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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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2
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Cantisani C, Musolff N, Longo C, Di Guardo A, Rovaldi E, Rossi G, Sasso F, Farnetani F, Rega F, Bánvölgyiv A, Azzella G, Paolino G, Pellacani G. Dynamic optical coherence tomography evaluation in locally advanced basal cell carcinoma during sonidegib treatment. J Eur Acad Dermatol Venereol 2024; 38:967-973. [PMID: 38270330 DOI: 10.1111/jdv.19806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Accepted: 12/06/2023] [Indexed: 01/26/2024]
Abstract
BACKGROUND Basal cell carcinoma (BCC) is the most common cancer in the Caucasian population. It has a multifactorial pathogenesis, in which constitutive activation of the Sonic Hedgehog signalling (SHH) pathway (via mutations in PTCH1 or SMO genes) represents by far the most common genetic aberration. The introduction of vismodegib and sonidegib, two SHH pathway inhibitors, changed the therapeutic approach of locally advanced and metastatic BCCs. EADO's (European Association of Dermato-Oncology) new staging system refers to these as 'difficult-to-treat' BCCs. OBJECTIVE The aim was to evaluate sonidegib's effectiveness in patients affected by difficult-to-treat BCCs by using non-invasive diagnostic techniques. METHODS We retrospectively evaluated 14 patients (4 females, 10 males; mean age 77 ± 11 years) affected by difficult-to-treat BCCs treated with oral sonidegib 200 mg/day that were followed with total body videodermoscopy (V-Track, Vidix 4.0) and dynamic optical coherence tomography (D-OCT, VivoSight Dx) since May 2022. Considering the risk of rhabdomyolysis routine blood tests, especially for creatine kinase concentrations, were performed. All treated patients were inserted in the BasoCare database, which aims to offer support to patients taking sonidegib. Complete and partial responses were evaluated by the overall reduction of the number of lesions and their individual sizes. Safety was evaluated by assessing the occurrence and severity of adverse reactions. RESULTS Eighty per cent achieved complete clearance and 75% reduction of diameter. D-OCT scans performed at every follow-up showed concordance with clinical appearance and demonstrated reduction of hyporeflective structures, that is, islets of tumour cells and overall improvement of morphology. CONCLUSION Sonidegib can be considered an effective treatment option in cases where surgery or radiotherapy would be unfeasible or has previously failed, although pigmented lesions did not show complete clearance, suggesting that there are factors other than the SHH pathway involved in tumour growth. Videodermoscopy and D-OCT were useful in the quick and seamless follow-up of lesions and added valuable information in assessing efficacy.
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Affiliation(s)
- C Cantisani
- UOC of Dermatology, Policlinico Umberto I Hospital, Sapienza Medical School of Rome, Rome, Italy
| | - N Musolff
- UOC of Dermatology, Policlinico Umberto I Hospital, Sapienza Medical School of Rome, Rome, Italy
| | - C Longo
- Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Skin Cancer Center, Reggio Emilia, Italy
- Dermatology Department, University of Modena and Reggio, Emilia, Italy
| | - A Di Guardo
- UOC of Dermatology, Policlinico Umberto I Hospital, Sapienza Medical School of Rome, Rome, Italy
| | - E Rovaldi
- UOC of Dermatology, Policlinico Umberto I Hospital, Sapienza Medical School of Rome, Rome, Italy
| | - G Rossi
- UOC of Dermatology, Policlinico Umberto I Hospital, Sapienza Medical School of Rome, Rome, Italy
| | - F Sasso
- UOC of Dermatology, Policlinico Umberto I Hospital, Sapienza Medical School of Rome, Rome, Italy
| | - F Farnetani
- Dermatology Unit, Department of Surgical, Medical and Morphological Sciences Related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - F Rega
- UOC of Dermatology, Policlinico Umberto I Hospital, Sapienza Medical School of Rome, Rome, Italy
| | - A Bánvölgyiv
- Department of Dermatology, Venereology and Dermato-oncology, Semmelweis University, Budapest, Hungary
| | - G Azzella
- UOC of Dermatology, Policlinico Umberto I Hospital, Sapienza Medical School of Rome, Rome, Italy
| | - G Paolino
- Unit of Dermatology, IRCCS, Ospedale San Raffaele, Milano, Italy
- Unit of Dermatologic Clinic, Università Vita-Salute San Raffaele, Milano, Italy
| | - G Pellacani
- UOC of Dermatology, Policlinico Umberto I Hospital, Sapienza Medical School of Rome, Rome, Italy
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3
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Soare C, Cozma EC, Celarel AM, Rosca AM, Lupu M, Voiculescu VM. Digitally Enhanced Methods for the Diagnosis and Monitoring of Treatment Responses in Actinic Keratoses: A New Avenue in Personalized Skin Care. Cancers (Basel) 2024; 16:484. [PMID: 38339236 PMCID: PMC10854727 DOI: 10.3390/cancers16030484] [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: 12/03/2023] [Revised: 01/10/2024] [Accepted: 01/17/2024] [Indexed: 02/12/2024] Open
Abstract
Non-melanocytic skin cancers represent an important public health problem due to the increasing incidence and the important local destructive potential. Thus, the early diagnosis and treatment of precancerous lesions (actinic keratoses) is a priority for the dermatologist. In recent years, non-invasive skin imaging methods have seen an important development, moving from simple observational methods used in clinical research, to true diagnostic and treatment methods that make the dermatologist's life easier. Given the frequency of these precancerous lesions, their location on photo-exposed areas, as well as the long treatment periods, with variable, imprecise end-points, the need to use non-invasive imaging devices is increasingly evident to complete the clinical observations in the diagnosis and treatment of these lesions, with the aim of increasing accuracy and decreasing the adverse effects due to long treatment duration. This is the first review that brings together all skin imaging methods (dermoscopy, reflectance confocal microscopy, ultrasonography, dermoscopy-guided high frequency ultrasonography, and optical coherence tomography) used in the evaluation of actinic keratoses and their response to different treatment regimens.
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Affiliation(s)
- Cristina Soare
- Department of Oncological Dermatology, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (C.S.); (M.L.); (V.M.V.)
| | - Elena Codruta Cozma
- Department of Pathophysiology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
- Department of Dermatology and Allergology, Elias University Emergency Hospital, 011461 Bucharest, Romania;
| | - Ana Maria Celarel
- Department of Dermatology and Allergology, Elias University Emergency Hospital, 011461 Bucharest, Romania;
| | - Ana Maria Rosca
- Department of Dermatology, University Military Hospital “Dr. Carol Davila”, 010825 Bucharest, Romania;
| | - Mihai Lupu
- Department of Oncological Dermatology, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (C.S.); (M.L.); (V.M.V.)
| | - Vlad Mihai Voiculescu
- Department of Oncological Dermatology, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (C.S.); (M.L.); (V.M.V.)
- Department of Dermatology and Allergology, Elias University Emergency Hospital, 011461 Bucharest, Romania;
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4
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Varga NN, Boostani M, Farkas K, Bánvölgyi A, Lőrincz K, Posta M, Lihacova I, Lihachev A, Medvecz M, Holló P, Paragh G, Wikonkál NM, Bozsányi S, Kiss N. Optically Guided High-Frequency Ultrasound Shows Superior Efficacy for Preoperative Estimation of Breslow Thickness in Comparison with Multispectral Imaging: A Single-Center Prospective Validation Study. Cancers (Basel) 2023; 16:157. [PMID: 38201584 PMCID: PMC10778011 DOI: 10.3390/cancers16010157] [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: 11/16/2023] [Revised: 12/07/2023] [Accepted: 12/21/2023] [Indexed: 01/12/2024] Open
Abstract
Melanoma is the most aggressive form of skin cancer that is known for its metastatic potential and has an increasing incidence worldwide. Breslow thickness, which determines the staging and surgical margin of the tumor, is unavailable at initial diagnosis. Novel imaging techniques for assessing Breslow thickness lack comparative data. This study evaluates optically guided high-frequency ultrasound (OG-HFUS) and multispectral imaging (MSI) for preoperative estimation of Breslow thickness and staging. We enrolled 101 patients with histologically confirmed primary melanoma and categorized them based on tumor thickness. Optically guided 33 MHz HFUS and MSI were utilized for the assessment. Our MSI-based algorithm categorized melanomas into three subgroups with a sensitivity of 62.6%, specificity of 81.3%, and fair agreement (κ = 0.440, CI: 0.298-0.583). In contrast, OG-HFUS demonstrated a sensitivity of 91.8%, specificity of 96.0%, and almost perfect agreement (κ = 0.858, CI: 0.763-0.952). OG-HFUS performed better than MSI in estimating Breslow thickness, emphasizing its potential as a valuable tool for melanoma diagnosis and patient management. OG-HFUS holds promise for enhancing preoperative staging and treatment decision-making in melanoma.
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Affiliation(s)
- Noémi Nóra Varga
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary; (N.N.V.); (M.B.); (K.F.); (A.B.); (K.L.); (M.M.); (P.H.); (N.M.W.); (S.B.)
| | - Mehdi Boostani
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary; (N.N.V.); (M.B.); (K.F.); (A.B.); (K.L.); (M.M.); (P.H.); (N.M.W.); (S.B.)
| | - Klára Farkas
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary; (N.N.V.); (M.B.); (K.F.); (A.B.); (K.L.); (M.M.); (P.H.); (N.M.W.); (S.B.)
| | - András Bánvölgyi
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary; (N.N.V.); (M.B.); (K.F.); (A.B.); (K.L.); (M.M.); (P.H.); (N.M.W.); (S.B.)
| | - Kende Lőrincz
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary; (N.N.V.); (M.B.); (K.F.); (A.B.); (K.L.); (M.M.); (P.H.); (N.M.W.); (S.B.)
| | - Máté Posta
- Systems Biology of Reproduction Research Group, Institute of Molecular Life Sciences, HUN-REN Research Centre for Natural Sciences, 1117 Budapest, Hungary;
| | - Ilze Lihacova
- Biophotonics Laboratory, Institute of Atomic Physics and Spectroscopy, University of Latvia, 1004 Riga, Latvia; (I.L.); (A.L.)
| | - Alexey Lihachev
- Biophotonics Laboratory, Institute of Atomic Physics and Spectroscopy, University of Latvia, 1004 Riga, Latvia; (I.L.); (A.L.)
| | - Márta Medvecz
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary; (N.N.V.); (M.B.); (K.F.); (A.B.); (K.L.); (M.M.); (P.H.); (N.M.W.); (S.B.)
| | - Péter Holló
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary; (N.N.V.); (M.B.); (K.F.); (A.B.); (K.L.); (M.M.); (P.H.); (N.M.W.); (S.B.)
| | - Gyorgy Paragh
- Department of Dermatology, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14203, USA;
| | - Norbert M. Wikonkál
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary; (N.N.V.); (M.B.); (K.F.); (A.B.); (K.L.); (M.M.); (P.H.); (N.M.W.); (S.B.)
| | - Szabolcs Bozsányi
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary; (N.N.V.); (M.B.); (K.F.); (A.B.); (K.L.); (M.M.); (P.H.); (N.M.W.); (S.B.)
- Department of Dermatology, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14203, USA;
| | - Norbert Kiss
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary; (N.N.V.); (M.B.); (K.F.); (A.B.); (K.L.); (M.M.); (P.H.); (N.M.W.); (S.B.)
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5
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Fitzgerald S, Akhtar J, Schartner E, Ebendorff-Heidepriem H, Mahadevan-Jansen A, Li J. Multimodal Raman spectroscopy and optical coherence tomography for biomedical analysis. JOURNAL OF BIOPHOTONICS 2023; 16:e202200231. [PMID: 36308009 PMCID: PMC10082563 DOI: 10.1002/jbio.202200231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 10/19/2022] [Accepted: 10/26/2022] [Indexed: 06/16/2023]
Abstract
Optical techniques hold great potential to detect and monitor disease states as they are a fast, non-invasive toolkit. Raman spectroscopy (RS) in particular is a powerful label-free method capable of quantifying the biomolecular content of tissues. Still, spontaneous Raman scattering lacks information about tissue morphology due to its inability to rapidly assess a large field of view. Optical Coherence Tomography (OCT) is an interferometric optical method capable of fast, depth-resolved imaging of tissue morphology, but lacks detailed molecular contrast. In many cases, pairing label-free techniques into multimodal systems allows for a more diverse field of applications. Integrating RS and OCT into a single instrument allows for both structural imaging and biochemical interrogation of tissues and therefore offers a more comprehensive means for clinical diagnosis. This review summarizes the efforts made to date toward combining spontaneous RS-OCT instrumentation for biomedical analysis, including insights into primary design considerations and data interpretation.
