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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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A Feasibility Study for Immediate Histological Assessment of Various Skin Biopsies Using Ex Vivo Confocal Laser Scanning Microscopy. Diagnostics (Basel) 2022; 12:diagnostics12123030. [PMID: 36553036 PMCID: PMC9777122 DOI: 10.3390/diagnostics12123030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 11/16/2022] [Accepted: 12/01/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Digitally stained ex vivo confocal laser scanning microscopy (CLSM) scans are a possible alternative to formalin-fixed and paraffin-embedded (FFPE) and hematoxylin-eosin (H&E) stained slides. This study explores the diagnostic accuracy of digitally-stained CLSM scans in comparison to H&E-stained slides in various dermatologic diseases in a real-life setting. METHODS Samples of patients out of one selected dermatologic office were primarily scanned via CLSM; a diagnosis was made afterwards using FFPE- and H&E-stained slides by two experienced dermatopathologists. Primary outcomes were sensitivity and specificity of diagnosis in digitally stained CLSM scans in three separate diagnostic groups. RESULTS CLSM evaluation of epithelial tumors (n = 132) demonstrated a sensitivity of 64.3%/83.9% and a specificity of 84.2%/71.1%. Diagnosis of melanocytic tumors (n = 86) showed a sensitivity of 19.1%/85.1% and a specificity of 96.3%/66.7%. In the diagnosis of other tumors/cysts and inflammatory dermatoses (n = 42), a sensitivity of 96.4%/96.8% and a specificity of 57.1%/45.5% was reached. CONCLUSIONS This study shows the possibilities and limitations of a broad use of CLSM. Because of a partly low diagnostic accuracy, such an application does not seem to be recommendable at present for every indication.
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Soglia S, Pérez-Anker J, Lobos Guede N, Giavedoni P, Puig S, Malvehy J. Diagnostics Using Non-Invasive Technologies in Dermatological Oncology. Cancers (Basel) 2022; 14:cancers14235886. [PMID: 36497368 PMCID: PMC9738560 DOI: 10.3390/cancers14235886] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 11/23/2022] [Accepted: 11/24/2022] [Indexed: 12/02/2022] Open
Abstract
The growing incidence of skin cancer, with its associated mortality and morbidity, has in recent years led to the developing of new non-invasive technologies, which allow an earlier and more accurate diagnosis. Some of these, such as digital photography, 2D and 3D total-body photography and dermoscopy are now widely used and others, such as reflectance confocal microscopy and optical coherence tomography, are limited to a few academic and referral skin cancer centers because of their cost or the long training period required. Health care professionals involved in the treatment of patients with skin cancer need to know the implications and benefits of new non-invasive technologies for dermatological oncology. In this article we review the characteristics and usability of the main diagnostic imaging methods available today.
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Affiliation(s)
- Simone Soglia
- Melanoma Unit, Dermatology Department, Hospital Clínic de Barcelona, IDIBAPS, Universitat de Barcelona, 08001 Barcelona, Spain
- Department of Dermatology, University of Brescia, 25121 Brescia, Italy
| | - Javiera Pérez-Anker
- Melanoma Unit, Dermatology Department, Hospital Clínic de Barcelona, IDIBAPS, Universitat de Barcelona, 08001 Barcelona, Spain
- Correspondence: ; Tel.: +34-932-275-400
| | - Nelson Lobos Guede
- Melanoma Unit, Dermatology Department, Hospital Clínic de Barcelona, IDIBAPS, Universitat de Barcelona, 08001 Barcelona, Spain
| | - Priscila Giavedoni
- Melanoma Unit, Dermatology Department, Hospital Clínic de Barcelona, IDIBAPS, Universitat de Barcelona, 08001 Barcelona, Spain
| | - Susana Puig
- Melanoma Unit, Dermatology Department, Hospital Clínic de Barcelona, IDIBAPS, Universitat de Barcelona, 08001 Barcelona, Spain
| | - Josep Malvehy
- Melanoma Unit, Dermatology Department, Hospital Clínic de Barcelona, IDIBAPS, Universitat de Barcelona, 08001 Barcelona, Spain
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Grizzetti L, Kuonen F. Ex vivo confocal microscopy for surgical margin assessment: A histology-compared study on 109 specimens. SKIN HEALTH AND DISEASE 2022; 2:e91. [PMID: 35677928 PMCID: PMC9168011 DOI: 10.1002/ski2.91] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 12/29/2021] [Accepted: 12/30/2021] [Indexed: 12/13/2022]
Abstract
Background The assessment of surgical margins is mandatory to prevent local recurrence or distant dissemination of skin cancers. Histological examination of haematoxylin and eosin (H&E)-stained slides from paraffin-embedded or frozen samples is the gold standard for margin assessment, but is a time-consuming procedure. Ex vivo confocal laser scanning microscopy (CLSM) is an upcoming technique that scans unfixed fresh tissue rapidly, allowing fast per-operative margin assessment. Objective Here, we propose to assess the efficiency of a new ex vivo confocal microscope for the per-operative assessment of surgical margins. Methods We analyzed 16 biopsies and 93 surgical specimens of basal cell and squamous cell carcinomas by ex vivo CLSM using Histolog® Scanner V2. Surgical specimens included fusiform excisions, slow-Mohs peripheral and deep compartments, and Mohs excisions. The time required from surgical excision to image analysis was recorded and the quality of the images obtained for each specimen assessed. The presence or absence of tumour was estimated based on ex vivo CLSM images and compared with conventional H&E-stained sections from paraffin-embedded or frozen (Mohs) specimens. Results Mean time for specimen processing using Histolog Scanner was 5.1 ± 3.4 min. We obtained 89% of high quality images. Mean time for confocal image analysis was 1 ± 0.76 min. The diagnostic sensitivity and specificity for ex vivo CLSM compared to classical H&E procedures were respectively 93% and 100% when performed on tumour biopsies. The overall sensitivity and specificity for ex vivo CLSM for margin assessment compared to classical H&E procedures were respectively 61.5% and 95%, with variations depending on the type of tumour or surgical specimen analyzed. In particular, we obtained 80% sensitivity and 100% specificity for the assessment of BCC surgical margins. Conclusion Our data suggest that ex vivo CLSM using Histolog® Scanner V2 could be a valid help for surgeons for a fast and accurate per-operative margin analysis.
