of Physics and Electronic Engineering, University of Science (Vietnam National University of Hochiminh City), Ho Chi Minh City, Vietnam
| | - Tzong Shiun Li
- Department of Plastic Surgery, Show Chwan Memorial Hospital, Changhua, Taiwan
| | - Ko-Chang Tsao
- Department of Dermatology, Puli Christian Hospital, Puli, Taiwan
| | - Congo Tak Shing Ching
- Graduate Institute of Biomedical Engineering, National Chung Hsing University, Taichung City, Taiwan
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21
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Hong EM, Pham TT, Seo S, Moy WJ, Borden P, Hansen K, Kim S, Mo JH, Wong BJF. Electrochemical Therapy of In Vivo Rabbit Cutaneous Tissue. Laryngoscope 2021; 131:E2196-E2203. [PMID: 33666252 DOI: 10.1002/lary.29461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 01/12/2021] [Accepted: 02/06/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVES To examine the acid-base and histological changes in in vivo rabbit cutaneous tissue after electrochemical therapy. STUDY DESIGN In vivo rabbit tissue study. METHODS The shaved skin on the backs of female Oryctolagus cuniculi were assigned to treatments with or without tumescence with normal saline. Two platinum-needle electrodes were inserted into each treatment area and connected to a direct current (DC) power supply. Voltage (3-5 V) was varied and applied for 5 minutes. The wound-healing process was monitored via digital photography and ultrasonography until euthanasia at day 29. Treatment areas were biopsied, and specimens were sectioned through a sagittal midline across both electrode insertion sites. Samples were then evaluated utilizing light microscopy (hematoxylin and eosin, Masson's Trichrome, and Picrosirius red). RESULTS Treatment sites developed mild inflammation that dissipated at lower voltages or became scabs at higher voltages. Ultrasonography demonstrated acoustic shadowing with spatial spread that increased with increasing voltage application. The 4- and 5-V sites treated with saline had localized areas of increased tissue density at day 29. Although specimens treated with 3 V did not look significantly different from control tissue, 4- and 5-V samples with and without saline tumescence had finer, less-organized collagen fibers and increased presence of fibrocytes and inflammatory infiltrates. CONCLUSIONS Electrochemical therapy caused localized injury to in vivo rabbit cutaneous tissue, prompting regenerative wound repair. With future development, this technology may offer precise, low-cost rejuvenation to restore the functionality and appearance of dermal scars and keloids. LEVEL OF EVIDENCE NA Laryngoscope, 131:E2196-E2203, 2021.
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Affiliation(s)
- Ellen M Hong
- Beckman Laser Institute & Medical Clinic, University of California, Irvine, California, U.S.A
| | - Tiffany T Pham
- Beckman Laser Institute & Medical Clinic, University of California, Irvine, California, U.S.A
| | - Soohong Seo
- Department of Dermatology, Korea University Anam Hospital, Seoul, South Korea
| | - Wesley J Moy
- Beckman Laser Institute & Medical Clinic, University of California, Irvine, California, U.S.A
| | - Pamela Borden
- Beckman Laser Institute & Medical Clinic, University of California, Irvine, California, U.S.A
| | - Kyle Hansen
- Beckman Laser Institute & Medical Clinic, University of California, Irvine, California, U.S.A
| | - Sehwan Kim
- Department of Biomedical Engineering, School of Medicine, Dankook University, Cheonan, Republic of Korea.,Beckman Laser Institute Korea, Dankook University, Cheonan-si, Chungnam, Republic of Korea
| | - Ji-Hun Mo
- Beckman Laser Institute Korea, Dankook University, Cheonan-si, Chungnam, Republic of Korea.,Department of Otorhinolaryngology, School of Medicine, Dankook University, Chenoan, Republic of Korea
| | - Brian J F Wong
- Beckman Laser Institute & Medical Clinic, University of California, Irvine, California, U.S.A.,Department of Biomedical Engineering, University of California-Irvine, Irvine, California, U.S.A.,Department of Otolaryngology-Head and Neck Surgery, University of California-Irvine, School of Medicine, Orange, California, U.S.A
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22
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Xing F, Lee JH, Polucha C, Lee J. Design and optimization of line-field optical coherence tomography at visible wavebands. BIOMEDICAL OPTICS EXPRESS 2021; 12:1351-1365. [PMID: 33796358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 01/25/2021] [Accepted: 01/29/2021] [Indexed: 06/12/2023]
Abstract
Parallel line-field Fourier-domain optical coherence tomography (LF-FDOCT) has emerged to enable relatively higher speeds than the conventional FDOCT system. In the LF-FDOCT, one B-scan is captured at a time instead of scanning the beam to acquire hundreds of A-scans. On the other hand, spectroscopic OCT using the visible waveband provides absorption information over multiple wavelengths at each voxel. This information of spectral absorption enables quantitative measurement of blood oxygenation, voxel by voxel. Here, we presented the design and optimization of a LF-FDOCT system at the visible waveband (520-620 nm), especially using a generic Camera Link area sensor (2048 × 1088 pixels). To optimize the axial resolution and depth of imaging volume, we simulated various parameters and found that two Nyquist optima can exist, the origin and implication of which has been discussed. As a result, our system acquired 1088 A-scans in parallel at the camera's frame rate of 281 frame per second, achieving an equivalent rate of over 300,000 A-scan/s, while minimizing sacrifice in the point spread function (2.8 × 3.1 × 3.2 µm3, x × y × z) and the field of view (750 × 750 × 750 µm3). As an example of application, we presented high-speed imaging of blood oxygenation in the rodent brain cortex.
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Affiliation(s)
- Fangjian Xing
- School of Computer and Electronic information, Nanjing Normal University, Nanjing, 210023, China
- Center for Biomedical Engineering, School of Engineering, Brown University, Providence, Rhode Island 02912, USA
| | - Jang-Hoon Lee
- Center for Biomedical Engineering, School of Engineering, Brown University, Providence, Rhode Island 02912, USA
| | - Collin Polucha
- Center for Biomedical Engineering, School of Engineering, Brown University, Providence, Rhode Island 02912, USA
| | - Jonghwan Lee
- Center for Biomedical Engineering, School of Engineering, Brown University, Providence, Rhode Island 02912, USA
- Carney Institute for Brain Science, Brown University, Providence, Rhode Island 02912, USA
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23
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Xing F, Lee JH, Polucha C, Lee J. Design and optimization of line-field optical coherence tomography at visible wavebands. BIOMEDICAL OPTICS EXPRESS 2021; 12:1351-1365. [PMID: 33796358 PMCID: PMC7984778 DOI: 10.1364/boe.413424] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 01/25/2021] [Accepted: 01/29/2021] [Indexed: 06/17/2023]
Abstract
Parallel line-field Fourier-domain optical coherence tomography (LF-FDOCT) has emerged to enable relatively higher speeds than the conventional FDOCT system. In the LF-FDOCT, one B-scan is captured at a time instead of scanning the beam to acquire hundreds of A-scans. On the other hand, spectroscopic OCT using the visible waveband provides absorption information over multiple wavelengths at each voxel. This information of spectral absorption enables quantitative measurement of blood oxygenation, voxel by voxel. Here, we presented the design and optimization of a LF-FDOCT system at the visible waveband (520-620 nm), especially using a generic Camera Link area sensor (2048 × 1088 pixels). To optimize the axial resolution and depth of imaging volume, we simulated various parameters and found that two Nyquist optima can exist, the origin and implication of which has been discussed. As a result, our system acquired 1088 A-scans in parallel at the camera's frame rate of 281 frame per second, achieving an equivalent rate of over 300,000 A-scan/s, while minimizing sacrifice in the point spread function (2.8 × 3.1 × 3.2 µm3, x × y × z) and the field of view (750 × 750 × 750 µm3). As an example of application, we presented high-speed imaging of blood oxygenation in the rodent brain cortex.