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Affiliation(s)
- Sean Fitzgerald
- Vanderbilt Biophotonics Center, Nashville, Tennessee, USA
- Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee, USA
| | - Jobaida Akhtar
- School of Physical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
- Institute for Photonics and Advanced Sensing, The University of Adelaide, Adelaide, South Australia, Australia
- Australian Research Council Centre of Excellence for Nanoscale BioPhotonics, Adelaide, South Australia, Australia
| | - Erik Schartner
- School of Physical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
- Institute for Photonics and Advanced Sensing, The University of Adelaide, Adelaide, South Australia, Australia
- Australian Research Council Centre of Excellence for Nanoscale BioPhotonics, Adelaide, South Australia, Australia
| | - Heike Ebendorff-Heidepriem
- School of Physical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
- Institute for Photonics and Advanced Sensing, The University of Adelaide, Adelaide, South Australia, Australia
- Australian Research Council Centre of Excellence for Nanoscale BioPhotonics, Adelaide, South Australia, Australia
| | - Anita Mahadevan-Jansen
- Vanderbilt Biophotonics Center, Nashville, Tennessee, USA
- Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee, USA
| | - Jiawen Li
- Institute for Photonics and Advanced Sensing, The University of Adelaide, Adelaide, South Australia, Australia
- Australian Research Council Centre of Excellence for Nanoscale BioPhotonics, Adelaide, South Australia, Australia
- School of Electrical and Electronic Engineering, The University of Adelaide, Adelaide, South Australia, Australia
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6
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Janowska A, Oranges T, Granieri G, Romanelli M, Fidanzi C, Iannone M, Dini V. Non-invasive imaging techniques in presurgical margin assessment of basal cell carcinoma: Current evidence. Skin Res Technol 2023; 29:e13271. [PMID: 36823508 PMCID: PMC10155792 DOI: 10.1111/srt.13271] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 12/19/2022] [Indexed: 02/05/2023]
Abstract
BACKGROUND The diagnosis of basal cell carcinoma (BCC) is based on clinical and dermoscopical features. In uncertain cases, innovative imaging techniques, such as reflectance confocal microscopy (RCM) and optical coherence tomography (OCT), have been used. The main limitation of these techniques is the inability to study deep margins. HFUS (high-frequency ultrasound) and the most recent UHFUS (ultra-high-frequency ultrasound) have been used in various applications in dermatology, but they are not yet routinely used in the diagnosis of BCC. A key point in clinical practice is to find an imaging technique that can help to reduce post-surgical recurrences with a careful presurgical assessment of the lesional margins. This technique should show high sensitivity, specificity, reproducibility and simplicity of execution. This concept is very important for the optimal management of patients who are often elderly and have many comorbidities. The aim of the paper is to analyse the characteristics of current imaging techniques and the studies in the literature on this topic. MATERIALS AND METHODS The authors independently searched the MEDLINE, PubMed, Embase, Scopus, ScienceDirect and Cochrane Library databases for studies looking for non-invasive imaging techniques for the presurgical margin assessment of BCC. RESULTS Preoperative study of the BCC subtype can help to obtain a complete excision with free margins. Different non-invasive imaging techniques have been studied for in vivo evaluation of tumour margins, comparing the histologic evaluation with a radical surgery. The possibility to study the lateral and deep margins would allow a reduction of recurrences and sparing of healthy tissue. CONCLUSION HFUS and UHFUS represent the most promising, non-invasive techniques for the pre-operative study of BCC facilitating the characterization of vascularization, deep lateral margins and high-risk subtypes, although they are limited by insufficient literature unlike RCM and OCT.
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Affiliation(s)
| | - Teresa Oranges
- Department of DermatologyAzienda Ospedaliero‐Universitaria Ospedale Pediatrico MeyerFlorenceItaly
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7
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One-class machine learning classification of skin tissue based on manually scanned optical coherence tomography imaging. Sci Rep 2023; 13:867. [PMID: 36650283 PMCID: PMC9845382 DOI: 10.1038/s41598-023-28155-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 01/13/2023] [Indexed: 01/19/2023] Open
Abstract
We investigated a method for automatic skin tissue characterization based on optical coherence tomography (OCT) imaging. We developed a manually scanned single fiber OCT instrument to perform in vivo skin imaging and tumor boundary assessment. The goal is to achieve more accurate tissue excision in Mohs micrographic surgery (MMS) and reduce the time required for MMS. The focus of this study was to develop a novel machine learning classification method to automatically identify abnormal skin tissues through one-class classification. We trained a deep convolutional neural network (CNN) with a U-Net architecture for automatic skin segmentation, used the pre-trained U-Net as a feature extractor, and trained one-class support vector machine (SVM) classifiers to detect abnormal tissues. The novelty of this study is the use of a neural network as a feature extractor and the use of a one-class SVM for abnormal tissue detection. Our approach eliminated the need to engineer the features for classification and eliminated the need to train the classifier with data obtained from abnormal tissues. To validate the effectiveness of the one-class classification method, we assessed the performance of our algorithm using computer synthesized data, and experimental data. We also performed a pilot study on a patient with skin cancer.
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8
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Beaulieu D, Tsao H, Michaud DS, Okhovat JP, Halpern AC, Geller AC. Factors associated with suspected nonmelanoma skin cancers, dysplastic nevus, and cutaneous melanoma among first-time SpotMe screening program participants during 2009-2010. J Am Acad Dermatol 2023; 88:60-70. [PMID: 30543833 DOI: 10.1016/j.jaad.2018.12.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Revised: 10/30/2018] [Accepted: 12/02/2018] [Indexed: 11/17/2022]
Abstract
BACKGROUND There have been no studies of the American Academy of Dermatology's SpotMe skin cancer screening program to collectively analyze and determine the factors associated with suspected basal cell carcinoma (BCC), squamous cell carcinoma (SCC), dysplastic nevus (DN), and cutaneous melanoma (CM) diagnoses. OBJECTIVE Describe the demographics, risk factors, and access to care profiles associated with suspected diagnoses of BCC, SCC, DN, and CM among first-time SpotMe screenees during 2009-2010. METHODS We conducted a cross-sectional analysis of data from the SpotMe skin cancer screenings conducted in 2009 and 2010. We performed multivariable logistic regression analysis for each diagnosis, incorporating standard demographic, access to care, and risk factor variables in the models. RESULTS Men, those without a regular dermatologist, persons reporting recently changing moles, and those with a personal history of melanoma were at increased risk for each of the suspected diagnoses analyzed. Uninsured persons were at increased risk for suspected malignancies (BCC, SCC, and CM). LIMITATIONS Lack of histologic confirmation for diagnoses and cross-sectional design. CONCLUSION Among first-time SpotMe participants, suspected diagnoses of BCC, SCC, DN, and CM shared several associated factors, which may be considered when planning outreach and screening for populations at risk for skin cancer.
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Affiliation(s)
- Derek Beaulieu
- Tufts University School of Medicine, Tufts Clinical and Translational Science Institute, Boston, Massachusetts; Signature Healthcare Brockton Hospital, Beth Israel Deaconess Medical Center, Brockton, Massachusetts
| | - Hensin Tsao
- Wellman Center for Photomedicine, Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Dominique S Michaud
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Tufts Clinical and Translational Science Institute, Boston, Massachusetts
| | - Jean-Phillip Okhovat
- Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts
| | - Allan C Halpern
- Dermatology Service of the Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Alan C Geller
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
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9
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Basal Cell Carcinoma. Dermatol Clin 2022; 41:13-21. [DOI: 10.1016/j.det.2022.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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10
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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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11
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Adan F, Mosterd K, Wolswijk T, Kelleners-Smeets NWJ, Essers BAB. Patient Preference for Optical Coherence Tomography versus Punch Biopsy for Diagnosis of Basal Cell Carcinoma: A Labelled Discrete Choice Experiment. Acta Derm Venereol 2021; 102:adv00638. [PMID: 34904680 DOI: 10.2340/actadv.v101.977] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Abstract is missing (Short communication)
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Affiliation(s)
- Fieke Adan
- Department of Dermatology, Maastricht University Medical Centre, Maastricht, NL 6229 HX Maastricht, The Netherlands.
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12
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Von Knorring T, Israelsen NM, Ung V, Formann JL, Jensen M, Hædersdal M, Bang O, Fredman G, Mogensen M. Bedside Differentiation Between Benign and Malignant Pigmented Skin Tumours by Four Diagnostic Imaging Technologies - A Pilot Study. Acta Derm Venereol 2021; 102:adv00634. [PMID: 34806755 DOI: 10.2340/actadv.v101.571] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Fast diagnosis of suspicious pigmented skin lesions is imperative, but current bedside skin imaging technologies are either limited in penetration depth or resolution. Combining imaging methods is therefore highly relevant for skin cancer diagnostics. This pilot study evaluates the ability of optical coherence tomography, reflectance confocal microscopy, photoacoustic imaging and high-frequency ultrasound to differentiate malignant from benign pigmented skin lesions. A total of 41 pigmented skin tumours were scanned prior to excision. Morphologic features and blood vessel characteristics were analysed in reflectance confocal microscopy, optical coherence tomography, high-frequency ultrasound and photoacoustic imaging images and diagnostic accuracy assessed. Three novel photoacoustic imaging features, 7 reflectance confocal microscopy features and two optical coherence tomography features were detected with a high correlation to malignancy, diagnostic accuracy > 71%. No significant features were found in high-frequency ultrasound. Conclusively, optical coherence tomography, reflectance confocal microscopy and photoacoustic imaging in combination enables image-guided evaluation of suspicious pigmented skin tumours at the bedside. Combining these advanced techniques may help to diagnose skin cancer more efficiently.
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Affiliation(s)
- Terese Von Knorring
- Department of Dermatology, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Nielsine Nielsens Vej 17, DK-2400 Copenhagen, Denmark.
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13
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Pathania YS, Apalla Z, Salerni G, Patil A, Grabbe S, Goldust M. Non-invasive diagnostic techniques in pigmentary skin disorders and skin cancer. J Cosmet Dermatol 2021; 21:444-450. [PMID: 34724325 DOI: 10.1111/jocd.14547] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 10/04/2021] [Accepted: 10/11/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Diagnosis of pigmentary skin disorders, pre-cancerous and cancerous skin diseases is traditionally relied on visual assessment. The most widely applied invasive diagnostic technique is the skin biopsy. There have been significant technological advances in non-invasive diagnostic methods for skin disorders. OBJECTIVE The objective of this article is to discuss different non-invasive diagnostic modalities, used in the diagnosis of pigmentary skin disorders and cutaneous cancers. METHODS Comprehensive literature search was performed to screen articles related to non-invasive diagnostic techniques in pigmentary skin disorders and cutaneous cancers. Articles published in journals indexed in PubMed were searched along with those in Google Scholar. Clinical trials, review articles, case series, case reports and other relevant articles were considered for review. References of relevant articles were also considered for review. RESULTS Dermoscopy and ultrasonography were the only non-invasive diagnostic and imaging techniques available to dermatologists for many years. The advent of computed tomography (CT) and magnetic resonance imaging (MRI) augmented the visualization of deeper structures. Confocal laser microscopy (CLM) and reflectance spectrophotometers have showed promising results in the non-invasive detection of pigmented lesions. Optical coherence tomography (OCT), electrical impedance spectroscopy (EIS), multispectral imaging, high frequency ultrasonography (HFUS) and adhesive patch biopsy aid in the accurate diagnosis of benign, as well as neoplastic skin diseases. CONCLUSION There have been significant advancements in non-invasive methods for diagnosis of dermatological diseases. These techniques can be repeatedly used in a comfort manner for the patient, and may offer an objective way to follow the course of a disease.