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Affiliation(s)
- L. Grizzetti
- Department of Dermatology and Venereology, Hôpital de BeaumontLausanne University Hospital CenterLausanneSwitzerland
| | - F. Kuonen
- Department of Dermatology and Venereology, Hôpital de BeaumontLausanne University Hospital CenterLausanneSwitzerland
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Mostafa O, Saleh HM, Salaheldin TA, Elfeky SA. Fluorescein/gold nanoparticles conjugated EGFR antibody for imaging and P53 upregulation in hamster mucosal cells carcinoma. J Drug Deliv Sci Technol 2022. [DOI: 10.1016/j.jddst.2022.103293] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Malvehy J, Pérez-Anker J, Toll A, Pigem R, Garcia A, Alos LL, Puig S. Ex vivo confocal microscopy: revolution in fast pathology in dermatology. Br J Dermatol 2020; 183:1011-1025. [PMID: 32134506 DOI: 10.1111/bjd.19017] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/02/2020] [Indexed: 02/06/2023]
Abstract
Confocal microscopy with in vivo and ex vivo modalities has been used in the evaluation of skin cancer and other dermatological disorders. Recent developments in ex vivo confocal microscopy allow for faster pathology assessment with greater accuracy by the visualization of cellular and architectural details, similarly to standard pathology, in either paraffin-embedded or frozen samples. They include the possibility of multimodal confocal microscopy using different lasers and fusion images. New staining protocols including immunostaining, with no damage to conventional histopathology preparation, have been recently described in melanocytic tumours and inflammatory skin diseases. Digital staining with haematoxylin and eosin is also incorporated in the new devices. In this review the applications of ex vivo confocal microscopy will be presented with the description of the technique and the technology, clinical evidence in dermatology and other fields, and further applications.
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Affiliation(s)
- J Malvehy
- Dermatology Department, University of Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomediques August Pi I Sunyer (IDIBAPS), Barcelona, Spain.,Biomedical Research Networking Centre on Rare Diseases (CIBERER), ISCIII, Barcelona, Spain
| | - J Pérez-Anker
- Dermatology Department, University of Barcelona, Barcelona, Spain
| | - A Toll
- Dermatology Department, University of Barcelona, Barcelona, Spain
| | - R Pigem
- Dermatology Department, University of Barcelona, Barcelona, Spain
| | - A Garcia
- Pathology Department, Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Spain
| | - L L Alos
- Pathology Department, Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Spain
| | - S Puig
- Dermatology Department, University of Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomediques August Pi I Sunyer (IDIBAPS), Barcelona, Spain.,Biomedical Research Networking Centre on Rare Diseases (CIBERER), ISCIII, Barcelona, Spain
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Walker E, Liu Y, Kim I, Biro M, Iyer SR, Ezaldein H, Scott J, Merati M, Mistur R, Zhou B, Straight B, Yim JJ, Bogyo M, Mann M, Wilson DL, Basilion JP, Popkin DL. A Protease-Activated Fluorescent Probe Allows Rapid Visualization of Keratinocyte Carcinoma during Excision. Cancer Res 2020; 80:2045-2055. [PMID: 32132111 DOI: 10.1158/0008-5472.can-19-3067] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 01/10/2020] [Accepted: 02/24/2020] [Indexed: 12/26/2022]
Abstract
Keratinocyte carcinomas, including basal and squamous cell carcinomas, are the most common human cancers worldwide. While 75% of all keratinocyte carcinoma (4 million annual cases in the United States) are treated with conventional excision, this surgical modality has much lower cure rates than Mohs micrographic surgery, likely due to the bread-loaf histopathologic assessment that visualizes <1% of the tissue margins. A quenched protease-activated fluorescent probe 6qcNIR, which produces a signal only in the protease-rich tumor microenvironment, was topically applied to 90 specimens ex vivo immediately following excision. "Puzzle-fit" analysis was used to correlate the fluorescent images with histology. Probe-dependent fluorescent images correlated with cancer determined by conventional histology. Point-of-care fluorescent detection of skin cancer had a clinically relevant sensitivity of 0.73 and corresponding specificity of 0.88. Importantly, clinicians were effectively trained to read fluorescent images within 15 minutes with reliability and confidence, resulting in sensitivities of 62%-78% and specificities of 92%-97%. Fluorescent imaging using 6qcNIR allows 100% tumor margin assessment by generating en face images that correlate with histology and may be used to overcome the limitations of conventional bread-loaf histology. The utility of 6qcNIR was validated in a busy real-world clinical setting, and clinicians were trained to effectively read fluorescent margins with a short guided instruction, highlighting clinical adaptability. When used in conventional excision, this approach may result in higher cure rates at a lower cost by allowing same-day reexcision when needed, reducing patient anxiety and improving compliance by expediting postsurgical specimen assessment. SIGNIFICANCE: A fluorescent-probe-tumor-visualization platform was developed and validated in human keratinocyte carcinoma excision specimens that may provide simple, rapid, and global assessment of margins during skin cancer excision, allowing same-day reexcision when needed.