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Affiliation(s)
- Fangjian Xing
- School of Computer and Electronic information, Nanjing Normal University, Nanjing, 210023, China
- Center for Biomedical Engineering, School of Engineering, Brown University, Providence, Rhode Island 02912, USA
| | - Jang-Hoon Lee
- Center for Biomedical Engineering, School of Engineering, Brown University, Providence, Rhode Island 02912, USA
| | - Collin Polucha
- Center for Biomedical Engineering, School of Engineering, Brown University, Providence, Rhode Island 02912, USA
| | - Jonghwan Lee
- Center for Biomedical Engineering, School of Engineering, Brown University, Providence, Rhode Island 02912, USA
- Carney Institute for Brain Science, Brown University, Providence, Rhode Island 02912, USA
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24
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Lu J, Deegan AJ, Cheng Y, Mandell SP, Wang RK. OCT-Based Angiography and Surface Topography in Burn-Damaged Skin. Lasers Surg Med 2020; 53:849-860. [PMID: 33305835 DOI: 10.1002/lsm.23367] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 11/26/2020] [Accepted: 11/30/2020] [Indexed: 01/12/2023]
Abstract
BACKGROUND AND OBJECTIVES There is a clinical need for an accurate, non-invasive imaging tool that can provide the objective assessment of burn wounds. The aims of this study are to demonstrate the potential of optical coherence tomography (OCT) in evaluating burn wound healing, as well as exploring the physiological basis of human wound healing. STUDY DESIGN/MATERIALS AND METHODS This was a retrospective study. Seven patients with severe burn wounds who were admitted to Harborview Medical Center were imaged using an in-house-built, clinical-prototype OCT system. OCT imaging was carried out at multiple scan sites on the burned skin across two time points (imaging session #1 and #2) with a field of view of ~9 × 9 mm. Due to pathological differences among burn zones, scan sites were classified into red sites (zone of hyperemia), white sites (zone of coagulation), and mixed sites. In addition to obtaining qualitative en face vascular and surface topography maps, we quantified vascular area density and surface roughness for comparative purposes. RESULTS En face vascular and surface topography maps demonstrated numerous morphological changes over both imaging sessions associated with burn injury, such as altered blood flow and loss of regular texture. Quantitative analyses revealed that during imaging session #1, vascular area density was significantly increased within the red sites compared with that of a healthy control (P = 0.0130), while vascular area density was significantly decreased within the white sites compared with that of a healthy control (P < 0.0001). During imaging session #2, vascular area density was significantly reduced to a more normal range within the red sites compared with imaging session #1 (P = 0.0215); however, vascular area density was still significantly lower within the white sites compared with that of a healthy control (P < 0.0001). Furthermore, vascular area density and surface roughness were significantly increased within the white sites during imaging session #2 compared with imaging session #1 (both P < 0.0001). CONCLUSIONS OCT is clinically feasible to monitor vascular changes and alterations in skin surface roughness during the process of burn wound healing. Variations in vascular area density and roughness measurements within the burn wounds revealed by OCT offer some key insights into the underlying pathophysiological mechanisms responsible for wound healing, which may become critical biological indicators in future clinical evaluation and monitoring of wound healing. Lasers Surg. Med. © 2020 Wiley Periodicals LLC.
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Affiliation(s)
- Jie Lu
- Department of Bioengineering, University of Washington, Seattle, Washington, 98195
| | - Anthony J Deegan
- Department of Bioengineering, University of Washington, Seattle, Washington, 98195
| | - Yuxuan Cheng
- Department of Bioengineering, University of Washington, Seattle, Washington, 98195
| | - Samuel P Mandell
- Department of Surgery, Division of Trauma, Critical Care, and Burn, School of Medicine, University of Washington, Seattle, Washington, 98104
| | - Ruikang K Wang
- Department of Bioengineering, University of Washington, Seattle, Washington, 98195.,Department of Ophthalmology, School of Medicine, University of Washington, Seattle, Washington, 98104
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Bergeron S, Arthurs B, Sanft DM, Mastromonaco C, Burnier MN. Optical Coherence Tomography of Peri-Ocular Skin Cancers: An Optical Biopsy. Ocul Oncol Pathol 2020; 7:149-158. [PMID: 33981698 DOI: 10.1159/000511188] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 08/24/2020] [Indexed: 12/15/2022] Open
Abstract
Introduction Optical coherence tomography (OCT) imaging has been used as a diagnostic tool for retinal disease for several years, and OCT apparatuses are becoming increasingly powerful. However, OCT has yet to reach its full potential in ophthalmology clinics. Alike retinal layers, it has been shown that OCT is able to generate cross-sectional images of the skin and allows visualization of skin lesions in a histopathology-like manner. Objective We aim to validate OCT as an imaging modality for peri-ocular skin cancer. Through a series of cases, we highlight findings for 3 common eyelid malignancies: basal cell carcinoma, squamous cell carcinoma and sebaceous carcinoma. We propose an OCT image-based signature for basal cell carcinoma. Methods This is a prospective study. Fifty-eight lesions suspicious of malignancy from 57 patients were subjected to OCT imaging prior to the surgical excision of the lesion. OCT images were analysed and scored according to previously identified OCT features. Eight representative examples are presented, highlighting the OCT patterns for each malignancy side by side to its corresponding histopathological sections. Results Out of the 58 lesions analysed, 53 were malignant. A loss of the dermal-epidermal junction is observed in all malignant lesions. A strong link is observed between the presence of subepithelial hyporeflective nests on OCT and the diagnosis of basal cell carcinoma (present in 83% of cases). Conversely, lesions of epithelial origin such as squamous cell carcinoma are most often represented on OCT by acanthosis. Two supplementary cases, one basal cell carcinoma and one sebaceous carcinoma, are provided to illustrate how OCT imaging is a valuable tool in cases where clinical observations may be unusual. Conclusions We provide evidence supporting the use of OCT for the evaluation of peri-ocular cancers. OCT enables visualization of the skin layers in vivo, before biopsy. Our results show that certain OCT features can contribute to include or exclude a diagnosis of basal cell carcinoma. By integrating this non-invasive imaging methodology into the routine assessment of peri-ocular skin lesions, especially in health care centres where access to specialists is limited, OCT imaging can increase clinical precision, reduce delays in patient referral and enhance patient care.
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Affiliation(s)
- Sabrina Bergeron
- The MUHC, McGill University Ocular Pathology and Translational Research Laboratory, McGill University, Montreal, Québec, Canada
| | - Bryan Arthurs
- Department of Ophthalmology, McGill University, Montreal, Québec, Canada
| | - Debra-Meghan Sanft
- Department of Ophthalmology, McGill University, Montreal, Québec, Canada
| | - Christina Mastromonaco
- The MUHC, McGill University Ocular Pathology and Translational Research Laboratory, McGill University, Montreal, Québec, Canada
| | - Miguel N Burnier
- The MUHC, McGill University Ocular Pathology and Translational Research Laboratory, McGill University, Montreal, Québec, Canada.,Department of Ophthalmology, McGill University, Montreal, Québec, Canada
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Urban G, Feil N, Csuka E, Hashemi K, Ekelem C, Choi F, Mesinkovska NA, Baldi P. Combining Deep Learning With Optical Coherence Tomography Imaging to Determine Scalp Hair and Follicle Counts. Lasers Surg Med 2020; 53:171-178. [PMID: 32960994 DOI: 10.1002/lsm.23324] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 08/27/2020] [Accepted: 09/09/2020] [Indexed: 12/27/2022]
Abstract
BACKGROUND AND OBJECTIVES One of the challenges in developing effective hair loss therapies is the lack of reliable methods to monitor treatment response or alopecia progression. In this study, we propose the use of optical coherence tomography (OCT) and automated deep learning to non-invasively evaluate hair and follicle counts that may be used to monitor the success of hair growth therapy more accurately and efficiently. STUDY DESIGN/MATERIALS AND METHODS We collected 70 OCT scans from 14 patients with alopecia and trained a convolutional neural network (CNN) to automatically count all follicles present in the scans. The model is based on a dual approach of both detecting hair follicles and estimating the local hair density in order to give accurate counts even for cases where two or more adjacent hairs are in close proximity to each other. RESULTS We evaluate our system on 70 OCT manually labeled scans taken at different scalp locations from 14 patients, with 20 of those redundantly labeled by two human expert OCT operators. When comparing the individual human predictions and considering the exact locations of hair and follicle predictions, we find that the two human raters disagree with each other on approximately 22% of hairs and follicles. Overall, the deep learning (DL) system predicts the number of follicles with an error rate of 11.8% and the number of hairs with an error rate of 18.7% on average on the 70 scans. The OCT system can capture one scalp location in three seconds, and the DL model can make all predictions in less than a second after processing the scan, which takes half a minute using an unoptimized implementation. CONCLUSION This approach is well-positioned to become the standard for non-invasive evaluation of hair growth treatment progress in patients, saving significant amounts of time and effort compared with manual evaluation. Lasers Surg. Med. © 2020 Wiley Periodicals, Inc.