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Affiliation(s)
- Yashdeep Singh Pathania
- Department of Dermatology, Venereology and Leprology, All India Institute of Medical Sciences, Jodhpur, India
| | - Zoe Apalla
- Second Dermatology Department, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Gabriel Salerni
- Department of Dermatology, Hospital Provincial del Centenario de Rosario-Universidad Nacional de Rosario, Rosario, Argentina
| | - Anant Patil
- Department of Pharmacology, Dr. DY Patil Medical College, Navi Mumbai, India
| | - Stephan Grabbe
- Department of Dermatology, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Mohamad Goldust
- Department of Dermatology, University Medical Center Mainz, Mainz, Germany
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14
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Liu Y, Chen D, Xu J, Tan Y, Wang Y, Zhao H, Li H, Liu H, Gu Y, Qiu H. Quantitative assessment of vascular features in port wine stains through optical coherence tomography angiography. Photodiagnosis Photodyn Ther 2021; 36:102607. [PMID: 34706276 DOI: 10.1016/j.pdpdt.2021.102607] [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: 02/09/2021] [Revised: 10/16/2021] [Accepted: 10/22/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Vascular lesions such as port wine stains (PWS) lead to facial and psychological problems, which require careful and precise treatments. The key point of treating PWS is to selectively destroy the abnormal blood vessels. Hence, the in vivo monitoring of targeted vessels is crucial. Optical coherence tomography angiography (OCTA), an emerging label-free imaging tool, facilitates the evaluation of skin structure and vasculature at a high resolution. In this study, we utilised OCTA to capture the structural and vascular morphology in patients with PWS. Moreover, we quantitatively characterised the morphological features of different types of PWS. METHODS This observational clinical study was conducted on 3 patients with flat PWS and 3 patients with thickened PWS. The age range was 4-27 years, and all of them had not received any treatment before this study. The OCTA images of the PWS lesions and contralateral skin were compared. Vascular morphology was characterized, and ectatic vessel depth was quantified according to the OCTA images. RESULTS The blood vessels of the PWS lesions tend to had larger diameters and higher densities than those in the contralateral normal skin. The vessel diameters of PWS lesions were 73 ± 14 μm, with high heterogeneity ranging from 10 to >150 μm, however, the vessel diameters of normal skin were 28 ± 2 μm, ranging from 10 μm to 60 μm. In terms of different PWS lesions, the thickened type showed a trend of larger vessel diameter and higher density than those of the purplish red type. The ectatic vessels were located at the depth of 216 ± 13 μm in the PWS skin. CONCLUSIONS OCTA can facilitate the in vivo three-dimensional visualization of structure and vasculature for PWS lesions. Various quantitative analysis parameters, such as vessel diameter, density, and depth, are typically measured using OCTA. This fact demonstrates the superior capability of OCTA for the precise and comprehensive assessment of PWS lesions.
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Affiliation(s)
- Yidi Liu
- Medical School of Chinese PLA, Beijing 100853, China; Department of Laser Medicine, the First Medical Centre, Chinese PLA General Hospital, Beijing 100853, China
| | - Defu Chen
- Institute of Engineering Medicine, Beijing Institute of Technology, Beijing 100081, China
| | - Jingjiang Xu
- School of Physics and Optoelectronic Engineering, Foshan University, Foshan 528000, China
| | - Yizhou Tan
- Department of Laser Medicine, the First Medical Centre, Chinese PLA General Hospital, Beijing 100853, China
| | - Ying Wang
- Department of Laser Medicine, the First Medical Centre, Chinese PLA General Hospital, Beijing 100853, China
| | - Hongyou Zhao
- Institute of Engineering Medicine, Beijing Institute of Technology, Beijing 100081, China
| | - Hui Li
- Medical School of Chinese PLA, Beijing 100853, China; Department of Laser Medicine, the First Medical Centre, Chinese PLA General Hospital, Beijing 100853, China
| | - Haolin Liu
- Medical School of Chinese PLA, Beijing 100853, China; Department of Laser Medicine, the First Medical Centre, Chinese PLA General Hospital, Beijing 100853, China
| | - Ying Gu
- Department of Laser Medicine, the First Medical Centre, Chinese PLA General Hospital, Beijing 100853, China; Institute of Engineering Medicine, Beijing Institute of Technology, Beijing 100081, China; Precision laser medical diagnosis and treatment Innovation unit, Chinese Academy of Medical Sciences, Beijing 100000, China.
| | - Haixia Qiu
- Department of Laser Medicine, the First Medical Centre, Chinese PLA General Hospital, Beijing 100853, China.
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15
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Li Y, Murthy RS, Zhu Y, Zhang F, Tang J, Mehrabi JN, Kelly KM, Chen Z. 1.7-Micron Optical Coherence Tomography Angiography for Characterization of Skin Lesions-A Feasibility Study. IEEE TRANSACTIONS ON MEDICAL IMAGING 2021; 40:2507-2512. [PMID: 33999817 PMCID: PMC8834583 DOI: 10.1109/tmi.2021.3081066] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Optical coherence tomography (OCT) is a non-invasive diagnostic method that offers real-time visualization of the layered architecture of the skin in vivo. The 1.7-micron OCT system has been applied in cardiology, gynecology and dermatology, demonstrating an improved penetration depth in contrast to conventional 1.3-micron OCT. To further extend the capability, we developed a 1.7-micron OCT/OCT angiography (OCTA) system that allows for visualization of both morphology and microvasculature in the deeper layers of the skin. Using this imaging system, we imaged human skin with different benign lesions and described the corresponding features of both structure and vasculature. The significantly improved imaging depth and additional functional information suggest that the 1.7-micron OCTA system has great potential to advance both dermatological clinical and research settings for characterization of benign and cancerous skin lesions.
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16
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Chuchvara N, Rao B, Liu X. Manually scanned single fiber optical coherence tomography for skin cancer characterization. Sci Rep 2021; 11:15570. [PMID: 34330974 PMCID: PMC8324861 DOI: 10.1038/s41598-021-95118-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 07/20/2021] [Indexed: 11/25/2022] Open
Abstract
Optical coherence tomography (OCT) is a cross-sectional imaging modality based on low coherence light interferometry. Within dermatology, it has found applications for in vivo diagnostic imaging purposes, as well as to guide Mohs micrographic surgery (MMS), due to its ability to visualize skin morphology up to several millimeters in depth. However, standard OCT probes have a large footprint and capture an extended area of the skin, making it difficult to precisely pinpoint clinically relevant location being imaged. Mohs surgeons stand to benefit from a handheld in vivo imaging device that can accurately trace surgical margins. In this study, we demonstrate the use of a single fiber OCT (sfOCT) instrument. Our imaging system features a miniature common path single fiber probe, and a novel speckle decorrelation technique that generates distortion free 2D images from manual scanning.By manually moving the single-fiber probe across the region of interest, the user can perform a lateral OCT scan while visualizing the location of the probe during data acquisition. Using the sfOCT, we have identified normal skin morphology, qualitatively correlated features of basal cell carcinoma and squamous cell carcinoma with histopathology, and quantified the disruption of the dermo-epidermal junction OCT pattern in skin tumors-each demonstrating the potential of utilizing sfOCT to differentiate tumor from normal skin. Using this imaging tool, a Mohs surgeon can enhance determination of surgical margins for the first stage of MMS, potentially decreasing the time and number of stages required for complete tumor removal.
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Affiliation(s)
- Nadiya Chuchvara
- Center for Dermatology, Rutgers Robert Wood Johnson Medical School, 1 Worlds Fair Drive, Somerset, NJ, 08873, USA
| | - Babar Rao
- Center for Dermatology, Rutgers Robert Wood Johnson Medical School, 1 Worlds Fair Drive, Somerset, NJ, 08873, USA
- Rao Dermatology, 95 First Avenue, Atlantic Highlands, NJ, 07716, USA
- Department of Dermatology, Weill Cornell Medicine, 1305 York Ave 9th Floor, New York, NY, 10021, USA
| | - Xuan Liu
- Department of Electrical and Computer Engineering, New Jersey Institute of Technology, University Heights, Newark, NJ, 07102, USA.
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17
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Liu X, Chuchvara N, Liu Y, Rao B. Real-time deep learning assisted skin layer delineation in dermal optical coherence tomography. OSA CONTINUUM 2021; 4:2008-2023. [PMID: 35822177 PMCID: PMC9273005 DOI: 10.1364/osac.426962] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
We present deep learning assisted optical coherence tomography (OCT) imaging for quantitative tissue characterization and differentiation in dermatology. We utilize a manually scanned single fiber OCT (sfOCT) instrument to acquire OCT images from the skin. The focus of this study is to train a U-Net for automatic skin layer delineation. We demonstrate that U-Net allows quantitative assessment of epidermal thickness automatically. U-Net segmentation achieves high accuracy for epidermal thickness estimation for normal skin and leads to a clear differentiation between normal skin and skin lesions. Our results suggest that a single fiber OCT instrument with AI assisted skin delineation capability has the potential to become a cost-effective tool in clinical dermatology, for diagnosis and tumor margin detection.
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Affiliation(s)
- Xuan Liu
- Department of Electrical and Computer Engineering, New Jersey Institute of Technology, University Heights, Newark, NJ 07102, USA
| | - Nadiya Chuchvara
- Center for Dermatology, Rutgers Robert Wood Johnson Medical School, 1 Worlds Fair Drive, Somerset, NJ 08873, USA
| | - Yuwei Liu
- Department of Electrical and Computer Engineering, New Jersey Institute of Technology, University Heights, Newark, NJ 07102, USA
| | - Babar Rao
- Center for Dermatology, Rutgers Robert Wood Johnson Medical School, 1 Worlds Fair Drive, Somerset, NJ 08873, USA
- Rao Dermatology, 95 First Avenue, Atlantic Highlands, NJ 07716, USA
- Department of Dermatology, Weill Cornell Medicine, 1305 York Ave 9th Floor, New York, NY 10021, USA
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18
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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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19
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Zhu AQ, Wang LF, Li XL, Wang Q, Li MX, Ma YY, Xiang LH, Guo LH, Xu HX. High-frequency ultrasound in the diagnosis of the spectrum of cutaneous squamous cell carcinoma: Noninvasively distinguishing actinic keratosis, Bowen's Disease, and invasive squamous cell carcinoma. Skin Res Technol 2021; 27:831-840. [PMID: 33751714 DOI: 10.1111/srt.13028] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2020] [Accepted: 02/13/2021] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To evaluate high-frequency ultrasound (HFUS) features for diagnosing cutaneous squamous cell carcinoma (cSCC) as a spectrum of progressively advanced malignancies, including precursor actinic keratosis (AK), Bowen's disease (BD), and invasive squamous cell carcinoma (iSCC). METHOD In this retrospective study, 160 skin lesions diagnosed histopathologically (54 AK, 54 BD, and 52 iSCC) in 160 patients were included. The HFUS features of AK, BD, and iSCC were analyzed. The obtained data were evaluated using univariate and forward multivariate logistic regression analyses. RESULTS The most significant HFUS features in AK were regular surface (odds ratio [OR], 8.42) and irregular basal border (OR, 6.36). The most significant HFUS features in BD were crumpled surface (OR, 19.62) and layer involvement confined to the epidermis (OR, 3.96). The most significant HFUS features in iSCC were concave surface (OR, 27.06), stratum corneum (SC) detachment (OR, 14.41), irregular basal border (OR, 4.01), and convex surface (OR, 3.73). The characteristics of surface features, basal border, and layer involvement could be valuable HFUS clues in the discrimination of AK, BD, and iSCC. CONCLUSION High-frequency ultrasound is valuable for the differentiation of AK, BD, and iSCC, which may allow dynamic and noninvasive monitoring in the spectrum of cSCC.