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Affiliation(s)
- Ethan Walker
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio
| | - Yiqiao Liu
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio
| | - InYoung Kim
- Department of Dermatology, Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, Ohio.,Department of Dermatology, Case Western Reserve University, Cleveland, Ohio
| | - Mark Biro
- Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Sukanya Raj Iyer
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio
| | - Harib Ezaldein
- Department of Dermatology, Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, Ohio.,Department of Dermatology, Case Western Reserve University, Cleveland, Ohio
| | - Jeffrey Scott
- Department of Dermatology, Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, Ohio.,Department of Dermatology, Case Western Reserve University, Cleveland, Ohio
| | - Miesha Merati
- Department of Dermatology, Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, Ohio.,Department of Dermatology, Case Western Reserve University, Cleveland, Ohio
| | - Rachel Mistur
- Department of Dermatology, Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, Ohio.,Department of Dermatology, Case Western Reserve University, Cleveland, Ohio
| | - Bo Zhou
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio
| | | | - Joshua J Yim
- Chemical and Systems Biology, Stanford University, Palo Alto, California
| | - Matthew Bogyo
- Chemical and Systems Biology, Stanford University, Palo Alto, California.,Department of Pathology, Stanford University, Palo Alto, California.,Department of Microbiology and Immunology, Stanford University, Palo Alto, California
| | - Margaret Mann
- Department of Dermatology, Case Western Reserve University, Cleveland, Ohio
| | - David L Wilson
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio.,Department of Radiology, Case Western Reserve University, Cleveland, Ohio
| | - James P Basilion
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio. .,Department of Radiology, Case Western Reserve University, Cleveland, Ohio.,Fellow, National Foundation for Cancer Research, Case Western Reserve University, Cleveland, Ohio
| | - Daniel L Popkin
- Department of Dermatology, Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, Ohio. .,Department of Dermatology, Case Western Reserve University, Cleveland, Ohio
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8
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Cinotti E, Perrot JL, Labeille B, Cambazard F, Rubegni P. Ex vivo confocal microscopy: an emerging technique in dermatology. Dermatol Pract Concept 2018; 8:109-119. [PMID: 29785327 PMCID: PMC5955077 DOI: 10.5826/dpc.0802a08] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Accepted: 01/18/2018] [Indexed: 12/13/2022] Open
Abstract
This review aims to give an overview of the current available applications of ex vivo confocal microscopy (EVCM) in dermatology. EVCM is a relatively new imaging technique that allows microscopic examination of freshly excised unfixed tissue. It enables a rapid examination of the skin sample directly in the surgery room and thus represents an alternative to the intraoperative micrographic control of the surgical margins of cutaneous tumors by standard microscopic examination on cryopreserved sections during Mohs surgery. Although this technique has mainly been developed for the margin’s control of basal cell carcinoma, many other skin tumors have been studied, including melanoma. Use of EVCM is continuing to evolve, and many possible applications are under investigation, such as the study of nails and hair diseases and the diagnosis of skin infections.
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Affiliation(s)
- Elisa Cinotti
- Department of Medical, Surgical and Neurological Science, Dermatology Section, University of Siena, S. Maria alle Scotte Hospital, Siena, Italy
| | - Jean Luc Perrot
- Department of Dermatology, University Hospital of Saint-Étienne, Saint-Étienne, France
| | - Bruno Labeille
- Department of Dermatology, University Hospital of Saint-Étienne, Saint-Étienne, France
| | - Frédéric Cambazard
- Department of Dermatology, University Hospital of Saint-Étienne, Saint-Étienne, France
| | - Pietro Rubegni
- Department of Medical, Surgical and Neurological Science, Dermatology Section, University of Siena, S. Maria alle Scotte Hospital, Siena, Italy
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9
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Hartmann D, Krammer S, Bachmann MR, Mathemeier L, Ruzicka T, Bagci IS, von Braunmühl T. Ex vivo confocal microscopy features of cutaneous squamous cell carcinoma. JOURNAL OF BIOPHOTONICS 2018; 11:e201700318. [PMID: 29227042 DOI: 10.1002/jbio.201700318] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Accepted: 12/07/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND Rapid microscopic evaluation of cutaneous squamous cell carcinoma (SCC), its grade of differentiation and level of invasiveness would enable better management of patients' therapy. OBJECTIVES Analyzing specific ex vivo confocal microscopy criteria whether they can predict diagnosis of invasive SCC vs carcinoma in situ and poorly differentiated or undifferentiated vs well and moderately differentiated SCC. METHODS Ex vivo confocal images of 102 SCCs in 57 patients were evaluated immediately after excision for the presence of predefined criteria based on confocal and histological knowledge. RESULTS In histopathological examination, 30 SCCs were in situ and 72 invasive. Of these, 29 invasive SCC tumors were well, 19 moderately, 15 poorly differentiated and 9 undifferentiated. χ2 analysis demonstrated that presence of erosion/ulceration, plump bright or speckled cells in dermis, keratin pearls and peritumoral inflammatory infiltrate correlated with diagnosis of invasive SCC. Erosion/ulceration and peritumoral inflammatory infiltrate were observed more frequently in poorly differentiated or undifferentiated tumors. Plump bright or speckled cells in the dermis were observed less often in well-differentiated tumors. The presence of keratin pearls was associated with well or moderately differentiated tumors. CONCLUSION Ex vivo CLSM allowed rapid examination of SCC and provided useful information on invasiveness and grading of the tumor.