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Affiliation(s)
- Gregor Urban
- Department of Computer Science, University of California, Irvine, California, 92697
| | - Nate Feil
- Department of Dermatology, School of Medicine, University of California, Irvine, California, 92697
| | - Ella Csuka
- Department of Dermatology, School of Medicine, University of California, Irvine, California, 92697
| | - Kiana Hashemi
- Department of Dermatology, School of Medicine, University of California, Irvine, California, 92697
| | - Chloe Ekelem
- Department of Dermatology, School of Medicine, University of California, Irvine, California, 92697.,Department of Dermatology, School of Medicine, University of Utah, 30 North 1900 East, 4A330, Salt Lake City, Utah, 84132
| | - Franchesca Choi
- Department of Computer Science, University of California, Irvine, California, 92697
| | - Natasha A Mesinkovska
- Department of Dermatology, School of Medicine, University of California, Irvine, California, 92697.,Beckman Laser Institute, Irvine, California, 92697
| | - Pierre Baldi
- Department of Computer Science, University of California, Irvine, California, 92697
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Derr K, Zou J, Luo K, Song MJ, Sittampalam GS, Zhou C, Michael S, Ferrer M, Derr P. Fully Three-Dimensional Bioprinted Skin Equivalent Constructs with Validated Morphology and Barrier Function. Tissue Eng Part C Methods 2020; 25:334-343. [PMID: 31007132 PMCID: PMC6589501 DOI: 10.1089/ten.tec.2018.0318] [Citation(s) in RCA: 60] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Development of high-throughput, reproducible, three-dimensional (3D) bioprinted skin equivalents (BPSEs) that are morphologically and functionally comparable to native skin tissue is advancing research in skin diseases, and providing a physiologically relevant platform for the development of therapeutics, transplants for regenerative medicine, and testing of skin products like cosmetics. Current protocols for the production of engineered skin grafts are limited in their ability to control 3D geometry of the structure and contraction leading to variability of skin function between constructs. In this study, we describe a method for the biofabrication of skin equivalents (SEs) that are fully bioprinted using an open-market bioprinter, made with commercially available primary cells and natural hydrogels. The unique hydrogel formulation allows for the production of a human-like SE with minimal lateral tissue contraction in a multiwell plate format, thus making them suitable for high-throughput bioprinting in a single print with fast print and relatively short incubation times. The morphology and barrier function of the fully 3D BPSEs are validated by immunohistochemistry staining, optical coherence tomography, and permeation assays.
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Affiliation(s)
- Kristy Derr
- 1 Department of Preclinical Innovation, National Center for Advancing Translational Sciences, National Institutes of Health, Rockville, Maryland
| | - Jinyun Zou
- 2 Department of Electrical and Computer Engineering, Bethlehem, Pennsylvania
| | - Keren Luo
- 2 Department of Electrical and Computer Engineering, Bethlehem, Pennsylvania
| | - Min Jae Song
- 3 National Eye Institute, National Institutes of Health, Rockville, Maryland
| | - G Sitta Sittampalam
- 1 Department of Preclinical Innovation, National Center for Advancing Translational Sciences, National Institutes of Health, Rockville, Maryland
| | - Chao Zhou
- 2 Department of Electrical and Computer Engineering, Bethlehem, Pennsylvania.,4 Department of Bioengineering, Lehigh University, Bethlehem, Pennsylvania
| | - Sam Michael
- 1 Department of Preclinical Innovation, National Center for Advancing Translational Sciences, National Institutes of Health, Rockville, Maryland
| | - Marc Ferrer
- 1 Department of Preclinical Innovation, National Center for Advancing Translational Sciences, National Institutes of Health, Rockville, Maryland
| | - Paige Derr
- 1 Department of Preclinical Innovation, National Center for Advancing Translational Sciences, National Institutes of Health, Rockville, Maryland
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Zhang T, Pled F, Desceliers C. Robust Multiscale Identification of Apparent Elastic Properties at Mesoscale for Random Heterogeneous Materials with Multiscale Field Measurements. MATERIALS (BASEL, SWITZERLAND) 2020; 13:E2826. [PMID: 32586015 PMCID: PMC7345255 DOI: 10.3390/ma13122826] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 06/16/2020] [Accepted: 06/17/2020] [Indexed: 11/27/2022]
Abstract
The aim of this work is to efficiently and robustly solve the statistical inverse problem related to the identification of the elastic properties at both macroscopic and mesoscopic scales of heterogeneous anisotropic materials with a complex microstructure that usually cannot be properly described in terms of their mechanical constituents at microscale. Within the context of linear elasticity theory, the apparent elasticity tensor field at a given mesoscale is modeled by a prior non-Gaussian tensor-valued random field. A general methodology using multiscale displacement field measurements simultaneously made at both macroscale and mesoscale has been recently proposed for the identification the hyperparameters of such a prior stochastic model by solving a multiscale statistical inverse problem using a stochastic computational model and some information from displacement fields at both macroscale and mesoscale. This paper contributes to the improvement of the computational efficiency, accuracy and robustness of such a method by introducing (i) a mesoscopic numerical indicator related to the spatial correlation length(s) of kinematic fields, allowing the time-consuming global optimization algorithm (genetic algorithm) used in a previous work to be replaced with a more efficient algorithm and (ii) an ad hoc stochastic representation of the hyperparameters involved in the prior stochastic model in order to enhance both the robustness and the precision of the statistical inverse identification method. Finally, the proposed improved method is first validated on in silico materials within the framework of 2D plane stress and 3D linear elasticity (using multiscale simulated data obtained through numerical computations) and then exemplified on a real heterogeneous biological material (beef cortical bone) within the framework of 2D plane stress linear elasticity (using multiscale experimental data obtained through mechanical testing monitored by digital image correlation).
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Ekelem C, Feil N, Csuka E, Juhasz M, Lin J, Choi F, Asghari A, Heydarlou D, Mesinkovska NA. Optical Coherence Tomography in the Evaluation of the Scalp and Hair: Common Features and Clinical Utility. Lasers Surg Med 2020; 53:129-140. [PMID: 32253781 DOI: 10.1002/lsm.23243] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 03/22/2020] [Accepted: 03/23/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND OBJECTIVE Early diagnosis and treatment of hair loss disorders is vital in providing patients with improved psychological outcomes. Non-invasive imaging with optical coherence tomography (OCT) may be useful in characterizing and managing alopecia. Despite expanding clinical applications of OCT in dermatology, guidelines demonstrating in vivo features of normal and alopecic scalp images remain scant. This pilot study aims to provide an atlas of OCT findings of healthy and alopecia subjects, explore diagnostic quantitative endpoints of alopecia, and compare epidermal thickness and follicular density between scalp regions. STUDY DESIGN/MATERIALS AND METHODS A total of 32 patients (19-76 years old) were enrolled in the study, including healthy patients (n = 6), and patients with scarring alopecia (n = 12) or non-scarring alopecia (n = 14). An in-line fiber-based swept source OCT was used to image five scalp locations at baseline and 6-month visits. Three investigators evaluated each image for gross features, epidermal thickness, and follicular density. RESULTS Only data from baseline imaging analysis is discussed in this manuscript. Qualitative differences of OCT images are identified in sample images from healthy scalp and each subtype of alopecia studied. Scarring alopecia is characterized by significantly increased epidermal thickness (average Image J pixel units 32 ± 2 compared with non-scarring alopecia [average 28 ± 3] and control [average 27 ± 3]) (P = 0.022) and decreased follicle count (average 35 ± 5 in a 5 × 7 mm2 area compared with control (50 ± 3) and non-scarring patients (47 ± 6)) (P = 0.0052). Scalp location had no impact on epidermal thickness (P = 0.861) or follicular density (P = 0.15). CONCLUSION OCT holds promise as a non-invasive technique to further characterize and objectively measure alopecia. Larger sample sizes and longitudinal data are needed to improve reliability and determine if additional distinction between alopecia subtypes and treatment monitoring is possible. Lasers Surg. Med. © 2020 Wiley Periodicals, Inc.
