1
|
Pham DL, Gillette AA, Riendeau J, Wiech K, Guzman EC, Datta R, Skala MC. Perspectives on label-free microscopy of heterogeneous and dynamic biological systems. JOURNAL OF BIOMEDICAL OPTICS 2025; 29:S22702. [PMID: 38434231 PMCID: PMC10903072 DOI: 10.1117/1.jbo.29.s2.s22702] [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: 09/20/2023] [Revised: 11/22/2023] [Accepted: 12/14/2023] [Indexed: 03/05/2024]
Abstract
Significance Advancements in label-free microscopy could provide real-time, non-invasive imaging with unique sources of contrast and automated standardized analysis to characterize heterogeneous and dynamic biological processes. These tools would overcome challenges with widely used methods that are destructive (e.g., histology, flow cytometry) or lack cellular resolution (e.g., plate-based assays, whole animal bioluminescence imaging). Aim This perspective aims to (1) justify the need for label-free microscopy to track heterogeneous cellular functions over time and space within unperturbed systems and (2) recommend improvements regarding instrumentation, image analysis, and image interpretation to address these needs. Approach Three key research areas (cancer research, autoimmune disease, and tissue and cell engineering) are considered to support the need for label-free microscopy to characterize heterogeneity and dynamics within biological systems. Based on the strengths (e.g., multiple sources of molecular contrast, non-invasive monitoring) and weaknesses (e.g., imaging depth, image interpretation) of several label-free microscopy modalities, improvements for future imaging systems are recommended. Conclusion Improvements in instrumentation including strategies that increase resolution and imaging speed, standardization and centralization of image analysis tools, and robust data validation and interpretation will expand the applications of label-free microscopy to study heterogeneous and dynamic biological systems.
Collapse
Affiliation(s)
- Dan L. Pham
- University of Wisconsin—Madison, Department of Biomedical Engineering, Madison, Wisconsin, United States
| | | | | | - Kasia Wiech
- University of Wisconsin—Madison, Department of Biomedical Engineering, Madison, Wisconsin, United States
| | | | - Rupsa Datta
- Morgridge Institute for Research, Madison, Wisconsin, United States
| | - Melissa C. Skala
- University of Wisconsin—Madison, Department of Biomedical Engineering, Madison, Wisconsin, United States
- Morgridge Institute for Research, Madison, Wisconsin, United States
| |
Collapse
|
2
|
Deußing M, Ruini C, Daxenberger F, French LE, Hartmann D, Oppel E, Sattler EC. Line-field confocal optical coherence tomography for in-vivo characterization of allergic contact dermatitis and support of the clinical grading: A prospective pilot study. Contact Dermatitis 2024; 91:243-245. [PMID: 38715448 DOI: 10.1111/cod.14578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2024] [Revised: 04/18/2024] [Accepted: 04/28/2024] [Indexed: 08/13/2024]
Affiliation(s)
- Maximilian Deußing
- Department of Dermatology and Allergy, LMU University Hospital, LMU Munich, Munich, Germany
| | - Cristel Ruini
- Department of Dermatology and Allergy, LMU University Hospital, LMU Munich, Munich, Germany
- Department of Dermatology, La Sapienza University, Rome, Italy
| | - Fabia Daxenberger
- Department of Dermatology and Allergy, LMU University Hospital, LMU Munich, Munich, Germany
| | - Lars E French
- Department of Dermatology and Allergy, LMU University Hospital, LMU Munich, Munich, Germany
- Department of Dermatology & Cutaneous Surgery, University of Miami, Miller School of Medicine, Miami, Florida, USA
| | - Daniela Hartmann
- Department of Dermatology and Allergy, LMU University Hospital, LMU Munich, Munich, Germany
| | - Eva Oppel