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Affiliation(s)
- Daniela Hartmann
- Department of Dermatology and Allergy, University Hospital LMU, Munich, Germany
| | - Sebastian Krammer
- Department of Dermatology and Allergy, University Hospital LMU, Munich, Germany
| | - Mario R Bachmann
- Department of Dermatology and Allergy, University Hospital LMU, Munich, Germany
| | - Leonie Mathemeier
- Department of Dermatology and Allergy, University Hospital LMU, Munich, Germany
| | - Thomas Ruzicka
- Department of Dermatology and Allergy, University Hospital LMU, Munich, Germany
| | - Isin S Bagci
- Department of Dermatology and Allergy, University Hospital LMU, Munich, Germany
| | - Tanja von Braunmühl
- Department of Dermatology and Allergy, University Hospital LMU, Munich, Germany
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10
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Hartmann D, Ruini C, Mathemeier L, Bachmann MR, Dietrich A, Ruzicka T, von Braunmühl T. Identification of ex-vivo confocal laser scanning microscopic features of melanocytic lesions and their histological correlates. JOURNAL OF BIOPHOTONICS 2017; 10:128-142. [PMID: 27091702 DOI: 10.1002/jbio.201500335] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Revised: 04/04/2016] [Accepted: 04/05/2016] [Indexed: 06/05/2023]
Abstract
Ex-vivo confocal laser scanning microscopy (CLSM) offers rapid tissue examination. Current literature shows promising results in the evaluation of non-melanoma skin cancer but little is known about presentation of melanocytic lesions (ML). This study evaluates ML with ex-vivo CLSM in comparison to histology and offers an overview of ex-vivo CLSM characteristics. 31 ML were stained with acridine orange or fluorescein and examined using ex-vivo CLSM (Vivascope2500® ; Lucid Inc; Rochester NY) in reflectance and fluorescence mode. Confocal images were correlated to histopathology. Benign and malignant features of the ML were listed and results were presented. Sensitivity and specificity were calculated using contingency tables. The ML included junctional, compound, dermal, Spitz and dysplastic nevi, as well as various melanoma subtypes. The correlation of the confocal findings with histopathology allowed the identification of different types of ML and differentiation of benign and malignant features. The study offers an overview of confocal characteristics of ML in comparison to histology. Ex-vivo CLSM does not reproduce the typical in-vivo horizontal mosaics but rather reflects the vertical histological presentation. Not all typical in-vivo patterns are detectable here. These findings may help to evaluate the ex-vivo CLSM as an adjunctive tool in the immediate intraoperative diagnosis of ML. Superficial spreading malignant melanoma. Histopathology (H&E stain; 200×) correlated to the reflectance (RM; 830 nm) and fluorescence mode (FM; 488 nm) in the ex-vivo CLSM (Vivablock® by VivaScan® , acridine orange).
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Affiliation(s)
- Daniela Hartmann
- Department of Dermatology and Allergology, Ludwig-Maximilian University, Frauenlobstr. 9-11, 80337, Munich, Germany
- Department of Dermatology, Municipal Hospital of Munich, Thalkirchner Str. 48, 80337, Munich, Germany
| | - Cristel Ruini
- Department of Dermatology and Allergology, Ludwig-Maximilian University, Frauenlobstr. 9-11, 80337, Munich, Germany
- Department of Dermatology, Municipal Hospital of Munich, Thalkirchner Str. 48, 80337, Munich, Germany
| | - Leonie Mathemeier
- Department of Dermatology and Allergology, Ludwig-Maximilian University, Frauenlobstr. 9-11, 80337, Munich, Germany
| | - Mario Raphael Bachmann
- Department of Dermatology and Allergology, Ludwig-Maximilian University, Frauenlobstr. 9-11, 80337, Munich, Germany
| | - Andreas Dietrich
- Department of Dermatology and Allergology, Ludwig-Maximilian University, Frauenlobstr. 9-11, 80337, Munich, Germany
| | - Thomas Ruzicka
- Department of Dermatology and Allergology, Ludwig-Maximilian University, Frauenlobstr. 9-11, 80337, Munich, Germany
- Department of Dermatology, Municipal Hospital of Munich, Thalkirchner Str. 48, 80337, Munich, Germany
| | - Tanja von Braunmühl
- Department of Dermatology and Allergology, Ludwig-Maximilian University, Frauenlobstr. 9-11, 80337, Munich, Germany
- Department of Dermatology, Municipal Hospital of Munich, Thalkirchner Str. 48, 80337, Munich, Germany
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Tsai MT, Li DR, Chan MC. Non-invasive image-guided laser microsurgery by a dual-wavelength fiber laser and an integrated fiber-optic multi-modal system. OPTICS LETTERS 2016; 41:4847-4850. [PMID: 28005846 DOI: 10.1364/ol.41.004847] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
A new approach to non-invasive image-guided laser micro-treatment is demonstrated by a dual-wavelength fiber laser source and an integrated fiber-based multi-modal system. The fiber-based source, operated in 1.55 and 1.2 μm simultaneously, was directly connected to an integrated fiber-based multi-modal system for imaging and laser micro-treatment at the same time. The 1.2 μm radiations, within the 1.2-1.35 μm bio-penetration window of skin, were utilized for spectral domain optical coherence tomography imaging. The 1.55 μm radiations, highly absorptive to waters, were utilized for laser microsurgery. The new approach, which is simple in configuration and accurately controls the positions and exposure time of the laser microsurgery, shows great promises for future clinical applications.