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Affiliation(s)
- An-Qi Zhu
- Department of Medical Ultrasound, Shanghai Skin Disease Hospital, Ultrasound Research and Education Institute, Tongji University School of Medicine, Shanghai, China.,Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Ultrasound Research and Education Institute, Clinical Research Center for Interventional Medicine, Shanghai Engineering Research Center of Ultrasound Diagnosis and Treatment, Tongji University School of Medicine, Shanghai, China.,Tumor Minimally Invasive Treatment Center, Tongji University Cancer Center, Shanghai, China
| | - Li-Fan Wang
- Department of Medical Ultrasound, Shanghai Skin Disease Hospital, Ultrasound Research and Education Institute, Tongji University School of Medicine, Shanghai, China.,Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Ultrasound Research and Education Institute, Clinical Research Center for Interventional Medicine, Shanghai Engineering Research Center of Ultrasound Diagnosis and Treatment, Tongji University School of Medicine, Shanghai, China.,Tumor Minimally Invasive Treatment Center, Tongji University Cancer Center, Shanghai, China
| | - Xiao-Long Li
- Department of Medical Ultrasound, Shanghai Skin Disease Hospital, Ultrasound Research and Education Institute, Tongji University School of Medicine, Shanghai, China.,Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Ultrasound Research and Education Institute, Clinical Research Center for Interventional Medicine, Shanghai Engineering Research Center of Ultrasound Diagnosis and Treatment, Tongji University School of Medicine, Shanghai, China.,Tumor Minimally Invasive Treatment Center, Tongji University Cancer Center, Shanghai, China
| | - Qiao Wang
- Department of Medical Ultrasound, Shanghai Skin Disease Hospital, Ultrasound Research and Education Institute, Tongji University School of Medicine, Shanghai, China.,Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Ultrasound Research and Education Institute, Clinical Research Center for Interventional Medicine, Shanghai Engineering Research Center of Ultrasound Diagnosis and Treatment, Tongji University School of Medicine, Shanghai, China.,Tumor Minimally Invasive Treatment Center, Tongji University Cancer Center, Shanghai, China
| | - Ming-Xu Li
- Department of Medical Ultrasound, Shanghai Skin Disease Hospital, Ultrasound Research and Education Institute, Tongji University School of Medicine, Shanghai, China.,Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Ultrasound Research and Education Institute, Clinical Research Center for Interventional Medicine, Shanghai Engineering Research Center of Ultrasound Diagnosis and Treatment, Tongji University School of Medicine, Shanghai, China.,Tumor Minimally Invasive Treatment Center, Tongji University Cancer Center, Shanghai, China
| | - Yuan-Yuan Ma
- Department of Medical Ultrasound, Shanghai Skin Disease Hospital, Ultrasound Research and Education Institute, Tongji University School of Medicine, Shanghai, China
| | - Li-Hua Xiang
- Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Ultrasound Research and Education Institute, Clinical Research Center for Interventional Medicine, Shanghai Engineering Research Center of Ultrasound Diagnosis and Treatment, Tongji University School of Medicine, Shanghai, China.,Tumor Minimally Invasive Treatment Center, Tongji University Cancer Center, Shanghai, China
| | - Le-Hang Guo
- Department of Medical Ultrasound, Shanghai Skin Disease Hospital, Ultrasound Research and Education Institute, Tongji University School of Medicine, Shanghai, China.,Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Ultrasound Research and Education Institute, Clinical Research Center for Interventional Medicine, Shanghai Engineering Research Center of Ultrasound Diagnosis and Treatment, Tongji University School of Medicine, Shanghai, China.,Tumor Minimally Invasive Treatment Center, Tongji University Cancer Center, Shanghai, China
| | - Hui-Xiong Xu
- Department of Medical Ultrasound, Shanghai Skin Disease Hospital, Ultrasound Research and Education Institute, Tongji University School of Medicine, Shanghai, China.,Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Ultrasound Research and Education Institute, Clinical Research Center for Interventional Medicine, Shanghai Engineering Research Center of Ultrasound Diagnosis and Treatment, Tongji University School of Medicine, Shanghai, China.,Tumor Minimally Invasive Treatment Center, Tongji University Cancer Center, Shanghai, China
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20
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Csuka EA, Ward SC, Ekelem C, Csuka DA, Ardigò M, Mesinkovska NA. Reflectance Confocal Microscopy, Optical Coherence Tomography, and Multiphoton Microscopy in Inflammatory Skin Disease Diagnosis. Lasers Surg Med 2021; 53:776-797. [PMID: 33527483 DOI: 10.1002/lsm.23386] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 01/13/2021] [Accepted: 01/18/2021] [Indexed: 12/27/2022]
Abstract
BACKGROUND AND OBJECTIVES Technological advances in medicine have brought about many novel skin imaging devices. This review aims to evaluate the scientific evidence supporting the use of noninvasive optical imaging techniques to aid in the diagnosis and prognosis of inflammatory skin diseases. STUDY DESIGN/MATERIALS AND METHODS PubMed and Scopus were searched in September 2020 according to PRISMA guidelines for articles using reflectance confocal microscopy (RCM), optical coherence tomography (OCT), and multiphoton microscopy (MPM) in inflammatory skin diseases, excluding studies monitoring treatment efficacy. RESULTS At the time of the study, there were 66 articles that addressed the utilization of noninvasive imaging in interface, spongiotic, psoriasiform, vesiculobullous, and fibrosing/sclerosing inflammatory skin dermatoses: RCM was utilized in 46, OCT in 16, and MPM in 5 articles. RCM was most investigated in psoriasiform dermatoses, whereas OCT and MPM were both most investigated in spongiotic dermatoses, including atopic dermatitis and allergic contact dermatitis. CONCLUSIONS There is preliminary evidence to support the diagnostic potential of noninvasive optical imaging techniques in inflammatory skin diseases. Improvements in the devices and further correlation with histology will help broaden their utility. Additional studies are needed to determine the parameters for diagnostic features, disease differentiation, and staging of inflammatory skin conditions. Lasers Surg. Med. © 2021 Wiley Periodicals LLC.
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Affiliation(s)
- Ella A Csuka
- Department of Dermatology, University of California, Irvine, Irvine, California, 92697
| | - Suzanne C Ward
- Department of Dermatology, University of California, Irvine, Irvine, California, 92697
| | - Chloe Ekelem
- Department of Dermatology, University of California, Irvine, Irvine, California, 92697
| | - David A Csuka
- Department of Dermatology, University of California, Irvine, Irvine, California, 92697
| | - Marco Ardigò
- San Gallicano Dermatological Institute-IRCCS, Via Chianesi 53, Rome, 00144, Italy
| | - Natasha A Mesinkovska
- Department of Dermatology, University of California, Irvine, Irvine, California, 92697
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21
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Gill M, Sahu A, Alessi-Fox C, Cordova M, Gonzalez S, Iftimia N, Aleissa S, Navarrete-Dechent C, Dusza S, Rossi A, Marghoob AA, Rajadhyaksha M, Chen CSJ. Angulated small nests and cords: Key diagnostic histopathologic features of infiltrative basal cell carcinoma can be identified using integrated reflectance confocal microscopy-optical coherence tomography. J Cutan Pathol 2021; 48:53-65. [PMID: 32989842 PMCID: PMC7755835 DOI: 10.1111/cup.13871] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 07/27/2020] [Accepted: 08/23/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Accurate basal cell carcinoma (BCC) subtyping is requisite for appropriate management, but non-representative sampling occurs in 18% to 25% of biopsies. By enabling non-invasive diagnosis and more comprehensive sampling, integrated reflectance confocal microscopy-optical coherence tomography (RCM-OCT) may improve the accuracy of BCC subtyping and subsequent management. We evaluated RCM-OCT images and histopathology slides for the presence of two key features, angulation and small nests and cords, and calculated (a) sensitivity and specificity of these features, combined and individually, for identifying an infiltrative BCC subtype and (b) agreement across modalities. METHODS Thirty-three RCM-OCT-imaged, histopathologically-proven BCCs (17 superficial and/or nodular; 16 containing an infiltrative component) were evaluated. RESULTS The presence of angulation or small nests and cords was sufficient to identify infiltrative BCC on RCM-OCT with 100% sensitivity and 82% specificity, similar to histopathology (100% sensitivity, 88% specificity, kappa = 0.82). When both features were present, the sensitivity for identifying infiltrative BCC was 100% using either modality and specificity was 88% on RCM-OCT vs 94% on histopathology, indicating near-perfect agreement between non-invasive and invasive diagnostic modalities (kappa = 0.94). CONCLUSIONS RCM-OCT can non-invasively identify key histopathologic features of infiltrative BCC offering a possible alternative to traditional invasive biopsy.
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Affiliation(s)
- Melissa Gill
- Department of Pathology, SUNY Downstate Medical Center, Brooklyn, NY, USA
- SkinMedical Research and Diagnostics, P.L.L.C., Dobbs Ferry, NY, USA
- Faculty of Medicine and Health Sciences, University of Alcala de Henares, Madrid, Spain
| | - Aditi Sahu
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY; USA
| | - Christi Alessi-Fox
- Caliber Imaging and Diagnostics Inc., 50 Methodist Hill Drive Suite 1000, Rochester, NY
| | - Miguel Cordova
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY; USA
| | - Salvador Gonzalez
- Faculty of Medicine and Health Sciences, University of Alcala de Henares, Madrid, Spain
| | - Nicusor Iftimia
- Physical Sciences, Inc., 20 New England Business Ctr. Drive, Andover, MA
| | - Saud Aleissa
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY; USA
| | | | - Stephen Dusza
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY; USA
| | - Anthony Rossi
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY; USA
| | - Ashfaq A. Marghoob
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY; USA
| | - Milind Rajadhyaksha
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY; USA
| | - Chih-Shan J. Chen
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY; USA
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22
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Suppa M, Fontaine M, Dejonckheere G, Cinotti E, Yélamos O, Diet G, Tognetti L, Miyamoto M, Orte Cano C, Perez-Anker J, Panagiotou V, Trepant AL, Monnier J, Berot V, Puig S, Rubegni P, Malvehy J, Perrot JL, Del Marmol V. Line-field confocal optical coherence tomography of basal cell carcinoma: a descriptive study. J Eur Acad Dermatol Venereol 2020; 35:1099-1110. [PMID: 33398911 DOI: 10.1111/jdv.17078] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 10/01/2020] [Accepted: 10/28/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND Early diagnosis and subtype classification of basal cell carcinoma (BCC) are crucial to reduce morbidity and optimize treatment. Good accuracy in differentiating BCC from clinical imitators has been achieved with existing diagnostic strategies but lower performance in discriminating BCC subtypes. Line-field confocal optical coherence tomography (LC-OCT) is a new technology able to combine the technical advantages of reflectance confocal microscopy and OCT. OBJECTIVES To identify and describe LC-OCT criteria associated with BCC and explore their association with BCC subtypes. METHODS Basal cell carcinoma were imaged with a handheld LC-OCT device before surgical excision. LC-OCT images were retrospectively evaluated by three observers for presence/absence of criteria for BCC. Multivariate logistic regression models were used to find independent predictors of BCC subtypes. RESULTS Eighty-nine histopathologically proven BCCs were included, of which 66 (74.2%) were pure subtypes [superficial BCC (sBCC): 19/66 (28.8%); nodular BCC (nBCC): 31/66 (47.0%); infiltrative BCC (iBCC): 16/66 (24.2%)]. Lobules, blood vessels and small bright cells within epidermis/lobules were the most frequent criteria for BCC. LC-OCT criteria independently associated with sBCC were presence of hemispheric lobules, absence of lobule separation from the epidermis, absence of stretching of the stroma; with nBCC were presence of macrolobules, absence of lobule connection to the epidermis; and with iBCC were presence of branched lobules. CONCLUSIONS This was the first study describing the characteristics of BCC under LC-OCT examination. We proposed morphologic criteria, which could be potentially useful for diagnosis and subtype classification of BCC, as well as for its therapeutic management. Future studies are needed to assess these hypotheses.