- Department of Dermatology and Allergy, LMU University Hospital, LMU Munich, Munich, Germany
| | - Elke C Sattler
- Department of Dermatology and Allergy, LMU University Hospital, LMU Munich, Munich, Germany
| |
Collapse
|
3
|
Li X, Yew YW, Vinod Ram K, Oon HH, Thng STG, Dinish U, Olivo M. Structural and functional imaging of psoriasis for severity assessment and quantitative monitoring of treatment response using high-resolution optoacoustic imaging. PHOTOACOUSTICS 2024; 38:100611. [PMID: 38764522 PMCID: PMC11101711 DOI: 10.1016/j.pacs.2024.100611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 04/19/2024] [Accepted: 04/22/2024] [Indexed: 05/21/2024]
Abstract
Psoriasis is a chronic inflammatory skin disease, characterized by thick scaly plaques. It imposes a notable disease burden with varying levels of severity affecting the quality of life significantly. Current disease severity assessment relies on semi-objective visual inspection based on the Psoriasis Area and Severity index (PASI) score that might not be sensitive to sub-clinical changes. Histology of psoriasis skin lesions necessitate invasive skin biopsies. This indicates an unmet need for a non-invasive, objective and quantitative approach to assess disease severity serially. Herein, we employ multispectral Raster-Scanning Optoacoustic Mesoscopy (ms-RSOM) derived structural and microvascular functional imaging metrics to examine the lesional and non-lesional skin in psoriasis subjects across different severities and also evaluate the treatment outcome in a subject with topical steroids and biologics, such as adalimumab. ms-RSOM derived structural metrics like epidermal thickness and total blood volume (TBV) and microvascular functional information such as oxygen saturation (sO2) are evaluated by spectrally resolving the endogenous chromophores like melanin, oxy-, and deoxy-hemoglobin. Initial findings reveal an elevated sO2 and TBV with severity in lesional and non-lesional psoriasis skin, thus representing increasing inflammation. An increase in epidermal thickness is also noted with the degree of severity, corresponding to the inflammation and increased abnormal cell growth. As a marker to evaluate the treatment response, we observed a decrease in epidermal thickness, sO2, and TBV in a psoriasis patient post-treatment, which is consistent with the decrease in the PASI score from 4.1 to 1.9. We envision that ms-RSOM has a huge potential to be translated into routine clinical setting for the diagnosis of severity and assessment of treatment monitoring in psoriasis subjects.
Collapse
Affiliation(s)
- Xiuting Li
- A⁎STAR Skin Research Labs (A⁎SRL), Agency for Science, Technology and Research (A⁎STAR), 31 Biopolis Way, #07-01 Nanos, Singapore 138669, Republic of Singapore
| | | | - Keertana Vinod Ram
- A⁎STAR Skin Research Labs (A⁎SRL), Agency for Science, Technology and Research (A⁎STAR), 31 Biopolis Way, #07-01 Nanos, Singapore 138669, Republic of Singapore
| | - Hazel H. Oon
- National Skin Centre and Skin Research Institute of Singapore (SRIS), Singapore
| | | | - U.S. Dinish
- A⁎STAR Skin Research Labs (A⁎SRL), Agency for Science, Technology and Research (A⁎STAR), 31 Biopolis Way, #07-01 Nanos, Singapore 138669, Republic of Singapore
| | - Malini Olivo
- A⁎STAR Skin Research Labs (A⁎SRL), Agency for Science, Technology and Research (A⁎STAR), 31 Biopolis Way, #07-01 Nanos, Singapore 138669, Republic of Singapore
| |
Collapse
|
4
|
Nutz M, Deußing M, Hartmann D, Daxenberger F, Eijkenboom QL, Gust C, French LE, Schuh S, Welzel J, Sattler EC. Line-field confocal optical coherence tomography: Characteristic hints for the diagnosis of scarring alopecia due to lupus erythematodes: A preliminary study. Skin Res Technol 2024; 30:e13859. [PMID: 39096179 PMCID: PMC11297418 DOI: 10.1111/srt.13859] [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: 07/02/2024] [Accepted: 07/05/2024] [Indexed: 08/05/2024]