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12
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13
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14
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Hartmann D, Ruini C, Mathemeier L, Dietrich A, Ruzicka T, von Braunmühl T. Identification of ex-vivo confocal scanning microscopic features and their histological correlates in human skin. JOURNAL OF BIOPHOTONICS 2016; 9:376-387. [PMID: 25996548 DOI: 10.1002/jbio.201500124] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2015] [Revised: 04/29/2015] [Accepted: 04/30/2015] [Indexed: 06/04/2023]
Abstract
Ex-vivo confocal laser scanning microscopy (CLSM) is an emerging diagnostic tool allowing fast and easy microscopic tissue examination. The first generation of ex-vivo devices have already shown promising results in the ex-vivo evaluation of basal cell carcinoma compared to Mohs surgery. Nevertheless, for the diagnostics of pathological skin lesions the knowledge of normal skin features is essential. Therefore we examined 50 samples of healthy skin from various donor sites including head and neck (n = 25), trunk (n = 10), upper (n = 10) and lower extremities (n = 5) using a new generation ex-vivo CLSM device offering three different laser wavelengths and compared the findings to the corresponding histological sections. In correlation with the histopathology we identified different layers of the epidermis, differentiated keratinocytes from melanocytes and described in detail skin appendages including hair follicle, sebaceous and sweat glands. Furthermore, structures of the dermis and subcutis were illustrated. Additionally, artefacts and pitfalls occurring with the use of ex-vivo CLSM have been documented. The study offers an overview of the main ex-vivo CLSM skin characteristics in comparison to the standard histological examination and helps to recognize and avoid common artefacts. Anatomy of a hair follicle in the reflectance mode (RM) CLSM, fluorescence mode (FM) CLSM and in a routine hematoxylin-eosin stained histological section (H).
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Affiliation(s)
- Daniela Hartmann
- Department of Dermatology and Allergology, Ludwig-Maximilian University, Munich, Germany.
| | - Cristel Ruini
- Department of Dermatology and Allergology, Ludwig-Maximilian University, Munich, Germany
| | - Leonie Mathemeier
- Department of Dermatology and Allergology, Ludwig-Maximilian University, Munich, Germany
| | - Andreas Dietrich
- Department of Dermatology and Allergology, Ludwig-Maximilian University, Munich, Germany
| | - Thomas Ruzicka
- Department of Dermatology and Allergology, Ludwig-Maximilian University, Munich, Germany
| | - Tanja von Braunmühl
- Department of Dermatology and Allergology, Ludwig-Maximilian University, Munich, Germany
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Dinnes J, Wong KY, Gulati A, Chuchu N, Leonardi-Bee J, Bayliss SE, Takwoingi Y, Davenport C, Matin RN, Bath-Hextall FJ, Jain A, Lear JT, Motley R, Deeks JJ, Williams HC, Godfrey K, O'Sullivan C. Tests to assist in the diagnosis of keratinocyte skin cancers in adults: a generic protocol. THE COCHRANE DATABASE OF SYSTEMATIC REVIEWS 2015. [DOI: 10.1002/14651858.cd011901] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Affiliation(s)
- Jac Dinnes
- University of Birmingham; Public Health, Epidemiology and Biostatistics; Birmingham UK B15 2TT
| | - Kai Yuen Wong
- Salisbury NHS Foundation Trust; Department of Plastic and Reconstructive Surgery; Salisbury UK
| | - Abha Gulati
- Barts Health NHS Trust; Department of Dermatology; Whitechapel London UK E11BB
| | - Naomi Chuchu
- University of Birmingham; Public Health, Epidemiology and Biostatistics; Birmingham UK B15 2TT
| | - Jo Leonardi-Bee
- The University of Nottingham; Division of Epidemiology and Public Health; Clinical Sciences Building Nottingham City Hospital NHS Trust Campus, Hucknall Road Nottingham UK NG5 1PB
| | - Susan E Bayliss
- University of Birmingham; Public Health, Epidemiology and Biostatistics; Birmingham UK B15 2TT
| | - Yemisi Takwoingi
- University of Birmingham; Public Health, Epidemiology and Biostatistics; Birmingham UK B15 2TT
| | - Clare Davenport
- University of Birmingham; Public Health, Epidemiology and Biostatistics; Birmingham UK B15 2TT
| | - Rubeta N Matin
- Churchill Hospital; Department of Dermatology; Old Road Headington Oxford UK OX3 7LJ
| | - Fiona J Bath-Hextall
- The University of Nottingham; School of Health Sciences; Room D83, Medical school Queens medical centre Nottingham UK NG7 2UH
| | - Abhilash Jain
- University of Oxford; NDORMS; 2 Chesham Close Oxford UK NW7 4AF
| | - John T Lear
- Manchester Royal Infirmary; Dermatology; Oxford Road Manchester UK M13 9WL
| | - Richard Motley
- University Hospital of Wales; Welsh Institute of Dermatology; Heath Park Cardiff UK CF14 4XW
| | - Jonathan J Deeks
- University of Birmingham; Public Health, Epidemiology and Biostatistics; Birmingham UK B15 2TT
| | - Hywel C Williams
- The University of Nottingham; Centre of Evidence Based Dermatology; Queen's Medical Centre Derby Road Nottingham UK NG7 2UH
| | - Kathie Godfrey