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Affiliation(s)
- Chloe Ekelem
- Department of Dermatology, University of California, Irvine, Irvine, California, 92697
| | - Nate Feil
- Department of Dermatology, University of California, Irvine, Irvine, California, 92697
| | - Ella Csuka
- Department of Dermatology, University of California, Irvine, Irvine, California, 92697
| | - Margit Juhasz
- Department of Dermatology, University of California, Irvine, Irvine, California, 92697
| | - Jessica Lin
- Department of Dermatology, University of California, Irvine, Irvine, California, 92697
| | - Franchesca Choi
- Department of Dermatology, University of California, Irvine, Irvine, California, 92697.,School of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan, 807
| | - Arya Asghari
- Department of Dermatology, University of California, Irvine, Irvine, California, 92697
| | - Dorsa Heydarlou
- Department of Dermatology, University of California, Irvine, Irvine, California, 92697
| | - Natasha A Mesinkovska
- Department of Dermatology, University of California, Irvine, Irvine, California, 92697
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Abstract
Onychomycosis is the most prevalent nail infection. Although it is not a life-threatening condition, it impacts the quality of life for many patients and often imposes a challenging diagnostic problem. The causative agents are dermatophytes, yeasts and non-dermatophytic moulds. Accurate and early diagnosis, including the identification of the causative species, is the key factor for rational therapy. Still, early diagnosis is not optimal as the current gold standard for the differentiation of the infectious agents is culture-based approaches. On the other hand, noninvasive optical technologies may enable differential diagnosis of nail pathologies including onychomycosis. When light penetrates and propagates along the nail tissue, it interacts in different ways with the components of either infected or healthy nail segments, providing a wealth of diagnostic information upon escaping the tissue. This review aims to assess alternative optical techniques for the rapid diagnosis of onychomycosis with a potential to monitor therapeutic response or even identify the fungal agent non-invasively and in real time in a clinical setting.
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James J, Kantere D, Enger J, Siarov J, Wennberg AM, Ericson MB. Report on fluorescence lifetime imaging using multiphoton laser scanning microscopy targeting sentinel lymph node diagnostics. JOURNAL OF BIOMEDICAL OPTICS 2020; 25:1-8. [PMID: 32172545 PMCID: PMC7070082 DOI: 10.1117/1.jbo.25.7.071204] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Accepted: 02/07/2020] [Indexed: 06/10/2023]
Abstract
SIGNIFICANCE Sentinel lymph node (SLN) biopsy is an important method for metastasis staging in, e.g., patients with malignant melanoma. Tools enabling prompt histopathological analysis are expected to facilitate diagnostics; optical technologies are explored for this purpose. AIM The objective of this exploratory study was to investigate the potential of adopting multiphoton laser scanning microscopy (MPM) together with fluorescence lifetime analysis (FLIM) for the examination of lymph node (LN) tissue ex vivo. APPROACH Five LN tissue samples (three metastasis positive and two negative) were acquired from a biobank comprising tissues from melanoma patients. Tissues were deparaffinized and subjected to MPM-FLIM using an experimental MPM set-up equipped with a time correlated single photon counting module enabling FLIM. RESULTS The data confirm that morphological features similar to conventional histology were observed. In addition, FLIM analysis revealed elevated morphological contrast, particularly for discriminating between metastatic cells, lymphocytes, and erythrocytes. CONCLUSIONS Taken together, the results from this investigation show promise for adopting MPM-FLIM in the context of SLN diagnostics and encourage further translational studies on fresh tissue samples.
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Affiliation(s)
- Jeemol James
- University of Gothenburg, Biomedical Photonics Group, Department of Chemistry and Molecular Biology, Gothenburg, Sweden
| | - Despoina Kantere
- University of Gothenburg, Institute of Clinical Sciences, Department of Dermatology and Venereology, Gothenburg, Sweden
| | - Jonas Enger
- University of Gothenburg, Department of Physics, Gothenburg, Sweden
| | - Jan Siarov
- University of Gothenburg, Department of Pathology, Gothenburg, Sweden
| | - Ann Marie Wennberg
- University of Gothenburg, Institute of Clinical Sciences, Department of Dermatology and Venereology, Gothenburg, Sweden
| | - Marica B. Ericson
- University of Gothenburg, Biomedical Photonics Group, Department of Chemistry and Molecular Biology, Gothenburg, Sweden
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Paasch U, Said T. Stimulation of collagen and elastin production in-vivo using 1,540 nm Er:Glass laser: assessment of safety and efficacy. J COSMET LASER THER 2020; 22:77-83. [PMID: 32079432 DOI: 10.1080/14764172.2020.1728339] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Introduction: Induction of collagen and elastin remodeling in the human skin can be achieved by non-ablative fractional laser (NAFXL) and ablative fractional laser (AFXL). Our objective was to compare the safety, efficacy, tolerability, and ability to induce collagen and elastin remodeling of NAFXL versus AFXL in a series of treatments over time.Materials and Methods: In this prospective, proof of principle, single-case study, the safety, tolerability and efficacy of the laser systems were assessed via histopathology and clinical evaluations including photographs. Optical biopsies by means of multiphoton tomography (MPT) were used to evaluate the induction of collagen and elastin remodeling.Results: Treatments by both NAFXL and AFXL were well tolerated. The NAFXL system was found to be less painful and resulted in a shorter down- and healing times. MPT findings showed the superior capability of the AFXL procedure to induce collagen; on the other hand, elastin induction was more pronounced after NAFXL treatments.Conclusions: While NAFXL is as effective and safe as the traditional AFXL, it is better tolerated and has a shorter downtime. Serial optical biopsies over time over time can be a useful tool to assess the induction of collagen and elastin remodeling in the human skin.
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Affiliation(s)
- Uwe Paasch
- Department of Dermatology, Venereology and Allergology, University of Leipzig, 04103 Leipzig, Saxony, Germany
| | - Tamer Said
- Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Alexandria University, Alexandria, Egypt
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Preciado D, Nolan RM, Joshi R, Krakovsky GM, Zhang A, Pudik NA, Kumar NK, Shelton RL, Boppart SA, Bauman NM. Otitis Media Middle Ear Effusion Identification and Characterization Using an Optical Coherence Tomography Otoscope. Otolaryngol Head Neck Surg 2020; 162:367-374. [PMID: 31959053 DOI: 10.1177/0194599819900762] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To determine the feasibility of detecting and differentiating middle ear effusions (MEEs) using an optical coherence tomography (OCT) otoscope. STUDY DESIGN Cross-sectional study. SETTING US tertiary care children's hospital. SUBJECTS AND METHODS Seventy pediatric patients undergoing tympanostomy tube placement were preoperatively imaged using an OCT otoscope. A blinded reader quiz was conducted using 24 readers from 4 groups of tiered medical expertise. The primary outcome assessed was reader ability to detect presence/absence of MEE. A secondary outcome assessed was reader ability to differentiate serous vs nonserous MEE. RESULTS OCT image data sets were analyzed from 45 of 70 total subjects. Blinded reader analysis of an OCT data subset for detection of MEE resulted in 90.6% accuracy, 90.9% sensitivity, 90.2% specificity, and intra/interreader agreement of 92.9% and 87.1%, respectively. Differentiating MEE type, reader identification of nonserous MEE had 70.8% accuracy, 53.6% sensitivity, 80.1% specificity, and intra/interreader agreement of 82.9% and 75.1%, respectively. Multivariate analysis revealed that age was the strongest predictor of OCT quality. The mean age of subjects with quality OCT was 5.01 years (n = 45), compared to 2.54 years (n = 25) in the remaining subjects imaged (P = .0028). The ability to capture quality images improved over time, from 50% to 69.4% over the study period. CONCLUSION OCT otoscopy shows promise for facilitating accurate MEE detection. The imageability with the prototype device was affected by age, with older children being easier to image, similar to current ear diagnostic technologies.
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Affiliation(s)
- Diego Preciado
- Division of Pediatric Otolaryngology, Children's National Health System (CNHS), Washington, DC, USA.,Sheikh Zayed Institute, CNHS, Washington, DC, USA
| | | | - Radhika Joshi
- Division of Pediatric Otolaryngology, Children's National Health System (CNHS), Washington, DC, USA.,Sheikh Zayed Institute, CNHS, Washington, DC, USA
| | - Gina M Krakovsky
- Division of Pediatric Otolaryngology, Children's National Health System (CNHS), Washington, DC, USA
| | | | | | | | | | | | - Nancy M Bauman
- Division of Pediatric Otolaryngology, Children's National Health System (CNHS), Washington, DC, USA
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Jovic A, Losilla NS, Durá JS, Zinoviev K, Rubio Guivernau JL, Margallo-Balbás E, Mastrangeli M, Pandraud G, Sarro PM. Self-aligned micro-optic integrated photonic platform. APPLIED OPTICS 2020; 59:180-189. [PMID: 32225286 DOI: 10.1364/ao.59.000180] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Accepted: 11/19/2019] [Indexed: 06/10/2023]
Abstract
In this work, we present the fabrication technology of a monolithically integrated photonic platform combining key components for optical coherence tomography (OCT) imaging, thereby including a photonic interferometer, a collimating lens, and a 45° reflecting mirror that directs the light from the interferometer to the collimator. The proposed integration process simplifies the fabrication of an interferometric system and inherently overcomes the complexity of costly alignment procedures while complying with the necessarily stringent optical constraints. Fabricated waveguide characterization shows total optical losses as low as 3 dB, and less than 1 dB of additional loss due to the Si 45° mirror facet. The alignment standard deviation of all components is within 15 nm. The integrated lens profile achieves a divergence angle smaller than 0.7°, which is close to that of a collimator. The proposed photonic platform provides the premise for low-cost and small-footprint single-chip OCT systems.