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Affiliation(s)
- M Suppa
- Department of Dermatology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium.,Department of Dermatology, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - M Fontaine
- Department of Dermatology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - G Dejonckheere
- Department of Dermatology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - E Cinotti
- Dermatology Unit, Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy
| | - O Yélamos
- Melanoma Unit, Hospital Clinic Barcelona, University of Barcelona, Barcelona, Spain.,Dermatology Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - G Diet
- Department of Dermatology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - L Tognetti
- Dermatology Unit, Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy
| | - M Miyamoto
- Department of Dermatology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - C Orte Cano
- Department of Dermatology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - J Perez-Anker
- Melanoma Unit, Hospital Clinic Barcelona, University of Barcelona, Barcelona, Spain.,CIBER de enfermedades raras, Instituto de Salud Carlos III, Barcelona, Spain
| | - V Panagiotou
- Department of Pathology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - A L Trepant
- Department of Pathology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - J Monnier
- Department of Dermatology, AP-HM, Aix-Marseille University, Marseille, France
| | - V Berot
- Department of Dermatology, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - S Puig
- Melanoma Unit, Hospital Clinic Barcelona, University of Barcelona, Barcelona, Spain.,CIBER de enfermedades raras, Instituto de Salud Carlos III, Barcelona, Spain
| | - P Rubegni
- Dermatology Unit, Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy
| | - J Malvehy
- Melanoma Unit, Hospital Clinic Barcelona, University of Barcelona, Barcelona, Spain.,CIBER de enfermedades raras, Instituto de Salud Carlos III, Barcelona, Spain
| | - J L Perrot
- Department of Dermatology, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - V Del Marmol
- Department of Dermatology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
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23
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Erickson-Bhatt SJ, Simpson DG, Boppart SA. Statistical evaluation of reader variability in assessing the diagnostic performance of optical coherence tomography. JOURNAL OF BIOMEDICAL OPTICS 2020; 25:116002. [PMID: 33179459 PMCID: PMC7657413 DOI: 10.1117/1.jbo.25.11.116002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Accepted: 10/19/2020] [Indexed: 06/11/2023]
Abstract
SIGNIFICANCE Optical coherence tomography (OCT) is widely used as a potential diagnostic tool for a variety of diseases including various types of cancer. However, sensitivity and specificity analyses of OCT in different cancers yield results varying from 11% to 100%. Hence, there is a need for more detailed statistical analysis of blinded reader studies. AIM Extensive statistical analysis is performed on results from a blinded study involving OCT of breast tumor margins to assess the impact of reader variability on sensitivity and specificity. APPROACH Five readers with varying levels of experience reading OCT images assessed 50 OCT images of breast tumor margins collected using an intraoperative OCT system. Statistical modeling and analysis was performed using the R language to analyze reader experience and variability. RESULTS Statistical analysis showed that the readers' prior experience with OCT images was directly related to the probability of the readers' assessment agreeing with histology. Additionally, results from readers with prior experience specific to OCT in breast cancer had a higher probability of agreement with histology compared to readers with experience with OCT in other (noncancer) diseases. CONCLUSIONS The results from this study demonstrate the potential impact of reader training and experience in the assessment of sensitivity and specificity. They also demonstrate even greater potential improvement in diagnostic performance by combining results from multiple readers. These preliminary findings suggest valuable directions for further study.
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Affiliation(s)
- Sarah J. Erickson-Bhatt
- University of Illinois at Urbana-Champaign, Beckman Institute for Advanced Science and Technology, Urbana, Illinois, United States
| | - Douglas G. Simpson
- University of Illinois at Urbana-Champaign, Beckman Institute for Advanced Science and Technology, Urbana, Illinois, United States
- University of Illinois at Urbana-Champaign, Department of Statistics, Champaign, Illinois, United States
| | - Stephen A. Boppart
- University of Illinois at Urbana-Champaign, Beckman Institute for Advanced Science and Technology, Urbana, Illinois, United States
- University of Illinois at Urbana-Champaign, Department of Electrical and Computer Engineering, Urbana, Illinois, United States
- University of Illinois at Urbana-Champaign, Department of Bioengineering, Urbana, Illinois, United States
- University of Illinois at Urbana-Champaign, Carle Illinois College of Medicine, Champaign, Illinois, United States
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24
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Fredman G, Qiu Y, Ardigò M, Mogensen M. Skin tags imaged by reflectance confocal microscopy, optical coherence tomography and multispectral optoacoustic tomography at the bedside. Skin Res Technol 2020; 27:324-331. [DOI: 10.1111/srt.12943] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 09/05/2020] [Indexed: 01/09/2023]
Affiliation(s)
- Gabriella Fredman
- Department of Dermatology, Bispebjerg and Frederiksberg Copenhagen University Hospital Copenhagen Denmark
| | - Yi Qiu
- iThera Medical GmbH München Germany
| | - Marco Ardigò
- San Gallicano Dermatological Institute – IRCCS Rome Italy
| | - Mette Mogensen
- Department of Dermatology, Bispebjerg and Frederiksberg Copenhagen University Hospital Copenhagen Denmark
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25
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Gambino A, Cabras M, Cafaro A, Broccoletti R, Carossa S, Hopper C, Chiusa L, El Haddad G, Porter SR, Arduino PG. In-vivo usefulness of optical coherence tomography in atrophic-erosive oral lichen planus: Comparison between histopathological and ultrastructural findings. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2020; 211:112009. [PMID: 32862089 DOI: 10.1016/j.jphotobiol.2020.112009] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 07/06/2020] [Accepted: 08/21/2020] [Indexed: 02/07/2023]
Abstract
Oral lichen planus (OLP) is a common premalignant chronic inflammatory disorder. Optical Coherence Tomography (OCT) provides a real-time, non-invasive, and in-situ optical signature using light of varying wavelengths to examine tissue. Aim of the present study was to assess the possible role of OCT as diagnostic tool for atrophic-erosive OLP by examining OCT scans of healthy buccal mucosa, and comparing their ultrastructural features with those of a buccal mucosa affected by atrophic-erosive OLP, using their histopathological counterparts as the gold standard. Through grayscale (enface scan) and an application in which the vascularization of the tissue is visible (dynamic scan), it was possible to distinguish the healthy from the lichenoid pattern from 20 controls (12 M; 8 F; mean age: 41.32 years) and 20 patients with histologically confirmed atrophic-erosive OLP (7 M; 13 F; mean age: 64.27 years). In detail, mean width of stratified squamous epithelium (EP) and lamina propria (LP) were evaluated. Among controls, EP and LP showed a mean width of 300 (±50) and of 600 (±50) μm respectively; among cases, disruption of membrane basement prevented from any measurement. Furthermore, a differential pattern of EP and LP emerged between the two groups: a light-grayish, hypo-reflective, homogeneous area of EP recurring in controls turned into a hyper-reflective, non-homogeneous area among cases. Dynamic scan showed a differential profile of LP vascularization, varying from a hypo-reflective red area with small blood vessels in the control group, to a hypo/hyper-reflective area, completely overrun by a denser, wider blood flow amid OLP cases. Although histopathological examination remains the gold standard for OLP diagnosis, OCT could be a potentially helpful tool for the clinician and the pathologist, since it allows analysis of the vascularization of the sample without adversely affecting histological processing.
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Affiliation(s)
- Alessio Gambino
- Department of Surgical Sciences, Oral Medicine Section, CIR-Dental School, University of Turin, Italy.
| | - Marco Cabras
- Department of Surgical Sciences, Oral Medicine Section, CIR-Dental School, University of Turin, Italy
| | - Adriana Cafaro
- Department of Surgical Sciences, Oral Medicine Section, CIR-Dental School, University of Turin, Italy
| | - Roberto Broccoletti
- Department of Surgical Sciences, Oral Medicine Section, CIR-Dental School, University of Turin, Italy
| | - Stefano Carossa
- Department of Surgical Sciences, Oral Medicine Section, CIR-Dental School, University of Turin, Italy
| | - Colin Hopper
- Department of Clinical Research, UCL Eastman Dental Institute, London, United Kingdom
| | - Luigi Chiusa
- AOU Città della salute e della Scienza di Torino, Turin, Italy
| | - Giorgia El Haddad
- Department of Surgical Sciences, Oral Medicine Section, CIR-Dental School, University of Turin, Italy
| | - Stephen R Porter
- Department of Clinical Research, UCL Eastman Dental Institute, London, United Kingdom
| | - Paolo G Arduino
- Department of Surgical Sciences, Oral Medicine Section, CIR-Dental School, University of Turin, Italy
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26
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Attia ABE, Bi R, Dev K, Du Y, Olivo M. Clinical noninvasive imaging and spectroscopic tools for dermatological applications: Review of recent progress. TRANSLATIONAL BIOPHOTONICS 2020. [DOI: 10.1002/tbio.202000010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Affiliation(s)
- Amalina Binte Ebrahim Attia
- Lab of Bio‐Optical Imaging, Singapore Bioimaging Consortium (SBIC) Agency for Science Technology and Research (A*STAR) Singapore Singapore
| | - Renzhe Bi
- Lab of Bio‐Optical Imaging, Singapore Bioimaging Consortium (SBIC) Agency for Science Technology and Research (A*STAR) Singapore Singapore
| | - Kapil Dev
- Lab of Bio‐Optical Imaging, Singapore Bioimaging Consortium (SBIC) Agency for Science Technology and Research (A*STAR) Singapore Singapore
| | | | - Malini Olivo
- Lab of Bio‐Optical Imaging, Singapore Bioimaging Consortium (SBIC) Agency for Science Technology and Research (A*STAR) Singapore Singapore
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27
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Abstract
As a result of increasing melanoma incidence and challenges with clinical and histopathologic evaluation of pigmented lesions, noninvasive techniques to assist in the assessment of skin lesions are highly sought after. This review discusses the methods, benefits, and limitations of adhesive patch biopsy, electrical impedance spectroscopy (EIS), multispectral imaging, high-frequency ultrasonography (HFUS), optical coherence tomography (OCT), and reflectance confocal microscopy (RCM) in the detection of skin cancer. Adhesive patch biopsy provides improved sensitivity and specificity for the detection of melanoma without a trade-off of higher sensitivity for lower specificity seen in other diagnostic tools to aid in skin cancer detection, including EIS and multispectral imaging. EIS and multispectral imaging provide objective information based on computer-assisted diagnosis to assist in the decision to biopsy and/or excise an atypical melanocytic lesion. HFUS may be useful for the determination of skin tumor depth and identification of surgical borders, although further studies are necessary to determine its accuracy in the detection of skin cancer. OCT and RCM provide enhanced resolution of skin tissue and have been applied for improved accuracy in skin cancer diagnosis, as well as monitoring the response of nonsurgical treatments of skin cancers and the determination of tumor margins and recurrences. These novel approaches to skin cancer assessment offer opportunities to dermatologists, but are dependent on the individual dermatologist's comfort, knowledge, and desire to invest in training and implementation of noninvasive techniques. These noninvasive modalities may have a role in the complementary assessment of skin cancers, although histopathologic diagnosis remains the gold standard for the evaluation of skin cancer.
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28
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Kiseleva TN, Lugovkina KV, Guseva NV, Zaitsev MS. [Possibilities of ultrasound methods in diagnostics of eyelid tumors]. Vestn Oftalmol 2020; 136:51-58. [PMID: 32504477 DOI: 10.17116/oftalma202013603151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To determine the informative value of ultrasound biomicroscopy (UBM) with A-scan for assessment of qualitative and quantitative characteristics of eyelid tumors less than 5 mm in size. MATERIAL AND METHODS The study included 25 patients (25 eyes) with eyelid tumors less than 5 mm in size. In addition to standard ophthalmic examination, complex ultrasound diagnostics including B-scan, Color Doppler imaging and UBM with A-scan were performed. The localization, size, structure of eyelid tumors and the state of perifocal tissues were evaluated. All patients underwent surgical treatment with following histological examinations of dissected tissues. Due to qualitative analysis of the studied formations and small number of included patients, there was no need in statistical analysis of the data. RESULTS Complex application of UBM and A-scan allowed specifying the localization, size, structure of the small-sized tumors and detecting typical echographic signs of benign or malignant properties of the pathological process. Ultrasound data (UBM and A-scan) of eyelid tumors was highly correlated to histological features. CONCLUSION UBM with A-scan can be recommended for differential diagnostics of small-sized tumors and optimizing their management.