- The University of Nottingham; c/o Cochrane Skin Group; Nottingham UK
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16
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Debarbieux S, Gaspar R, Depaepe L, Dalle S, Balme B, Thomas L. Intraoperative diagnosis of nonpigmented nail tumours withex vivofluorescence confocal microscopy: 10 cases. Br J Dermatol 2015; 172:1037-44. [DOI: 10.1111/bjd.13384] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/25/2014] [Indexed: 11/30/2022]
Affiliation(s)
- S. Debarbieux
- Department of Dermatology; Centre Hospitalier Lyon Sud; 69 495 Pierre Bénite Cedex France
| | - R. Gaspar
- Department of Dermatology; Centre Hospitalier Lyon Sud; 69 495 Pierre Bénite Cedex France
| | - L. Depaepe
- Department of Pathology; Centre Hospitalier Lyon Sud; 69 495 Pierre Bénite Cedex France
| | - S. Dalle
- Department of Dermatology; Centre Hospitalier Lyon Sud; 69 495 Pierre Bénite Cedex France
| | - B. Balme
- Department of Pathology; Centre Hospitalier Lyon Sud; 69 495 Pierre Bénite Cedex France
| | - L. Thomas
- Department of Dermatology; Centre Hospitalier Lyon Sud; 69 495 Pierre Bénite Cedex France
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17
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Ulrich M, Astner S, Stockfleth E, Röwert-Huber J. Noninvasive diagnosis of non-melanoma skin cancer: focus on reflectance confocal microscopy. ACTA ACUST UNITED AC 2014. [DOI: 10.1586/17469872.3.5.557] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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18
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Mittal R, Balu M, Krasieva T, Potma EO, Elkeeb L, Zachary CB, Wilder-Smith P. Evaluation of stimulated Raman scattering microscopy for identifying squamous cell carcinoma in human skin. Lasers Surg Med 2013. [PMID: 23996592 DOI: 10.1002/lsm.22168.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND AND SIGNIFICANCE There is a need to develop non-invasive diagnostic tools to achieve early and accurate detection of skin cancer in a non-surgical manner. In this study, we evaluate the capability of stimulated Raman scattering (SRS) microscopy, a potentially non-invasive optical imaging technique, for identifying the pathological features of s squamous cell carcinoma (SCC) tissue. STUDY DESIGN We studied ex vivo SCC and healthy skin tissues using SRS microscopy, and compared the SRS contrast with the contrast obtained in reflectance confocal microscopy (RCM) and standard histology. RESULTS AND CONCLUSION SRS images obtained at the carbon-hydrogen stretching vibration at 2945 cm(-1) exhibit contrast related protein density that clearly delineates the cell nucleus from the cell cytoplasm. The morphological features of SCC tumor seen in the SRS images show excellent correlation with the diagnostic features identified by histological examination. Additionally, SRS exhibits enhanced cellular contrast in comparison to that seen in confocal microscopy. In conclusion, SRS represents an attractive approach for generating protein density maps with contrast that closely resembles histopathological contrast of SCC in human skin.
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Affiliation(s)
- Richa Mittal
- Beckman Laser Institute and Medical Clinic, University of California, Irvine, California, 92612; Department of Chemical Engineering and Materials Sciences, University of California, Irvine, California, 92697
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19
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Mittal R, Balu M, Krasieva T, Potma EO, Elkeeb L, Zachary CB, Wilder-Smith P. Evaluation of stimulated Raman scattering microscopy for identifying squamous cell carcinoma in human skin. Lasers Surg Med 2013; 45:496-502. [PMID: 23996592 DOI: 10.1002/lsm.22168] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/25/2013] [Indexed: 12/26/2022]
Abstract
BACKGROUND AND SIGNIFICANCE There is a need to develop non-invasive diagnostic tools to achieve early and accurate detection of skin cancer in a non-surgical manner. In this study, we evaluate the capability of stimulated Raman scattering (SRS) microscopy, a potentially non-invasive optical imaging technique, for identifying the pathological features of s squamous cell carcinoma (SCC) tissue. STUDY DESIGN We studied ex vivo SCC and healthy skin tissues using SRS microscopy, and compared the SRS contrast with the contrast obtained in reflectance confocal microscopy (RCM) and standard histology. RESULTS AND CONCLUSION SRS images obtained at the carbon-hydrogen stretching vibration at 2945 cm(-1) exhibit contrast related protein density that clearly delineates the cell nucleus from the cell cytoplasm. The morphological features of SCC tumor seen in the SRS images show excellent correlation with the diagnostic features identified by histological examination. Additionally, SRS exhibits enhanced cellular contrast in comparison to that seen in confocal microscopy. In conclusion, SRS represents an attractive approach for generating protein density maps with contrast that closely resembles histopathological contrast of SCC in human skin.