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Gubarkova EV, Feldchtein FI, Zagaynova EV, Gamayunov SV, Sirotkina MA, Sedova ES, Kuznetsov SS, Moiseev AA, Matveev LA, Zaitsev VY, Karashtin DA, Gelikonov GV, Pires L, Vitkin A, Gladkova ND. Optical coherence angiography for pre-treatment assessment and treatment monitoring following photodynamic therapy: a basal cell carcinoma patient study. Sci Rep 2019; 9:18670. [PMID: 31822752 PMCID: PMC6904495 DOI: 10.1038/s41598-019-55215-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Accepted: 11/26/2019] [Indexed: 01/10/2023] Open
Abstract
Microvascular networks of human basal cell carcinomas (BCC) and surrounding skin were assessed with optical coherence angiography (OCA) in conjunction with photodynamic therapy (PDT). OCA images were collected and analyzed in 31 lesions pre-treatment, and immediately/24 hours/3-12 months post-treatment. Pre-treatment OCA enabled differentiation between prevalent subtypes of BCC (nodular and superficial) and nodular-with-necrotic-core BCC subtypes with a diagnostic accuracy of 78%; this can facilitate more accurate biopsy reducing sampling error and better therapy regimen selection. Post-treatment OCA images at 24 hours were 98% predictive of eventual outcome. Additional findings highlight the importance of pre-treatment necrotic core, vascular metrics associated with hypertrophic scar formation, and early microvascular changes necessary in both tumorous and peri-tumorous regions to ensure treatment success.
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Affiliation(s)
- E V Gubarkova
- Privolzhsky Research Medical University, Minina Square 10/1, 603005, Nizhny Novgorod, Russia.
| | - F I Feldchtein
- Privolzhsky Research Medical University, Minina Square 10/1, 603005, Nizhny Novgorod, Russia
| | - E V Zagaynova
- Privolzhsky Research Medical University, Minina Square 10/1, 603005, Nizhny Novgorod, Russia
| | - S V Gamayunov
- A. Tsyb Medical Radiological Research Center, Korolev Street 4, Obninsk, 249036, Kaluga region, Russia
| | - M A Sirotkina
- Privolzhsky Research Medical University, Minina Square 10/1, 603005, Nizhny Novgorod, Russia
| | - E S Sedova
- Privolzhsky Research Medical University, Minina Square 10/1, 603005, Nizhny Novgorod, Russia
| | - S S Kuznetsov
- N.A. Semashko Nizhny Novgorod Regional Clinical Hospital, Rodionova Street 190, 603093, Nizhny Novgorod, Russia
| | - A A Moiseev
- Institute of Applied Physics Russian Academy of Science, Ulyanova Street 46, 603950, Nizhny Novgorod, Russia
| | - L A Matveev
- Institute of Applied Physics Russian Academy of Science, Ulyanova Street 46, 603950, Nizhny Novgorod, Russia
| | - V Y Zaitsev
- Institute of Applied Physics Russian Academy of Science, Ulyanova Street 46, 603950, Nizhny Novgorod, Russia
| | - D A Karashtin
- Institute of Applied Physics Russian Academy of Science, Ulyanova Street 46, 603950, Nizhny Novgorod, Russia
| | - G V Gelikonov
- Institute of Applied Physics Russian Academy of Science, Ulyanova Street 46, 603950, Nizhny Novgorod, Russia
| | - L Pires
- University of Toronto and University Health Network, 610 University Ave., Toronto, Ontario, M5G 2M9, Canada
| | - A Vitkin
- University of Toronto and University Health Network, 610 University Ave., Toronto, Ontario, M5G 2M9, Canada
| | - N D Gladkova
- Privolzhsky Research Medical University, Minina Square 10/1, 603005, Nizhny Novgorod, Russia
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Law TSM, Wu F, Xu H, Wang CC, Li TC. Endometrium imaging using real-time rotational optical coherence tomography imaging system: A pilot, prospective and ex-vivo study. Medicine (Baltimore) 2019; 98:e17738. [PMID: 31689821 PMCID: PMC6946521 DOI: 10.1097/md.0000000000017738] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
This study aimed to evaluate a novel real-time rotational optical coherence tomography (OCT) imaging system (OCTIS) with a fiber-optic probe to look at endometrium and to correlate the OCTIS images with standard histology. OCT could obtain real-time images resembling histological examination. With recent development of customized probes, it allows OCT to be used in the field of gynecology.This is a pilot, prospective, ex-vivo and observational study. Women underwent hysterectomy for various gynecological conditions were recruited and OCTIS images were obtained from endometrium of 15 fresh uterus specimens immediately after hysterectomy. The excised uterus was cut open and OCTIS imaging was obtained. The scanned region of endometrium was excised for histological examination and OCTIS images were precisely compared to corresponding histological images and ultrasound images. Blinded qualitative analysis on OCTIS images was performed by 2 assessors to determine inter-rating reliability on the histopathological diagnosis.Epithelium, glands, cysts, and stroma of endometrium were clearly seen by the OCTIS. Different phases of menstrual cycle of normal endometrium could be differentiated and pathological condition such as hyperplastic and dysplasic endometrium, which corresponded well with histological findings, could be identified. The inter-rater reliability between assessors on overall OCTIS endometrium and neoplastic OCTIS endometrium was moderate (Kendall τb of 0.58) and substantial (Kendall τb of 0.76), respectively.OCTIS can provide real-time, high-resolution and rotational imaging modality to view endometrial structure with high consistency with histological examination and satisfactory agreement between observers. It has a great potential to be developed in the clinical use of endometrial assessment for gynecological applications.
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Affiliation(s)
| | | | - Hui Xu
- Department of Obstetrics and Gynaecology
| | - Chi Chiu Wang
- Department of Obstetrics and Gynaecology
- Li Ka Shing Institute of Health Sciences
- School of Biomedical Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong
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Current methods for the assessment of skin microcirculation: Part 2. Postepy Dermatol Alergol 2019; 36:377-381. [PMID: 31616209 PMCID: PMC6791164 DOI: 10.5114/ada.2019.83657] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Accepted: 02/22/2018] [Indexed: 11/17/2022] Open
Abstract
Microcirculation accounts for about 99% of blood vessels in adults and mediates between the arterial and venous parts of the cardiovascular system, both structurally and functionally. Skin microcirculation consists of two vascular plexuses: superficial and deep. Microcirculation includes vessels with a diameter of less than 150 μm, i.e. arteries, small veins, lymphatic vessels and arteriovenous anastomoses, which build the microcirculation unit. Skin microcirculation may be affected both in systemic pathologies and specific skin disorders. Several non-invasive techniques are available to assess the skin microcirculation. Methods used in clinical practice were presented previously in Advances in Dermatology and Allergology. The current article describes methods that may be used in clinical research.
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Guo S, Wei S, Lee S, Sheu M, Kang S, Kang JU. Intraoperative Speckle Variance Optical Coherence Tomography for Tissue Temperature Monitoring During Cutaneous Laser Therapy. IEEE JOURNAL OF TRANSLATIONAL ENGINEERING IN HEALTH AND MEDICINE 2019; 7:1800608. [PMID: 32309052 PMCID: PMC6788854 DOI: 10.1109/jtehm.2019.2943317] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Revised: 09/13/2019] [Accepted: 09/19/2019] [Indexed: 01/18/2023]
Abstract
Background: Tissue temperature monitoring during cutaneous laser therapy can lead to safer and more effective treatments. In this study, we investigate the use of speckle variance optical coherence tomography (svOCT) to monitor real-time temperature changes in the excised human skin tissue sample during laser irradiation. Methods: To accomplish this, we combined the pulse laser system with a reference-based svOCT system. To calibrate the svOCT, the ex-vivo human skin samples from three individuals with tissues collected from the arm, face, and back were heated with 1-degree increments. Additionally, linear regression was used to extract and evaluate the linear relationship between the temperature and normalized speckle variance value. Experiments were conducted on excised human skin sample to monitor the temperature change during laser therapy with a svOCT system. Thermal modeling of ex-vivo human skin was used to numerically simulate the laser-tissue interaction and estimate the thermal diffusion and peak temperature of the tissue during the laser treatment. Results and Conclusion: These results showed that normalized speckle variance had a linear relationship with the tissue temperature before the onset of tissue coagulation (52°) and we were able to measure the rapid increase of the tissue temperature during laser therapy. The result of the experiment is also in good agreement with the numerical simulation result that estimated the laser-induced peak temperature and thermal relaxation time.