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Affiliation(s)
- T N Kiseleva
- Helmholtz National Medical Research Center of Eye Diseases, Moscow, Russia
| | - K V Lugovkina
- Helmholtz National Medical Research Center of Eye Diseases, Moscow, Russia
| | - N V Guseva
- Helmholtz National Medical Research Center of Eye Diseases, Moscow, Russia
| | - M S Zaitsev
- Helmholtz National Medical Research Center of Eye Diseases, Moscow, Russia
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29
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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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30
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Moftah N, Samy N, Allam RSHM, El Tagy SAH, Abdelghani R. Optical coherence tomographic (OCT) evaluation of intraoral non‐ablative erbium: YAG laser (SMOOTH mode) in rejuvenation of nasolabial folds; A prospective randomized split face comparative pilot study. Skin Res Technol 2019; 26:405-412. [DOI: 10.1111/srt.12816] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Accepted: 11/09/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Nayera Moftah
- Dermatology and Venereology Department Faculty of Medicine for Girls Al‐Azhar University Cairo Egypt
| | - Nevien Samy
- Medical Applications of Laser Department National Institute of Laser Enhanced Sciences Cairo University Cairo Egypt
| | | | - Shaza A. H. El Tagy
- Dermatology and Venereology Department Air Forces General Hospital Cairo Egypt
| | - Rania Abdelghani
- Dermatology and Venereology Department Faculty of Medicine for Girls Al‐Azhar University Cairo Egypt
- Dermatology Department Armed Forces College of Medicine Cairo Egypt
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31
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Oh BH, Kim KH, Chung KY. Skin Imaging Using Ultrasound Imaging, Optical Coherence Tomography, Confocal Microscopy, and Two-Photon Microscopy in Cutaneous Oncology. Front Med (Lausanne) 2019; 6:274. [PMID: 31824956 PMCID: PMC6883721 DOI: 10.3389/fmed.2019.00274] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 11/11/2019] [Indexed: 12/21/2022] Open
Abstract
With the recognition of dermoscopy as a new medical technology and its available fee assessment in Korea comes an increased interest in imaging-based dermatological diagnosis. For the dermatologist, who treats benign tumors and malignant skin cancers, imaging-based evaluations can assist with determining the surgical method and future follow-up plans. The identification of the tumor's location and the existence of blood vessels can guide safe treatment and enable the use of minimal incisions. The recent development of high-resolution microscopy based on laser reflection has enabled observation of the skin at the cellular level. Despite the limitation of a shallow imaging depth, non-invasive light-based histopathologic examinations are being investigated as a rapid and pain-free process that would be appreciated by patients and feature reduced time from consultation to treatment. In the United States, the current procedural terminology billing code was established for reflectance confocal microscopy in 2016 and has been used for the skin cancer diagnosis ever since. In this review, we introduce the basic concepts and images of ultrasound imaging, optical coherence tomography, confocal microscopy, and two-photon microscopy and discuss how they can be utilized in the field of dermatological oncology.
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Affiliation(s)
- Byung Ho Oh
- Department of Dermatology and Cutaneous Biology Research Institute, Yonsei University College of Medicine, Seoul, South Korea
| | - Ki Hean Kim
- Department of Mechanical Engineering, Pohang University of Science and Technology, Pohang-si, South Korea
| | - Kee Yang Chung
- Department of Dermatology and Cutaneous Biology Research Institute, Yonsei University College of Medicine, Seoul, South Korea
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32
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Jerjes W, Hamdoon Z, Hopper C. Structural validation of facial skin using optical coherence tomography: A descriptive study. Skin Res Technol 2019; 26:153-162. [PMID: 31544983 DOI: 10.1111/srt.12791] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2019] [Accepted: 09/05/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND In this immediate ex vivo study, we aimed to identify the structures of normal and pathological facial skin using optical coherence tomography (OCT) and compared them to the gold standard histopathology. MATERIAL AND METHODS A total of 53 patients, with 57 suspicious facial lesions, participated in this study. A set of variables have been highlighted by the pathologist to represent the minimum unique features that could be used to diagnose a skin pathology have been included in a checklist. One pathologist used this checklist while examining the histopathology slides and one clinician while examining the OCT images. The data from both checklists have been reviewed and compared. RESULTS Optical coherence tomography's overall accuracy in diagnosing AK was 83%. Best accuracy was achieved in diagnosing BCC and was 97%, while it was 85% for cutaneous SCC. OCT failed to diagnose LM with an accuracy of 33.3% based on the two parameters of the pathology checklist, while it was 81% for malignant melanoma. CONCLUSION This study proved the success of OCT in identifying structural changes in normal and pathological facial skin. Further studies to prove its usefulness in vivo are recommended.
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Affiliation(s)
- Waseem Jerjes
- University College London Medical School, London, UK.,North End Medical Centre, London, UK
| | - Zaid Hamdoon
- College of Dental Medicine, University of Sharjah, Sharjah, UAE.,Unit of OMFS, UCL Eastman Dental Institute, London, UK
| | - Colin Hopper
- University College London Medical School, London, UK.,Unit of OMFS, UCL Eastman Dental Institute, London, UK
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33
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Hariri LP, Adams DC, Applegate MB, Miller AJ, Roop BW, Villiger M, Bouma BE, Suter MJ. Distinguishing Tumor from Associated Fibrosis to Increase Diagnostic Biopsy Yield with Polarization-Sensitive Optical Coherence Tomography. Clin Cancer Res 2019; 25:5242-5249. [PMID: 31175092 DOI: 10.1158/1078-0432.ccr-19-0566] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Revised: 04/09/2019] [Accepted: 06/03/2019] [Indexed: 12/20/2022]
Abstract
PURPOSE With recent advancements in personalized medicine, biopsies must contain sufficient tumor for histologic diagnosis and molecular testing. However, inadvertent biopsy of tumor-associated fibrosis compromises tumor yield, resulting in delayed diagnoses and/or repeat procedures when additional tumor is needed. The ability to differentiate tumor from fibrosis intraprocedurally during biopsy could significantly increase tumor yield. Polarization-sensitive optical coherence tomography (PS-OCT) is an imaging modality that is endoscope- and/or needle-compatible, and provides large volumetric views of tissue microstructure with high resolution (∼10 μm) while simultaneously measuring birefringence of organized tissues such as collagen. We aim to determine whether PS-OCT can accurately detect and distinguish tumor-associated fibrosis from tumor. EXPERIMENTAL DESIGN PS-OCT was obtained ex vivo in 64 lung nodule samples. PS-OCT birefringence was measured and correlated to collagen content in precisely matched histology, quantified on picrosirius red (PSR) staining. RESULTS There was a strong positive correlation between PS-OCT measurement of birefringent fibrosis and total collagen content by PSR (r = 0.793; P < 0.001). In addition, PS-OCT was able to accurately classify tumor regions with >20% fibrosis from those with low fibrosis (≤20%) that would likely yield higher tumor content (P < 0.0001). CONCLUSIONS PS-OCT enables accurate fibrosis detection and can distinguish tumor regions with low fibrosis. PS-OCT has significant potential for clinical impact, as the ability to differentiate tumor from fibrosis could be used to guide intraprocedural tissue sampling in vivo, or for rapid biopsy adequacy assessment ex vivo, to increase diagnostic tumor yield essential for patient care and research.
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Affiliation(s)
- Lida P Hariri
- Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Boston, Massachusetts. .,Department of Pathology, Massachusetts General Hospital, Boston, Massachusetts.,Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts
| | - David C Adams
- Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Boston, Massachusetts.,Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts
| | - Matthew B Applegate
- Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Boston, Massachusetts.,Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts
| | - Alyssa J Miller
- Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Boston, Massachusetts.,Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts
| | - Benjamin W Roop
- Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Boston, Massachusetts.,Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts
| | - Martin Villiger
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts
| | - Brett E Bouma
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts
| | - Melissa J Suter
- Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Boston, Massachusetts. .,Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts
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Ring HC, Israelsen NM, Bang O, Haedersdal M, Mogensen M. Potential of contrast agents to enhance in vivo confocal microscopy and optical coherence tomography in dermatology: A review. JOURNAL OF BIOPHOTONICS 2019; 12:e201800462. [PMID: 30851078 DOI: 10.1002/jbio.201800462] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 03/02/2019] [Accepted: 03/07/2019] [Indexed: 06/09/2023]
Abstract
Distinction between normal skin and pathology can be a diagnostic challenge. This systematic review summarizes how various contrast agents, either topically delivered or injected into the skin, affect distinction between skin disease and normal skin when imaged by optical coherence tomography (OCT) and confocal microscopy (CM). A systematic review of in vivo OCT and CM studies using exogenous contrast agents on healthy human skin or skin disease was performed. In total, nine CM studies and one OCT study were eligible. Four contrast agents aluminum chloride (AlCl) n = 2, indocyanine green (ICG) n = 3, sodium fluorescein n = 3 and acetic acid n = 1 applied to CM in variety of skin diseases. ICG, acetic acid and AlCl showed promise to increase contrast of tumor nests in keratinocyte carcinomas. Fluorescein and ICG enhanced contrast of keratinocytes and adnexal structures. In OCT of healthy skin gold nanoshells, increased contrast of natural skin openings. Contrast agents may improve delineation and diagnosis of skin cancers; ICG, acetic acid and AlCl have potential in CM and gold nanoshells facilitate visualization of adnexal skin structures in OCT. However, as utility of bedside optical imaging increases, further studies with robust methodological quality are necessary to implement contrast agents into routine dermatological practice.
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Affiliation(s)
- Hans C Ring
- Department of Dermatology, Bispebjerg Hospital, Nielsine Nielsens Vej 9, 2400 København NV, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Niels M Israelsen
- DTU Fotonik, Department of Photonics Engineering, Technical University of Denmark, Kongens Lyngby, Denmark
| | - Ole Bang
- DTU Fotonik, Department of Photonics Engineering, Technical University of Denmark, Kongens Lyngby, Denmark
| | - Merete Haedersdal
- Department of Dermatology, Bispebjerg Hospital, Nielsine Nielsens Vej 9, 2400 København NV, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Mette Mogensen
- Department of Dermatology, Bispebjerg Hospital, Nielsine Nielsens Vej 9, 2400 København NV, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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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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36
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Chuah SY, Attia ABE, Ho CJH, Li X, Lee JSS, Tan MWP, Yong AA, Tan AWM, Razansky D, Olivo M, Thng STG. Volumetric Multispectral Optoacoustic Tomography for 3-Dimensional Reconstruction of Skin Tumors: A Further Evaluation with Histopathologic Correlation. J Invest Dermatol 2019; 139:481-485. [DOI: 10.1016/j.jid.2018.08.014] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 08/06/2018] [Accepted: 08/07/2018] [Indexed: 10/28/2022]
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Ferrante di Ruffano L, Dinnes J, Deeks JJ, Chuchu N, Bayliss SE, Davenport C, Takwoingi Y, Godfrey K, O'Sullivan C, Matin RN, Tehrani H, Williams HC. Optical coherence tomography for diagnosing skin cancer in adults. Cochrane Database Syst Rev 2018; 12:CD013189. [PMID: 30521690 PMCID: PMC6516952 DOI: 10.1002/14651858.cd013189] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Early accurate detection of all skin cancer types is essential to guide appropriate management and to improve morbidity and survival. Melanoma and squamous cell carcinoma (SCC) are high-risk skin cancers, which have the potential to metastasise and ultimately lead to death, whereas basal cell carcinoma (BCC) is usually localised, with potential to infiltrate and damage surrounding tissue. Anxiety around missing early cases needs to be balanced against inappropriate referral and unnecessary excision of benign lesions. Optical coherence tomography (OCT) is a microscopic imaging technique, which magnifies the surface of a skin lesion using near-infrared light. Used in conjunction with clinical or dermoscopic examination of suspected skin cancer, or both, OCT may offer additional diagnostic information compared to other technologies. OBJECTIVES To determine the diagnostic accuracy of OCT for the detection of cutaneous invasive melanoma and atypical intraepidermal melanocytic variants, basal cell carcinoma (BCC), or cutaneous squamous cell carcinoma (cSCC) in adults. SEARCH METHODS We undertook a comprehensive search of the following databases from inception up to August 2016: Cochrane Central Register of Controlled Trials; MEDLINE; Embase; CINAHL; CPCI; Zetoc; Science Citation Index; US National Institutes of Health Ongoing Trials Register; NIHR Clinical Research Network Portfolio Database; and the World Health Organization International Clinical Trials Registry Platform. We studied reference lists and published systematic review articles. SELECTION CRITERIA We included studies of any design evaluating OCT in adults with lesions suspicious for invasive melanoma and atypical intraepidermal melanocytic variants, BCC or cSCC, compared with a reference standard of histological confirmation or clinical follow-up. DATA COLLECTION AND ANALYSIS Two review authors independently extracted data using a standardised data extraction and quality assessment form (based on QUADAS-2). Our unit of analysis was lesions. Where possible, we estimated summary sensitivities and specificities using the bivariate hierarchical model. MAIN RESULTS We included five studies with 529 cutaneous lesions (282 malignant lesions) providing nine datasets for OCT, two for visual inspection alone, and two for visual inspection plus dermoscopy. Studies were of moderate to unclear quality, using data-driven thresholds for test positivity and giving poor accounts of reference standard interpretation and blinding. Studies may not have been representative of populations eligible for OCT in practice, for example due to high disease prevalence in study populations, and may not have reflected how OCT is used in practice, for example by using previously acquired OCT images.It was not possible to make summary statements regarding accuracy of detection of melanoma or of cSCC because of the paucity of studies, small sample sizes, and for melanoma differences in the OCT technologies used (high-definition versus conventional resolution OCT), and differences in the degree of testing performed prior to OCT (i.e. visual inspection alone or visual inspection plus dermoscopy).Pooled data from two studies using conventional swept-source OCT alongside visual inspection and dermoscopy for the detection of BCC estimated the sensitivity of OCT as 95% (95% confidence interval (CI) 91% to 97%) and specificity of 77% (95% CI 69% to 83%).When applied to a hypothetical population of 1000 lesions at the mean observed BCC prevalence of 60%, OCT would miss 31 BCCs (91 fewer than would be missed by visual inspection alone and 53 fewer than would be missed by visual inspection plus dermoscopy), and OCT would lead to 93 false-positive results for BCC (a reduction in unnecessary excisions of 159 compared to using visual inspection alone and of 87 compared to visual inspection plus dermoscopy). AUTHORS' CONCLUSIONS Insufficient data are available on the use of OCT for the detection of melanoma or cSCC. Initial data suggest conventional OCT may have a role for the diagnosis of BCC in clinically challenging lesions, with our meta-analysis showing a higher sensitivity and higher specificity when compared to visual inspection plus dermoscopy. However, the small number of studies and varying methodological quality means implications to guide practice cannot currently be drawn.Appropriately designed prospective comparative studies are required, given the paucity of data comparing OCT with dermoscopy and other similar diagnostic aids such as reflectance confocal microscopy.