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Affiliation(s)
- Richa Mittal
- Beckman Laser Institute and Medical Clinic, University of California, Irvine, California, 92612; Department of Chemical Engineering and Materials Sciences, University of California, Irvine, California, 92697
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20
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Shtirshnayder YY, Michenko AV, Katunina OR, Zubarev AR, SHTIRSHNEIDER YUYU, MICHENKO AV, KATUNINA OR, ZUBAREV AR. Up-to-date non-invasive visualization technologies in dermatology. VESTNIK DERMATOLOGII I VENEROLOGII 2011. [DOI: 10.25208/vdv1062] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
The authors present a review of up-to-date non-invasive visualization methods used in diagnostics of diseases of skin
and its appendages. They describe physical principles forming the basis for non-invasive visualization methods such
as dermatoscopy, confocal laser scanning microscopy, optical video monitoring, optical topometry, optical coherent
tomography, ultrasound scanning, 3D-modeling. They also describe the potential of practical application of these diagnostics
methods at the current stage of their development. The authors have demonstrated that it is possible to reduce the clinicians
need in biopsy diagnostics due to the high information value of non-invasive visual diagnostics methods.
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21
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Kurzeja M, Rakowska A, Rudnicka L, Olszewska M. Criteria for diagnosing pemphigus vulgaris and pemphigus foliaceus by reflectance confocal microscopy. Skin Res Technol 2011; 18:339-46. [DOI: 10.1111/j.1600-0846.2011.00574.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/07/2011] [Indexed: 12/01/2022]
Affiliation(s)
- Marta Kurzeja
- Department of Dermatology; CSK MSWiA; Warsaw; Poland
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22
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23
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Vargas G, Shilagard T, Johnston R, Bell B, Stegall RL, Vincent K, Stanberry L, Motamedi M, Bourne N. Use of high-resolution confocal imaging of the vaginal epithelial microstructure to detect microbicide toxicity. J Infect Dis 2009; 199:1546-52. [PMID: 19355817 DOI: 10.1086/598221] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE High-resolution optical imaging by confocal reflectance microscopy (CRM) was investigated for its ability to delineate the epithelial microstructure of the vaginal tract and detect alterations that may result from the use of vaginal microbicides. METHODS The vaginal tracts of Swiss Webster mice treated with medroxyprogesterone acetate were exposed in vivo to a 4% nonoxynol-9 (N-9)-containing gel or saline. The vaginal tract was removed 4 h, 16 h, or 48 h after treatment and imaged by CRM without staining, and biopsy specimens were obtained from the imaged regions and processed for histological analysis. RESULTS In control mice, CRM revealed a columnar epithelium and lamina propria with features resembling those observed via histological analysis. CRM revealed an exfoliated epithelium 4 h and 16 h after N-9 treatment, and quantitative measurement of epithelial thickness revealed a mean thickness (+/- standard error of the mean) of approximately ~41.7 +/- 1.7 mum in control specimens, compared with 14.9 +/- 4.5 mum for specimens obtained 4 h after treatment and 24.4 +/- 2.1 mum for specimens obtained 16 h after treatment. Inflammation 4 h after treatment was indicated through detection of inflammatory infiltrates. In samples collected 48 h after treatment, the epithelium was regenerating. The time line of changes in the morphological structure and epithelial thickness detected by CRM closely resembled that of changes revealed by histological analysis. CONCLUSIONS This study demonstrates that CRM can delineate the epithelial structure and detect indicators of inflammation after treatment with N-9 and that it may be a useful imaging tool for evaluating the effects of vaginal microbicides.
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Affiliation(s)
- Gracie Vargas
- Center for Biomedical Engineering , The University of Texas Medical Branch, Galveston, TX 77555, USA.
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24
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Schüle D, Breuninger H, Schippert W, Dietz K, Moehrle M. Confocal laser scanning microscopy in micrographic surgery (three-dimensional histology) of basal cell carcinomas. Br J Dermatol 2009; 161:698-700. [PMID: 19575731 DOI: 10.1111/j.1365-2133.2009.09354.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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25
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Venturini M, Sala R, Semenza D, Santoro A, Facchetti F, Calzavara-Pinton P. Reflectance confocal microscopy for the in vivo detection of Treponema pallidum in skin lesions of secondary syphilis. J Am Acad Dermatol 2009; 60:639-42. [DOI: 10.1016/j.jaad.2008.11.901] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2008] [Revised: 11/17/2008] [Accepted: 11/17/2008] [Indexed: 11/16/2022]
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26
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Tsai TH, Jee SH, Chan JY, Lee JN, Lee WR, Dong CY, Lin SJ. Visualizing laser-skin interaction in vivo by multiphoton microscopy. JOURNAL OF BIOMEDICAL OPTICS 2009; 14:024034. [PMID: 19405763 DOI: 10.1117/1.3116711] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Recently, multiphoton microscopy has gained much popularity as a noninvasive imaging modality in biomedical research. We evaluate the potential of multiphoton microscopy for monitoring laser-skin reaction in vivo. Nude mouse skin is irradiated with an erbium:YAG laser at various fluences and immediately imaged by a multiphoton microscope. The alterations of cutaneous nonlinear optical properties including multiphoton autofluorescence and second-harmonic generation associated with laser irradiation are evaluated morphologically and quantitatively. Our results show that an erbium:YAG laser at a low fluence can selectively disrupt the stratum corneum, and this alteration may account for the penetration enhancing effect of laser-assisted transcutaneous drug delivery. At a higher fluence, the zone of tissue ablation as well as the disruption of the surrounding stratum corneum, keratinocytes, and dermal extracellular matrix can be better characterized by multiphoton microscopy as compared with conventional histology. Furthermore, the degree of collagen damage in the residual thermal zone can be quantified by second-harmonic generation signals, which have significant difference between control skin, skin irradiated with a 1.5-, 8-, and 16-J/cm2 erbium:YAG laser (P<0.05). We show that multiphoton microscopy can be a useful noninvasive imaging modality for monitoring laser-skin reaction in vivo.