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Affiliation(s)
- Shoujing Guo
- Electrical and Computer Engineering DepartmentJohns Hopkins UniversityBaltimoreMD21218USA
| | - Shuwen Wei
- Electrical and Computer Engineering DepartmentJohns Hopkins UniversityBaltimoreMD21218USA
| | - Soohyun Lee
- Electrical and Computer Engineering DepartmentJohns Hopkins UniversityBaltimoreMD21218USA
| | - Mary Sheu
- Department of DermatologyJohns Hopkins Medicine - Green Spring StationLuthervilleMD21093USA
| | - Sewon Kang
- Department of DermatologyThe Johns Hopkins HospitalBaltimoreMD21287USA
| | - Jin U. Kang
- Electrical and Computer Engineering DepartmentJohns Hopkins UniversityBaltimoreMD21218USA
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Egawa M, Iwanaga S, Hosoi J, Goto M, Yamanishi H, Miyai M, Katagiri C, Tokunaga K, Asai T, Ozeki Y. Label-free stimulated Raman scattering microscopy visualizes changes in intracellular morphology during human epidermal keratinocyte differentiation. Sci Rep 2019; 9:12601. [PMID: 31467379 PMCID: PMC6715667 DOI: 10.1038/s41598-019-49035-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Accepted: 08/19/2019] [Indexed: 11/14/2022] Open
Abstract
Epidermal keratinocyte (KC) differentiation, which involves the process from proliferation to cell death for shedding the outermost layer of skin, is crucial for the barrier function of skin. Therefore, in dermatology, it is important to elucidate the epidermal KC differentiation process to evaluate the symptom level of diseases and skin conditions. Previous dermatological studies used staining or labelling techniques for this purpose, but they have technological limitations for revealing the entire process of epidermal KC differentiation, especially when applied to humans. Here, we demonstrate label-free visualization of three-dimensional (3D) intracellular morphological changes of ex vivo human epidermis during epidermal KC differentiation using stimulated Raman scattering (SRS) microscopy. Specifically, we observed changes in nuclei during the initial enucleation process in which the nucleus is digested prior to flattening. Furthermore, we found holes left behind by improperly digested nuclei in the stratum corneum, suggesting abnormal differentiation. Our findings indicate the great potential of SRS microscopy for discrimination of the degree of epidermal KC differentiation.
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Affiliation(s)
- Mariko Egawa
- Shiseido Global Innovation Center, Yokohama, 220-0011, Japan.
| | - Shinya Iwanaga
- Shiseido Global Innovation Center, Yokohama, 220-0011, Japan
| | - Junichi Hosoi
- Shiseido Global Innovation Center, Yokohama, 220-0011, Japan
| | - Makiko Goto
- Shiseido Global Innovation Center, Yokohama, 220-0011, Japan
| | | | - Masashi Miyai
- Shiseido Global Innovation Center, Yokohama, 220-0011, Japan
| | - Chika Katagiri
- Shiseido Global Innovation Center, Yokohama, 220-0011, Japan
| | - Kyoya Tokunaga
- Department of Electrical Engineering and Information Systems, Graduate School of Engineering, The University of Tokyo, Tokyo, 113-8656, Japan
| | - Takuya Asai
- Department of Electrical Engineering and Information Systems, Graduate School of Engineering, The University of Tokyo, Tokyo, 113-8656, Japan
| | - Yasuyuki Ozeki
- Department of Electrical Engineering and Information Systems, Graduate School of Engineering, The University of Tokyo, Tokyo, 113-8656, Japan
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Hermsmeier M, Sawant T, Chowdhury K, Nagavarapu U, Chan KF. First Use of Optical Coherence Tomography on In Vivo Inflammatory Acne-Like Lesions: A Murine Model. Lasers Surg Med 2019; 52:207-217. [PMID: 31347184 DOI: 10.1002/lsm.23140] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/30/2019] [Indexed: 01/19/2023]
Abstract
BACKGROUND AND OBJECTIVES Successful outcomes of clinical studies for acne vulgaris depend greatly on achieving statistically significant reduction in acne lesion count and improvement in Investigator's Global Assessment score of the investigational drug product against its vehicle control. To date, there has not been a validated preclinical acne model to evaluate investigational drug products in order to improve the probability of clinical success. An inflammatory acne-like lesion mouse model developed in-house has previously been used for clinical guidance in our drug development program. In this study, we aim to implement and assess the adequacy of swept-source optical coherence tomography (SS-OCT) in quantifying the dynamic changes in inflammatory acne-like lesions. STUDY DESIGN/MATERIALS AND METHODS Live Propionibacterium acnes bacteria were injected intradermally resulting in inflammatory acne-like lesions. Topical 1% and 2% minocycline gels were applied to the lesions in separate groups once daily for 2 weeks and compared with vehicle and untreated control groups. The growth of these lesions was monitored and measured with a ruler (height)/microcaliper (width)-an approach previously developed, and with SS-OCT. The reliability of the two methods were assessed. Acquired OCT images across the apex of these inflammatory lesions were statistically analyzed for lesion volume reduction from baseline as well as between the treatment groups and the control groups. RESULTS The OCT technique allowed for reliable lesion volume analysis with varying conic profiles. After 14 days of topical minocycline treatments (1%, 2% minocycline), statistically significant reduction in lesion volume (P ≤ 0.05) based on OCT image analysis was observed compared with untreated and vehicle control groups as well as compared with baseline measurements. Under the right conditions, some morphological aspects of the P. acnes injection site were discernible within the skin in images captured with OCT. CONCLUSIONS We demonstrated the first use of SS-OCT in evaluating in vivo inflammatory acne-like lesions in a murine model. Our findings support the use of OCT in assessing lesion size and evolution of P. acnes injection sites non-invasively in preclinical in vivo studies, which could potentially lead to more consistent and predictable outcomes in clinical development. Lasers Surg. Med. © 2019 Wiley Periodicals, Inc.
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Affiliation(s)
- Maiko Hermsmeier
- Research and Development, BioPharmX, Inc., 115 Nicholson Lane, San Jose, California, 95134
| | - Tanvee Sawant
- Research and Development, BioPharmX, Inc., 115 Nicholson Lane, San Jose, California, 95134
| | - Khadiza Chowdhury
- Research and Development, BioPharmX, Inc., 115 Nicholson Lane, San Jose, California, 95134
| | - Usha Nagavarapu
- Research and Development, BioPharmX, Inc., 115 Nicholson Lane, San Jose, California, 95134
| | - Kin F Chan
- Research and Development, BioPharmX, Inc., 115 Nicholson Lane, San Jose, California, 95134
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Ekelem C, Yu J, Heydarlou D, Heidari E, Csuka E, Chen Z, Mesinkovska NA. The effect of melanin on in vivo optical coherence tomography of the skin in a multiethnic cohort. Lasers Surg Med 2019; 51:407-411. [PMID: 30883841 DOI: 10.1002/lsm.23086] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/02/2019] [Indexed: 11/11/2022]
Abstract
BACKGROUND Noninvasive real-time assessment of living tissue is quickly becoming invaluable for bolstering histologic and dermatoscopic measures of cutaneous conditions. While many skin researchers have explored the utility of noninvasive imaging in inflammatory and malignant skin conditions, there is yet to be a definitive and direct assessment of the effects of melanin on the quality of optical coherence tomography (OCT) imaging and its accuracy in multiethnic patient populations. We conducted a study to evaluate the effects of melanin on the quality of in vivo OCT imaging. METHODS Volunteers of all Fitzpatrick skin types were imaged once in five skin regions. Images were analyzed for quality, defined quantitatively as depreciation of light as it passes through the depth of skin, and qualitatively as depth and contrast ranked by blinded clinicians. RESULTS Our analysis of sixteen subjects shows that there is a significant difference in quantitative OCT image quality between light (Fitzpatrick I-III) and dark (IV-VI) skin types for both epidermal (p 0.0328) and dermal levels (p 0.0021). However, there was no significant difference in qualitative blinded rater measures of image clarity (p 0.11) or perceived depth (p 0.13). CONCLUSION Based on our definition of image quality, our study shows that OCT images taken from darker skin types have slightly lower quality than those taken from lighter skin. However, because blinded rater assessment showed no differences in clarity or perceived depth, we conclude that OCT may be used without hesitation for manual visualization of skin and its appendages in all Fitzpatrick skin types. Further studies are required to more extensively characterize the effects of melanin on OCT imaging. Lasers Surg. Med. 51:407-411, 2019. © 2019 Wiley Periodicals, Inc.