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Affiliation(s)
| | - Jacqueline Dinnes
- University of BirminghamInstitute of Applied Health ResearchEdgbaston CampusBirminghamUKB15 2TT
- University Hospitals Birmingham NHS Foundation Trust and University of BirminghamNIHR Birmingham Biomedical Research CentreBirminghamUK
| | - Jonathan J Deeks
- University of BirminghamInstitute of Applied Health ResearchEdgbaston CampusBirminghamUKB15 2TT
- University Hospitals Birmingham NHS Foundation Trust and University of BirminghamNIHR Birmingham Biomedical Research CentreBirminghamUK
| | - Naomi Chuchu
- University of BirminghamInstitute of Applied Health ResearchEdgbaston CampusBirminghamUKB15 2TT
| | - Susan E Bayliss
- University of BirminghamInstitute of Applied Health ResearchEdgbaston CampusBirminghamUKB15 2TT
| | - Clare Davenport
- University of BirminghamInstitute of Applied Health ResearchEdgbaston CampusBirminghamUKB15 2TT
| | - Yemisi Takwoingi
- University of BirminghamInstitute of Applied Health ResearchEdgbaston CampusBirminghamUKB15 2TT
- University Hospitals Birmingham NHS Foundation Trust and University of BirminghamNIHR Birmingham Biomedical Research CentreBirminghamUK
| | - Kathie Godfrey
- The University of Nottinghamc/o Cochrane Skin GroupNottinghamUK
| | | | - Rubeta N Matin
- Churchill HospitalDepartment of DermatologyOld RoadHeadingtonOxfordUKOX3 7LE
| | - Hamid Tehrani
- Whiston HospitalDepartment of Plastic and Reconstructive SurgeryWarrington RoadLiverpoolUKL35 5DR
| | - Hywel C Williams
- University of NottinghamCentre of Evidence Based DermatologyQueen's Medical CentreDerby RoadNottinghamUKNG7 2UH
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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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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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40
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Cha HG, Park ES, Nam SM. Usefulness of Optical Coherence Tomography in the Preoperative Assessment of Nail Deformities. ARCHIVES OF AESTHETIC PLASTIC SURGERY 2018. [DOI: 10.14730/aaps.2018.24.3.138] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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41
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Leitgeb RA, Baumann B. Multimodal Optical Medical Imaging Concepts Based on Optical Coherence Tomography. FRONTIERS IN PHYSICS 2018; 6. [PMID: 0 DOI: 10.3389/fphy.2018.00114] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
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42
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van Manen L, Dijkstra J, Boccara C, Benoit E, Vahrmeijer AL, Gora MJ, Mieog JSD. The clinical usefulness of optical coherence tomography during cancer interventions. J Cancer Res Clin Oncol 2018; 144:1967-1990. [PMID: 29926160 PMCID: PMC6153603 DOI: 10.1007/s00432-018-2690-9] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Accepted: 06/16/2018] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Tumor detection and visualization plays a key role in the clinical workflow of a patient with suspected cancer, both in the diagnosis and treatment. Several optical imaging techniques have been evaluated for guidance during oncological interventions. Optical coherence tomography (OCT) is a technique which has been widely evaluated during the past decades. This review aims to determine the clinical usefulness of OCT during cancer interventions focussing on qualitative features, quantitative features and the diagnostic value of OCT. METHODS A systematic literature search was performed for articles published before May 2018 using OCT in the field of surgical oncology. Based on these articles, an overview of the clinical usefulness of OCT was provided per tumor type. RESULTS A total of 785 articles were revealed by our search, of which a total of 136 original articles were available for analysis, which formed the basis of this review. OCT is currently utilised for both preoperative diagnosis and intraoperative detection of skin, oral, lung, breast, hepatobiliary, gastrointestinal, urological, and gynaecological malignancies. It showed promising results in tumor detection on a microscopic level, especially using higher resolution imaging techniques, such as high-definition OCT and full-field OCT. CONCLUSION In the near future, OCT could be used as an additional tool during bronchoscopic or endoscopic interventions and could also be implemented in margin assessment during (laparoscopic) cancer surgery if a laparoscopic or handheld OCT device will be further developed to make routine clinical use possible.
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Affiliation(s)
- Labrinus van Manen
- Department of Surgery, Leiden University Medical Center, Albinusdreef 2, 2300 RC, Leiden, The Netherlands
| | - Jouke Dijkstra
- Division of Image Processing, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | | | | | - Alexander L Vahrmeijer
- Department of Surgery, Leiden University Medical Center, Albinusdreef 2, 2300 RC, Leiden, The Netherlands
| | - Michalina J Gora
- ICube Laboratory, CNRS, Strasbourg University, Strasbourg, France
| | - J Sven D Mieog
- Department of Surgery, Leiden University Medical Center, Albinusdreef 2, 2300 RC, Leiden, The Netherlands.
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43
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Mogensen M, Bojesen S, Israelsen NM, Maria M, Jensen M, Podoleanu A, Bang O, Haedersdal M. Two optical coherence tomography systems detect topical gold nanoshells in hair follicles, sweat ducts and measure epidermis. JOURNAL OF BIOPHOTONICS 2018; 11:e201700348. [PMID: 29611306 DOI: 10.1002/jbio.201700348] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Accepted: 04/02/2018] [Indexed: 06/08/2023]
Abstract
Optical coherence tomography (OCT) is an established imaging technology for in vivo skin investigation. Topical application of gold nanoshells (GNS) provides contrast enhancement in OCT by generating a strong hyperreflective signal from hair follicles and sweat glands, which are the natural skin openings. This study explores the utility of 150 nm diameter GNS as contrast agent for OCT imaging. GNS was massaged into skin and examined in four skin areas of 11 healthy volunteers. A commercial OCT system and a prototype with 3 μm resolution (UHR-OCT) were employed to detect potential benefits of increased resolution and variability in intensity generated by the GNS. In both OCT-systems GNS enhanced contrast from hair follicles and sweat ducts. Highest average penetration depth of GNS was in armpit 0.64 mm ± SD 0.17, maximum penetration depth was 1.20 mm in hair follicles and 15 to 40 μm in sweat ducts. Pixel intensity generated from GNS in hair follicles was significantly higher in UHR-OCT images (P = .002) and epidermal thickness significantly lower 0.14 vs 0.16 mm (P = .027). This study suggests that GNSs are interesting candidates for increasing sensitivity in OCT diagnosis of hair and sweat gland disorders and demonstrates that choice of OCT systems influences results.
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Affiliation(s)
- Mette Mogensen
- Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Sophie Bojesen
- Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Niels M Israelsen
- DTU Fotonik, Department of Photonics Engineering, Technical University of Denmark, Kongens Lyngby, Denmark
| | - Michael Maria
- DTU Fotonik, Department of Photonics Engineering, Technical University of Denmark, Kongens Lyngby, Denmark
| | - Mikkel Jensen
- DTU Fotonik, Department of Photonics Engineering, Technical University of Denmark, Kongens Lyngby, Denmark
| | - Adrian Podoleanu
- School of Physical Sciences, Ingram Building, University of Kent, Canterbury, UK
| | - Ole Bang
- DTU Fotonik, Department of Photonics Engineering, Technical University of Denmark, Kongens Lyngby, Denmark
- NKT Photonics A/S, Birkerød, Denmark
| | - Merete Haedersdal
- Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark
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Lindsø Andersen P, Olsen J, Friis KBE, Themstrup L, Grandahl K, Mortensen OS, Jemec GBE. Vascular morphology in normal skin studied with dynamic optical coherence tomography. Exp Dermatol 2018; 27:966-972. [PMID: 29733465 DOI: 10.1111/exd.13680] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/23/2018] [Indexed: 01/08/2023]
Abstract
Dynamic optical coherence tomography (D-OCT) is a non-invasive imaging technique, suitable for the study of structural and dynamic features of cutaneous microvasculature. Studies with D-OCT have primarily focused on non-melanoma skin cancer (NMSC), and a reference description of healthy skin is lacking. The aim of the study was to describe the prevalence of standard microvascular features in normal skin. A total of 280 participants without skin disease were D-OCT-scanned on four body locations: three sun-exposed areas and one unexposed: forehead, back of the neck, back of the hand and medial side of the upper arm. Frequencies of standard vascular features were reported, and relations to anatomical location and demographic data were investigated. "Dots," "lines" and "curves" were the most frequent shapes at 150 μm, 300 μm and 500 μm. "Mottle" was the predominant pattern at 150 μm and 300 μm. "Mesh" was found from 300 μm and primarily found at 500 μm. Regional differences in vascular characteristics were primarily found comparing the medial side of the arm with the other body locations. In normal skin, the most frequent shapes were "dots," "lines" and "curves," and "mottle" was present more superficially than "mesh." In conclusion, regional anatomical differences should be taken into account when evaluating D-OCT images.