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Affiliation(s)
- Tsung-Hua Tsai
- Far Eastern Memorial Hospital, Department of Dermatology, 21, Nan-Ya South Road, Section 2, Pan-Chiao, Taipei 220, Taiwan
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27
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Gareau DS, Patel YG, Li Y, Aranda I, Halpern AC, Nehal KS, Rajadhyaksha M. Confocal mosaicing microscopy in skin excisions: a demonstration of rapid surgical pathology. J Microsc 2009; 233:149-59. [PMID: 19196421 PMCID: PMC2662487 DOI: 10.1111/j.1365-2818.2008.03105.x] [Citation(s) in RCA: 67] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Precise micro-surgical removal of tumour with minimal damage to the surrounding normal tissue requires a series of excisions, each guided by an examination of frozen histology of the previous. An example is Mohs surgery for the removal of basal cell carcinomas (BCCs) in skin. The preparation of frozen histology is labour-intensive and slow. Confocal microscopy may enable rapid detection of tumours directly in surgical excisions with minimal need for frozen histology. Mosaicing of images enables observation of nuclear and cellular morphology in large areas of surgically excised tissue. In skin, the use of 10-1% acetic acid as a reflectance contrast agent brightens nuclei in 0.5-5 min and enhances nuclear-to-dermis contrast and detectability of BCCs. A tissue fixture was engineered for precisely mounting surgical excisions to enable mosaicing of 36 x 36 images to create a field of view of 12 x 12 mm. This large field of view displays the excision at 2x magnification, similar to that routinely used by Mohs surgeons when examining frozen histology. Comparison of mosaics to histology demonstrates detectability of BCCs. Confocal mosaicing presently requires 9 min, instead of 20-45 min per excision for preparing frozen histology, and thus may provide a means for rapid pathology-at-the-bedside to expedite and guide surgery.
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Affiliation(s)
- D S Gareau
- Dermatology Service, Room 230, Memorial Sloan-Kettering Cancer Center, 160 East 53rd Street, New York, NY 10022, USA.
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Abstract
Skin cancer is the most common form of cancer types. It is generally divided into two categories: melanoma (∼ 5%) and nonmelanoma (∼ 95%), which can be further categorized into basal cell carcinoma, squamous cell carcinoma, and some rare skin cancer types. Biopsy is still the gold standard for skin cancer evaluation in the clinic. Various anatomical imaging techniques have been used to evaluate different types of skin cancer lesions, including laser scanning confocal microscopy, optical coherence tomography, high-frequency ultrasound, terahertz pulsed imaging, magnetic resonance imaging, and some other recently developed techniques such as photoacoustic microscopy. However, anatomical imaging alone may not be sufficient in guiding skin cancer diagnosis and therapy. Over the last decade, various molecular imaging techniques (in particular single photon emission computed tomography and positron emission tomography) have been investigated for skin cancer imaging. The pathways or molecular targets that have been studied include glucose metabolism, integrin αvβ3, melanocortin-1 receptor, high molecular weight melanoma-associated antigen, and several other molecular markers. Preclinical molecular imaging is thriving all over the world, while clinical molecular imaging has not lived up to the expectations because of slow bench-to-bedside translation. It is likely that this situation will change in the near future and molecular imaging will truly play an important role in personalized medicine of melanoma patients.
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Affiliation(s)
- Hao Hong
- Departments of Radiology and Medical Physics, School of Medicine and Public Health, University of Wisconsin - Madison, Madison, Wisconsin, USA
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Nehal KS, Gareau D, Rajadhyaksha M. Skin imaging with reflectance confocal microscopy. ACTA ACUST UNITED AC 2008; 27:37-43. [PMID: 18486023 DOI: 10.1016/j.sder.2008.01.006] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Confocal microscopy is a new imaging modality for noninvasive real-time tissue imaging with high resolution and contrast comparable with conventional histology. Application of this technology to skin imaging during the last decade has been an exciting advance in dermatology, allowing a virtual widow into living skin without the need for a conventional biopsy or histologic processing of tissue. High-resolution noninvasive skin imaging with confocal microscopy has potential broad applications in the clinical and research arenas, including differentiating between benign and malignant skin lesions, tumor margin mapping, monitoring response to medical or surgical treatments, and pathophysiologic study of inflammatory processes.
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Affiliation(s)
- Kishwer S Nehal
- Memorial Sloan Kettering Cancer Center, New York, NY 10022, USA
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30
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Research Snippets. J Invest Dermatol 2007. [DOI: 10.1038/sj.jid.5700732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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