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Affiliation(s)
- Chloe Ekelem
- Department of Dermatology, University of California, Irvine, 92697, California
| | - Junxiao Yu
- Beckman Laser Institute, University of California, Irvine, 92697, California
| | - Dorsa Heydarlou
- Department of Dermatology, University of California, Irvine, 92697, California
| | - Emon Heidari
- Beckman Laser Institute, University of California, Irvine, 92697, California
| | - Ella Csuka
- Department of Dermatology, University of California, Irvine, 92697, California
| | - Zhongping Chen
- Beckman Laser Institute, University of California, Irvine, 92697, California
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Lee JH, Shih YT, Wei ML, Sun CK, Chiang BL. Classification of established atopic dermatitis in children with the in vivo imaging methods. JOURNAL OF BIOPHOTONICS 2019; 12:e201800148. [PMID: 30302943 DOI: 10.1002/jbio.201800148] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Revised: 08/24/2018] [Accepted: 10/08/2018] [Indexed: 06/08/2023]
Abstract
Atopic dermatitis (AD) is a cutaneous disease resulting from a defective barrier and dysregulated immune response. The severity scoring of atopic dermatitis (SCORAD) is used to classify AD. Noninvasive imaging approaches supplementary to SCORAD were investigated. Cr:forsterite laser-based microscopy was employed to analyze endogenous third-harmonic generation (THG) and second-harmonic generation (SHG) signals from skin. Imaging parameters were compared between different AD severities. Three-dimensional reconstruction of imaged skin layers was performed. Finally, statistic models from quantitative imaging parameters were developed for predicting disease severity. Our data demonstrate that THG signal intensity of lesional skin in AD were significantly increased and was positively correlated with AD severity. Characteristic gray level co-occurrence matrix (GLCM) values were observed in more severe AD. In the 3D reconstruction video, individual dermal papilla and obvious fibrosis in the upper papillary dermis were easily identified. Our estimation models could predict the disease severity of AD patients with an accuracy of nearly 85%. The THG signal intensity and characteristic GLCM patterns are associated with AD severity and can serve as quantitative predictive parameters. Our imaging approach can be used to identify the histopathological changes of AD objectively, and to complement the SCORAD index, thus improving the accuracy of classifying AD severity.
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Affiliation(s)
- Jyh-Hong Lee
- Department of Pediatrics, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan, Republic of China
| | - Yuan-Ta Shih
- Graduate Institute of Photonics and Optoelectronics and Department of Electrical Engineering, National Taiwan University, Taipei, Taiwan, Republic of China
| | - Ming-Liang Wei
- Graduate Institute of Photonics and Optoelectronics and Department of Electrical Engineering, National Taiwan University, Taipei, Taiwan, Republic of China
| | - Chi-Kuang Sun
- Graduate Institute of Photonics and Optoelectronics and Department of Electrical Engineering, National Taiwan University, Taipei, Taiwan, Republic of China
- Research Center for Applied Sciences and Institute of Physics, Academia Sinica, Taipei, Taiwan, Republic of China
| | - Bor-Luen Chiang
- Department of Pediatrics, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan, Republic of China
- Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan, Republic of China
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Rajabi‐Estarabadi A, Tsang DC, Nouri K, Tosti A. Evaluation of positive patch test reactions using optical coherence tomography: A pilot study. Skin Res Technol 2019; 25:625-630. [DOI: 10.1111/srt.12695] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Accepted: 02/16/2019] [Indexed: 01/17/2023]
Affiliation(s)
- Ali Rajabi‐Estarabadi
- Dr.Phillip Frost Department of Dermatology and Cutaneous SurgeryUniversity of Miami Miller School of Medicine Miami Florida USA
| | - Darren C. Tsang
- Dr.Phillip Frost Department of Dermatology and Cutaneous SurgeryUniversity of Miami Miller School of Medicine Miami Florida USA
| | - Keyvan Nouri
- Dr.Phillip Frost Department of Dermatology and Cutaneous SurgeryUniversity of Miami Miller School of Medicine Miami Florida USA
| | - Antonella Tosti
- Dr.Phillip Frost Department of Dermatology and Cutaneous SurgeryUniversity of Miami Miller School of Medicine Miami Florida USA
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Schneider SL, Kohli I, Hamzavi IH, Council ML, Rossi AM, Ozog DM. Emerging imaging technologies in dermatology: Part II: Applications and limitations. J Am Acad Dermatol 2018; 80:1121-1131. [PMID: 30528310 DOI: 10.1016/j.jaad.2018.11.043] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Revised: 11/14/2018] [Accepted: 11/20/2018] [Indexed: 12/11/2022]
Abstract
Clinical examination is critical for the diagnosis and identification of response to treatment. It is fortunate that technologies are continuing to evolve, enabling augmentation of classical clinical examination with noninvasive imaging modalities. This article discusses emerging technologies with a focus on digital photographic imaging, confocal microscopy, optical coherence tomography, and high-frequency ultrasound, as well as several additional developing modalities. The most readily adopted technologies to date include total-body digital photography and dermoscopy, with some practitioners beginning to use confocal microscopy. In this article, applications and limitations are addressed. For a detailed discussion of the principles involved in these technologies, please refer to the first part of this review article.
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Affiliation(s)
| | - Indermeet Kohli
- Department of Dermatology, Henry Ford Hospital, Detroit, Michigan
| | | | - M Laurin Council
- Division of Dermatology, Washington University, St. Louis, Missouri
| | - Anthony M Rossi
- Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, New York
| | - David M Ozog
- Department of Dermatology, Henry Ford Hospital, Detroit, Michigan.
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45
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Schneider SL, Kohli I, Hamzavi IH, Council ML, Rossi AM, Ozog DM. Emerging imaging technologies in dermatology: Part I: Basic principles. J Am Acad Dermatol 2018; 80:1114-1120. [PMID: 30528311 DOI: 10.1016/j.jaad.2018.11.042] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Revised: 11/14/2018] [Accepted: 11/20/2018] [Indexed: 12/27/2022]
Abstract
Dermatologists rely primarily on clinical examination in combination with histopathology to diagnose conditions; however, clinical examination alone might not be sufficient for accurate diagnosis and skin biopsies have associated morbidity. With continued technological advancement, there are emerging ancillary imaging technologies available to dermatologists to aid in diagnosis and management. This 2-part review article will discuss these emerging technologies including: digital photographic imaging, confocal microscopy, optical coherence tomography, and high-frequency ultrasound, as well as several additional modalities in development. In this first installment, the authors describe the breadth of technologies available and the science behind them. Then, in the second article, the authors discuss the applications and limitations of these technologies and future directions.
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Affiliation(s)
| | - Indermeet Kohli
- Department of Dermatology, Henry Ford Hospital, Detroit, Michigan
| | | | - M Laurin Council
- Division of Dermatology, Washington University, St. Louis, Missouri
| | - Anthony M Rossi
- Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, New York
| | - David M Ozog
- Department of Dermatology, Henry Ford Hospital, Detroit, Michigan.