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Affiliation(s)
- Pernille Lindsø Andersen
- Department of Dermatology, Zealand University Hospital, Roskilde, Denmark.,Health Sciences Faculty, University of Copenhagen, Copenhagen, Denmark
| | - Jonas Olsen
- Department of Dermatology, Zealand University Hospital, Roskilde, Denmark.,Health Sciences Faculty, University of Copenhagen, Copenhagen, Denmark
| | - Kersti Brosbøl Engelund Friis
- Department of Dermatology, Zealand University Hospital, Roskilde, Denmark.,Health Sciences Faculty, University of Copenhagen, Copenhagen, Denmark
| | - Lotte Themstrup
- Department of Dermatology, Zealand University Hospital, Roskilde, Denmark.,Health Sciences Faculty, University of Copenhagen, Copenhagen, Denmark
| | - Kasper Grandahl
- Health Sciences Faculty, University of Copenhagen, Copenhagen, Denmark.,Department of Occupational Medicine, Copenhagen University Hospital, Holbaek, Denmark
| | - Ole Steen Mortensen
- Health Sciences Faculty, University of Copenhagen, Copenhagen, Denmark.,Department of Occupational Medicine, Copenhagen University Hospital, Holbaek, Denmark.,Department of Public Health, Section of Social Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Gregor Borut Ernst Jemec
- Department of Dermatology, Zealand University Hospital, Roskilde, Denmark.,Health Sciences Faculty, University of Copenhagen, Copenhagen, Denmark
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Batz S, Wahrlich C, Alawi A, Ulrich M, Lademann J. Differentiation of Different Nonmelanoma Skin Cancer Types Using OCT. Skin Pharmacol Physiol 2018; 31:238-245. [PMID: 29894994 DOI: 10.1159/000489269] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Accepted: 04/09/2018] [Indexed: 12/12/2022]
Abstract
BACKGROUND Early detection of various types of nonmelanoma skin cancer has been a challenge in dermatology. Noninvasive examination procedures such as optical coherence tomography (OCT) play an increasingly important role, besides the established gold standard of histological tissue sample analysis. OCT is a noninvasive, cross-sectional, real-time technique that allows conclusions to be drawn with regard to the presence of pathologies. OBJECTIVE The objective of this study was to investigate whether it is possible to distinguish between different types of nonmelanoma skin cancer using OCT or not. METHODS A study population of a total of 25 cases, comprising 5 cases, each, of 5 tumor entities (i.e., basal cell carcinoma, superficial basal cell carcinoma, actinic keratosis, squamous cell carcinoma, and Bowen disease) was examined. Relevant lesions were scanned both centrally and peripherally in the multislice mode. All OCT images were blinded, randomized, analyzed, and evaluated by 2 clinicians experienced in OCT. RESULTS This study demonstrated that it is possible to determine correlations between various types of tumors and recurring tumor characteristics. CONCLUSION This study showed that it is possible to distinguish between the different nonmelanoma skin cancers by using OCT, but further prospective studies have to be conducted to validate the sensitivity and specificity of the criteria.
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Affiliation(s)
- Sebastian Batz
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Department of Dermatology, Venerology and Allergology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Caroline Wahrlich
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Department of Dermatology, Venerology and Allergology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Arash Alawi
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Department of Dermatology, Venerology and Allergology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Martina Ulrich
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Department of Dermatology, Venerology and Allergology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Jürgen Lademann
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Department of Dermatology, Venerology and Allergology, Charité - Universitätsmedizin Berlin, Berlin, Germany
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46
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Bayan CAY, Khanna T, Rotemberg V, Samie FH, Zeitouni NC. A review of non-invasive imaging in extramammary Paget's disease. J Eur Acad Dermatol Venereol 2018; 32:1862-1873. [PMID: 29763511 DOI: 10.1111/jdv.15072] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2017] [Accepted: 04/30/2018] [Indexed: 01/04/2023]
Abstract
Extramammary Paget's Disease (EMPD) is a rare intraepithelial adenocarcinoma that classically manifests with pruritic, erythematous and scaling plaques. The clinical picture frequently mimics inflammatory or infectious conditions and is thus commonly misdiagnosed. The assessment of tumour margins is equally challenging as tumours have a propensity to spread beyond clinically visible boundaries. Appropriate non-invasive diagnostic tools can assist in the early detection, diagnosis and management of EMPD. This paper will review the literature on non-invasive imaging modalities used in EMPD. Articles from the PubMed database were selected based on relevance to the topic of this review. Articles that were not specific to EMPD and non-invasive imaging were excluded. Search strategy is further described in the methods section below. Eighteen articles were selected for this review: six PET/CT, five reflectance confocal microscopy (RCM), two photodynamic diagnosis (PDD), two dermoscopy, two MRI and one optical coherence tomography (OCT) paper(s). Dermoscopy, PDD, RCM and OCT can help to distinguish malignant conditions, including EMPD, from benign conditions. RCM and OCT can identify atypical cells in real-time, and have the potential to improve the accuracy of surgical margins intraoperatively and overall management. Distinctive confocal characteristics of EMPD have been described using RCM. The sensitivity and specificity of these findings require additional validation. Radiographic techniques also play a central role in the diagnosis of EMPD and assessment of disease spread. PET/CT and MRI can detect primary disease, nodal and distant metastases, with superior delineation of disease spread on MRI. Limitations of PET/CT are mainly related to primary tumour thickness, and size and FDG-avidity of nodal and distant metastases. Limitations of MRI include the fact that few studies have examined its use in EMPD; additional research is warranted. Randomized controlled trials and large prospective studies evaluating the use of non-invasive imaging in EMPD are needed.
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Affiliation(s)
- C-A Y Bayan
- Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - T Khanna
- Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - V Rotemberg
- Department of Dermatology, Columbia University Medical Center, New York, NY, USA
| | - F H Samie
- Department of Dermatology, Columbia University Medical Center, New York, NY, USA
| | - N C Zeitouni
- Department of Dermatology, University of Arizona and University of Arizona Cancer Center at Dignity Health, Phoenix, AZ, USA
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Israelsen NM, Maria M, Mogensen M, Bojesen S, Jensen M, Haedersdal M, Podoleanu A, Bang O. The value of ultrahigh resolution OCT in dermatology - delineating the dermo-epidermal junction, capillaries in the dermal papillae and vellus hairs. BIOMEDICAL OPTICS EXPRESS 2018; 9:2240-2265. [PMID: 29760984 PMCID: PMC5946785 DOI: 10.1364/boe.9.002240] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Revised: 03/08/2018] [Accepted: 03/14/2018] [Indexed: 05/13/2023]
Abstract
Optical coherence tomography (OCT) imaging of the skin is gaining recognition and is increasingly applied to dermatological research. A key dermatological parameter inferred from an OCT image is the epidermal (Ep) thickness as a thickened Ep can be an indicator of a skin disease. Agreement in the literature on the signal characters of Ep and the subjacent skin layer, the dermis (D), is evident. Ambiguities of the OCT signal interpretation in the literature is however seen for the transition region between the Ep and D, which from histology is known as the dermo-epidermal junction (DEJ); a distinct junction comprised of the lower surface of a single cell layer in epidermis (the stratum basale) connected to an even thinner membrane (the basement membrane). The basement membrane is attached to the underlying dermis. In this work we investigate the impact of an improved axial and lateral resolution on the applicability of OCT for imaging of the skin. To this goal, OCT images are compared produced by a commercial OCT system (Vivosight from Michaelson Diagnostics) and by an in-house built ultrahigh resolution (UHR-) OCT system for dermatology. In 11 healthy volunteers, we investigate the DEJ signal characteristics. We perform a detailed analysis of the dark (low) signal band clearly seen for UHR-OCT in the DEJ region where we, by using a transition function, find the signal transition of axial sub-resolution character, which can be directly attributed to the exact location of DEJ, both in normal (thin/hairy) and glabrous (thick) skin. To our knowledge no detailed delineating of the DEJ in the UHR-OCT image has previously been reported, despite many publications within this field. For selected healthy volunteers, we investigate the dermal papillae and the vellus hairs and identify distinct features that only UHR-OCT can resolve. Differences are seen in tracing hairs of diameter below 20 μm, and in imaging the dermal papillae where, when utilising the UHR-OCT, capillary structures are identified in the hand palm, not previously reported in OCT studies and specifically for glabrous skin not reported in any other in vivo optical imaging studies.
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Affiliation(s)
| | - Michael Maria
- Technical University of Denmark, DTU Fotonik, Kongens Lyngby, 2800,
Denmark
- University of Kent, School of Physical Sciences, Canterbury, Kent,
England, CT2 7NZ
| | - Mette Mogensen
- Department of Dermatology, Bisbebjerg Hospital, University of Copenhagen, Bispebjerg Bakke 23, DK-2400 Copenhagen NV,
Denmark
| | - Sophie Bojesen
- Department of Dermatology, Bisbebjerg Hospital, University of Copenhagen, Bispebjerg Bakke 23, DK-2400 Copenhagen NV,
Denmark
| | - Mikkel Jensen
- Technical University of Denmark, DTU Fotonik, Kongens Lyngby, 2800,
Denmark
| | - Merete Haedersdal
- Department of Dermatology, Bisbebjerg Hospital, University of Copenhagen, Bispebjerg Bakke 23, DK-2400 Copenhagen NV,
Denmark
| | - Adrian Podoleanu
- University of Kent, School of Physical Sciences, Canterbury, Kent,
England, CT2 7NZ
| | - Ole Bang
- Technical University of Denmark, DTU Fotonik, Kongens Lyngby, 2800,
Denmark
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Halani S, Foster FS, Breslavets M, Shear NH. Ultrasound and Infrared-Based Imaging Modalities for Diagnosis and Management of Cutaneous Diseases. Front Med (Lausanne) 2018; 5:115. [PMID: 29922650 PMCID: PMC5996893 DOI: 10.3389/fmed.2018.00115] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Accepted: 04/06/2018] [Indexed: 12/16/2022] Open
Abstract
Non-invasive bedside imaging tools are becoming more prevalent for assessing cutaneous lesions. Ultrasound used at specific frequencies allows us to assess margins of lesions to minimize the extent of the biopsy that is performed and improve cosmetic outcomes. Vascularity, seen on Doppler ultrasound and contrast-enhanced ultrasound, and stiffness, assessed on tissue elastography, can help differentiate between benign and malignant lesions for clinicians to be more judicious in deciding whether to biopsy. Moreover, research has shown the efficacy in using ultrasound in monitoring flares of hidradenitis suppurativa, a disease affecting apocrine gland-rich areas of the body, for which the current gold standard involves examining and scoring inflammatory lesions with the naked eye. Infrared-based modalities have also been on the uptrend to aid in clinical decision-making regarding suspiciousness of lesions. Reflectance confocal microscopy has lateral resolution that is comparable to histopathology and it has been shown to be an appropriate adjunctive tool to dermoscopy, specifically when evaluating melanomas. Optical coherence tomography has utility in determining lesion thickness because of its depth penetration, and spectrophotometric intracutaneous analysis is becoming more popular as a tool that can be used by general practitioners to know when to refer to dermatology regarding worrisome pigmented lesions. Strides have been made to incorporate electrical impedance spectroscopy alongside dermoscopy in decision-making regarding excision, although the evidence for its use in the clincial setting remains inconclusive. This paper reviews the efficacy and drawbacks of these techniques in the field of dermatology and suggests future directions.
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Affiliation(s)
- Sheliza Halani
- Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - F Stuart Foster
- Medical Biophysics, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | | | - Neil H Shear
- Faculty of Medicine, University of Toronto, Toronto, ON, Canada.,Dermatology, University of Toronto, Toronto, ON, Canada
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Olsen J, Holmes J, Jemec GB. Advances in optical coherence tomography in dermatology-a review. JOURNAL OF BIOMEDICAL OPTICS 2018; 23:1-10. [PMID: 29701018 DOI: 10.1117/1.jbo.23.4.040901] [Citation(s) in RCA: 81] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Accepted: 03/26/2018] [Indexed: 05/24/2023]
Abstract
Optical coherence tomography (OCT) was introduced as an imaging system, but like ultrasonography, other measures, such as blood perfusion and polarization of light, have enabled the technology to approach clinical utility. This review aims at providing an overview of the advances in clinical research based on the improving technical aspects. OCT provides cross-sectional and en face images down to skin depths of 0.4 to 2.00 mm with optical resolution of 3 to 15 μm. Dynamic optical coherence tomography (D-OCT) enables the visualization of cutaneous microvasculature via detection of rapid changes in the interferometric signal of blood flow. Nonmelanoma skin cancer (NMSC) is the most comprehensively investigated topic, resulting in improved descriptions of morphological features and diagnostic criteria. A refined scoring system for diagnosing NMSC, taking findings from conventional and D-OCT into account, is warranted. OCT diagnosis of melanoma is hampered by the resolution and the optical properties of melanin. D-OCT may be of value in diseases characterized with dynamic changes in the vasculature of the skin and the addition of functional measures is strongly encouraged. In conclusion, OCT in dermatology is still an emerging technology that has great potential for improving further in the future.
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Affiliation(s)
| | - Jon Holmes
- Michelson Diagnostics Ltd., United Kingdom
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50
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Update on Noninvasive Diagnostic Imaging and Management of Nonmelanoma Skin Cancer. CURRENT DERMATOLOGY REPORTS 2018. [DOI: 10.1007/s13671-018-0207-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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