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Navarrete-Dechent C, Cordova M, Sahu A, Liopyris K, Rishpon A, Chen C, Rajadhyaksha M, Busam KJ, Marghoob AA, Chen CSJ. Optical imaging guided- 'precision' biopsy of skin tumors: a novel approach for targeted sampling and histopathologic correlation. Arch Dermatol Res 2021; 313:517-529. [PMID: 32844312 PMCID: PMC10185006 DOI: 10.1007/s00403-020-02126-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 08/02/2020] [Accepted: 08/08/2020] [Indexed: 01/25/2023]
Abstract
Dermoscopy and reflectance confocal microscopy (RCM) are two noninvasive, optical imaging tools used to facilitate clinical diagnosis. A biopsy technique that produces exact correlation with optical imaging features is not previously reported. To evaluate the applications of a novel feature-focused 'precision biopsy' technique that correlates clinical-dermoscopy-RCM findings with histopathology. This was a prospective case-series performed during August 2017 and June 2019 at a tertiary care cancer. We included consecutive patients requiring a precise dermoscopy-RCM-histopathologic correlation. We performed prebiopsy dermoscopy and both wide probe and handheld RCM of suspicious lesions. Features of interest were isolated with the aid of paper rings and a 2 mm punch biopsy was performed in the dermoscopy- or RCM-highlighted area. Tissue was processed either en face or with vertical sections. One-to-one correlation with histopathology was obtained. Twenty-three patients with 24 lesions were included in the study. The mean age was 64.6 years (range 22-91 years); there were 16 (69.6%) males, 14 (58.3%) lesions biopsied were on head and neck region. We achieved tissue-conservation diagnosis in 100% (24/24), 13 (54.2%) were clinically equivocal lesions, six (25%) were selected for 'feature correlation' of structures on dermoscopy or RCM, and five (20.8%) for 'correlation of new/unknown' RCM features seen on follow-up. The precision biopsy technique described herein is a novel method that facilitates direct histopathological correlation of dermoscopy and RCM features. With the aids of optical imaging devices, accurate diagnosis may be achieved by minimally invasive tissue extraction.
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Affiliation(s)
- Cristian Navarrete-Dechent
- Dermatology Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center, 800 Veterans Memorial Highway, 2nd floor Hauppauge, New York, NY, 11788, USA
- Department of Dermatology, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - Miguel Cordova
- Dermatology Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center, 800 Veterans Memorial Highway, 2nd floor Hauppauge, New York, NY, 11788, USA
| | - Aditi Sahu
- Dermatology Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center, 800 Veterans Memorial Highway, 2nd floor Hauppauge, New York, NY, 11788, USA
| | - Konstantinos Liopyris
- Dermatology Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center, 800 Veterans Memorial Highway, 2nd floor Hauppauge, New York, NY, 11788, USA
| | - Ayelet Rishpon
- Dermatology Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center, 800 Veterans Memorial Highway, 2nd floor Hauppauge, New York, NY, 11788, USA
- Department of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Curtis Chen
- Dermatology Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center, 800 Veterans Memorial Highway, 2nd floor Hauppauge, New York, NY, 11788, USA
| | - Milind Rajadhyaksha
- Dermatology Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center, 800 Veterans Memorial Highway, 2nd floor Hauppauge, New York, NY, 11788, USA
| | - Klaus J Busam
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Ashfaq A Marghoob
- Dermatology Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center, 800 Veterans Memorial Highway, 2nd floor Hauppauge, New York, NY, 11788, USA
| | - Chih-Shan Jason Chen
- Dermatology Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center, 800 Veterans Memorial Highway, 2nd floor Hauppauge, New York, NY, 11788, USA.
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Navarrete-Dechent C, Liopyris K, Molenda MA, Braun R, Curiel-Lewandrowski C, Dusza SW, Guitera P, Hofmann-Wellenhof R, Kittler H, Lallas A, Malvehy J, Marchetti MA, Oliviero M, Pellacani G, Puig S, Soyer HP, Tejasvi T, Thomas L, Tschandl P, Scope A, Marghoob AA, Halpern AC. Human surface anatomy terminology for dermatology: a Delphi consensus from the International Skin Imaging Collaboration. J Eur Acad Dermatol Venereol 2020; 34:2659-2663. [PMID: 32770737 DOI: 10.1111/jdv.16855] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 07/29/2020] [Indexed: 01/05/2023]
Abstract
BACKGROUND There is no internationally vetted set of anatomic terms to describe human surface anatomy. OBJECTIVE To establish expert consensus on a standardized set of terms that describe clinically relevant human surface anatomy. METHODS We conducted a Delphi consensus on surface anatomy terminology between July 2017 and July 2019. The initial survey included 385 anatomic terms, organized in seven levels of hierarchy. If agreement exceeded the 75% established threshold, the term was considered 'accepted' and included in the final list. Terms added by the participants were passed on to the next round of consensus. Terms with <75% agreement were included in subsequent surveys along with alternative terms proposed by participants until agreement was reached on all terms. RESULTS The Delphi included 21 participants. We found consensus (≥75% agreement) on 361/385 (93.8%) terms and eliminated one term in the first round. Of 49 new terms suggested by participants, 45 were added via consensus. To adjust for a recently published International Classification of Diseases-Surface Topography list of terms, a third survey including 111 discrepant terms was sent to participants. Finally, a total of 513 terms reached agreement via the Delphi method. CONCLUSIONS We have established a set of 513 clinically relevant terms for denoting human surface anatomy, towards the use of standardized terminology in dermatologic documentation.
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Affiliation(s)
- C Navarrete-Dechent
- Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA.,Department of Dermatology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - K Liopyris
- Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA.,Andreas Syggros Hospital of Cutaneous & Venereal Diseases, University of Athens, Athens, Greece
| | | | - R Braun
- Department of Dermatology, University Hospital Zürich, Zurich, Switzerland
| | - C Curiel-Lewandrowski
- Department of Dermatology, The University of Arizona Cancer Center, University of Arizona, Tucson, AZ, USA
| | - S W Dusza
- Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - P Guitera
- Melanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia
| | | | - H Kittler
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - A Lallas
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | - J Malvehy
- Melanoma Unit, Department of Dermatology, Hospital Clinic, Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain.,CIBER de Enfermedades Raras, Instituto de Salud Carlos III, Barcelona, Spain
| | - M A Marchetti
- Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - M Oliviero
- Dermatology Associates, Plantation, FL, USA
| | - G Pellacani
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - S Puig
- Melanoma Unit, Department of Dermatology, Hospital Clinic, Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain.,CIBER de Enfermedades Raras, Instituto de Salud Carlos III, Barcelona, Spain
| | - H P Soyer
- Dermatology Research Center, The University of Queensland Diamantina Institute, The University of Queensland, Brisbane, Australia
| | - T Tejasvi
- Department of Dermatology, University of Michigan, Ann Arbor, MI, USA
| | - L Thomas
- Service de Dermatologie, Centre Hospitalier Lyon Sud, Lyon 1 University and Cancer Research Center of Lyons INSERM U1052 - CNRS UMR5286, Lyon, France
| | - P Tschandl
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - A Scope
- The Kittner Skin Cancer Screening and Research Institute, Sheba Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - A A Marghoob
- Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - A C Halpern
- Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
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