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46
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Andleeb F, Ullah H. Optical coherence tomography in early detection of malignancies. MINERVA BIOTECNOL 2018. [DOI: 10.23736/s1120-4826.18.02466-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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47
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Ianoși SL, Forsea AM, Lupu M, Ilie MA, Zurac S, Boda D, Ianosi G, Neagoe D, Tutunaru C, Popa CM, Caruntu C. Role of modern imaging techniques for the in vivo diagnosis of lichen planus. Exp Ther Med 2018; 17:1052-1060. [PMID: 30679973 PMCID: PMC6327670 DOI: 10.3892/etm.2018.6974] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Accepted: 08/21/2018] [Indexed: 12/21/2022] Open
Abstract
Lichen planus (LP) is a chronic inflammatory skin disease that can sometimes affect mucosal surfaces, with unknown pathogenesis, even though it appears to be an autoimmune disease. The diagnosis of lichen planus is usually based on histopathological examination of the lesions. Nowadays, the classical invasive diagnostic methods are replaced by modern non-invasive techniques. In this review, we present the main non-invasive imaging methods (dermoscopy, reflectance confocal microscopy, optical coherence tomography, ultrasound and diffuse reflection spectrophotometry) used in the diagnosis and therapeutic monitoring of lichen planus. Dermoscopy is a non-invasive method initially used for diagnosis of pigmented tumors but now is used also for inflammatory and infectious skin diseases. In lichen planus, the dermoscopy increases the accuracy of diagnosis, avoids skin biopsies commonly used and can be useful in the therapeutic monitoring by repeated investigation at different stages of treatment. Reflectance confocal microscopy (RCM) is a novel non-invasive imaging technique that is prevalently used for the diagnosis of skin tumors and inflammatory skin diseases. This technology has been mostly employed for bedside, real-time microscopic evaluation of psoriasis, lichen planus, contact dermatitis, revealing specific confocal features to support clinical diagnosis and assist with patient management. Optical coherence tomography (OCT) is an emergent imaging technique, developed over the last decade, based on the interaction of the infrared radiation (900–1,500 nm) and the living tissues. A limited information exists on the benefits of OCT technology for the in vivo diagnosis of LP but could be a useful auxiliary tool in the in vivo differential diagnosis, especially in clinical equivocal settings like mucosal lesions, and in monitoring the response to treatment. Our review shows the possibility of using modern imaging techniques for the in vivo diagnosis and also for evaluation of the treatment response.
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Affiliation(s)
- Simona Laura Ianoși
- Department of Dermatology, University of Medicine and Pharmacy of Craiova, Emergency County Hospital, 200349 Craiova, Romania
| | - Ana Maria Forsea
- Department of Dermatology, 'Carol Davila' University of Medicine and Pharmacy, Elias Emergency University Hospital, 011461 Bucharest, Romania
| | - Mihai Lupu
- Department of Dermatology, 'Carol Davila' University of Medicine and Pharmacy, Elias Emergency University Hospital, 011461 Bucharest, Romania
| | - Mihaela Adriana Ilie
- Department of Biochemistry, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania.,Dermatology Research Laboratory, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Sabina Zurac
- Department of Pathology, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania.,Department of Pathology, 'Colentina' University Hospital, 020125 Bucharest, Romania
| | - Daniel Boda
- Dermatology Research Laboratory, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania.,Carol Medical Center, 010626 Bucharest, Romania
| | - Gabriel Ianosi
- Department of Surgery, University of Medicine and Pharmacy of Craiova, Military Hospital, 200349 Craiova, Romania
| | - Daniela Neagoe
- Department of Internal Medicine, University of Medicine and Pharmacy of Craiova, Emergency County Hospital, 200349 Craiova, Romania
| | - Cristina Tutunaru
- Department of Dermatology, University of Medicine and Pharmacy of Craiova, Emergency County Hospital, 200349 Craiova, Romania
| | - Cristina Maria Popa
- Department of Dermatology, University of Medicine and Pharmacy of Craiova, Emergency County Hospital, 200349 Craiova, Romania
| | - Constantin Caruntu
- Department of Physiology, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania.,Department of Dermatology, 'Prof. N. Paulescu' National Institute of Diabetes, Nutrition and Metabolic Diseases, 011233 Bucharest, Romania
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Comparison of biophysical, biomechanical and ultrasonographic properties of skin in chronic dermatitis, psoriasis and lichen planus. Med J Islam Repub Iran 2018; 32:108. [PMID: 30815403 PMCID: PMC6387801 DOI: 10.14196/mjiri.32.108] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Indexed: 11/18/2022] Open
Abstract
Background: Skin biometrology is a useful method for evaluation of inflammatory skin disorders such as dermatitis, psoriasis, and lichen planus. The current study tries to compare the biophysical features of skin in dermatitis, psoriasis, and lichen planus.
Methods: By a convenient sampling method, 22 mild to moderate chronic dermatitis, 26 psoriasis, and 21 lichen planus patients were recruited in the study. Stratum corneum (S.C.) hydration, Transepidermal water loss (TEWL), pH, erythema, melanin, sebum, friction, elasticity parameters (R0, R2, and R5), skin temperature, skin thickness, and echo-density of epidermis and dermis were measured on the lesional (selected active lesion), uninvolved perilesional, and uninvolved symmetrical skin. The average of perilesional and symmetrical uninvolved parameters was used as control, while the percentage change of each parameter [(lesion – control / control) ×100] was calculated, and compared among three diseases by ANOVA test using SPSS software version 18. The significance level was set at α=0.05.
Results: Comparison of percentage changes showed that the changes in TEWL, friction index, sebum content, R2 (gross elasticity), R5 (net elasticity), skin temperature, dermal thickness, and epidermal density are not significantly different among three skin diseases. But there were significant differences in three diseases considering the decrease in S.C. hydration (p<0.001), R0 (opposed to firmness) (p<0.001), and dermal density (p<0.001) compared to control skin. Moreover, the increase in skin pH (p<0.001), melanin content (p=0.048), erythema (p=0.023), and epidermal thickness (p <0.001) significantly differed among these diseases.
Conclusion: Dermatitis, psoriasis and lichen planus lesions had specific biophysical changes. It may be helpful in their differential diagnosis.
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49
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Reddy N, Nguyen B. The utility of optical coherence tomography for diagnosis of basal cell carcinoma: a quantitative review. Br J Dermatol 2018; 180:475-483. [DOI: 10.1111/bjd.17201] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2018] [Indexed: 12/14/2022]
Affiliation(s)
- N. Reddy
- Department of Dermatology Tufts Medical Center/Tufts University School of Medicine 800 Washington St, #114 Boston MA 02111 U.S.A
| | - B.T. Nguyen
- Department of Dermatology Tufts Medical Center/Tufts University School of Medicine 800 Washington St, #114 Boston MA 02111 U.S.A
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Schmitz L, Hessam S, Scholl L, Reitenbach S, Segert MH, Gambichler T, Stockfleth E, Bechara FG. Argon plasma coagulation of actinic keratoses imaged by optical coherence tomography: An in vivo study indicating a possible lesion-directed treatment. JOURNAL OF BIOPHOTONICS 2018; 11:e201800075. [PMID: 29893051 DOI: 10.1002/jbio.201800075] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Accepted: 06/11/2018] [Indexed: 06/08/2023]
Abstract
Actinic keratoses (AKs) can progress into invasive squamous cell carcinoma and thus may become a life threatening disease. Argon plasma coagulation (APC) might complement the therapeutic armamentarium in particular for AK lesions. However, there is no data on APC-induced micromorphological changes following the treatment of AKs. We aimed to determine in vivo APC-induced effects on the epidermis and dermoepidermal junction (DEJ) zone in AK lesions. We performed APC in 108 AKs using the spray mode with a power setting of 15 W and a flow rate of 2.0 L/min. Before and after the intervention, optical coherence tomography (OCT) was performed. After APC, 74.2% (46/62) lesions presented with clearly demarcated DEJ and without any epidermal tissue left, 25.8% (16/62) of treated lesions showed residual epidermal tissue left. In 19.4% (12/62), parts of the DEJ and in 6.5% (4/62), the entire DEJ could not be discriminated. The χ2 test showed a significant (P = 0.0025) association between the presence of hyperkeratosis prior to APC and intact DEJ after APC. In conclusion, APC as shown by OCT is a well controllable treatment modality for AKs causing only limited damage to dermal tissue. Further studies are needed to evaluate clinical outcome as well as recurrence rates.
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Affiliation(s)
- Lutz Schmitz
- Department of Dermatology, Surgery Unit, Ruhr-University Bochum, Bochum, Germany
| | - Schapoor Hessam
- Department of Dermatology, Surgery Unit, Ruhr-University Bochum, Bochum, Germany
| | - Lisa Scholl
- Department of Dermatology, Surgery Unit, Ruhr-University Bochum, Bochum, Germany
| | - Sarah Reitenbach
- Department of Dermatology, Surgery Unit, Ruhr-University Bochum, Bochum, Germany
| | - Marc H Segert
- Department of Dermatology, Surgery Unit, Ruhr-University Bochum, Bochum, Germany
| | - Thilo Gambichler
- Department of Dermatology, Skin Cancer Centre, Ruhr-University Bochum, Bochum, Germany
| | - Eggert Stockfleth
- Department of Dermatology, Skin Cancer Centre, Ruhr-University Bochum, Bochum, Germany
| | - Falk G Bechara
- Department of Dermatology, Surgery Unit, Ruhr-University Bochum, Bochum, Germany
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