Abstract
INTRODUCTION Lupus erythematosus (LE) is an inflammatory autoimmune disease, that can affect the skin to varying degree. In particular, discoid LE (DLE) and the rare form of lupus panniculitis/profundus are associated with scarring alopecia. The heterogeneity of the clinical, dermatoscopic, and histologic presentation poses a major challenge to the clinician in the diagnosis and differential diagnosis of other forms of scarring alopecia. OBJECTIVE While noninvasive imaging techniques using optical coherence tomography (OCT) and reflectance confocal microscopy (RCM) have proven to be helpful in the diagnosis of scarring alopecia in the context of LE, this study aimed to investigate line-field confocal OCT (LC-OCT) to identify characteristic features of cicatricial alopecia in LE. METHODS Fifteen patients with cicatricial alopecia in LE were included and the most affected/inflamed areas of the scalp were prospectively examined. In analogy to histopathology and previously reported criteria in RCM, all images were evaluated according to seven established criteria and underwent descriptive analyses. RESULTS LC-OCT revealed characteristic features of cicatricial alopecia, such as lymphocytic interface dermatitis (14/15; 93.3%) and basal cell vacuolization (13/15; 86.7%). The most impressive feature was the occurrence of prominent hyperreflective fibers in 14/15 patients (93.3%). CONCLUSION LC-OCT imaging can noninvasively detect morphologic criteria such as lymphocytic and vacuolar interface dermatitis of cicatricial alopecia due to LE. In particular, the presence of hyperreflective collagen fibers appears to be a characteristic easily recognizable feature that may facilitate differential diagnosis with other forms of cicatricial alopecia. Further studies are mandatory to differentiate other forms of scarring alopecia.
Collapse
Affiliation(s)
- Marie‐Christine Nutz
- Department of Dermatology and AllergyLMU University HospitalLMU MunichMunichGermany
| | - Maximilian Deußing
- Department of Dermatology and AllergyLMU University HospitalLMU MunichMunichGermany
| | - Daniela Hartmann
- Department of Dermatology and AllergyLMU University HospitalLMU MunichMunichGermany
| | - Fabia Daxenberger
- Department of Dermatology and AllergyLMU University HospitalLMU MunichMunichGermany
| | | | - Charlotte Gust
- Department of Dermatology and AllergyLMU University HospitalLMU MunichMunichGermany
| | - Lars E. French
- Department of Dermatology and AllergyLMU University HospitalLMU MunichMunichGermany
- Department of Dermatology and Cutaneous SurgeryMiller School of MedicineUniversity of MiamiMiamiFloridaUSA
| | - Sandra Schuh
- Department of Dermatology and AllergologyUniversity HospitalUniversity of AugsburgAugsburgGermany
| | - Julia Welzel
- Department of Dermatology and AllergologyUniversity HospitalUniversity of AugsburgAugsburgGermany
| | - Elke C. Sattler
- Department of Dermatology and AllergyLMU University HospitalLMU MunichMunichGermany
| |
Collapse
|
5
|
Carmona-Rocha E, Rusiñol L, García-Melendo C, Iznardo H, Mozos A, López-Sánchez C, Yélamos O. Lentigo maligna: a comprehensive review on diagnosis and treatment. Ital J Dermatol Venerol 2024; 159:390-411. [PMID: 39069838 DOI: 10.23736/s2784-8671.24.07837-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/30/2024]
Abstract
Lentigo maligna (LM), a form of melanoma in situ, and LM melanoma (LMM), its invasive counterpart, exhibit distinctive epidemiology, risk factors, and clinical features compared to other melanoma subtypes. Notably, LM occurs on chronically sun-damaged skin presenting as a slow-growing, ill-defined patch which makes it difficult to diagnose and to treat. Additionally, while LM generally presents a favourable prognosis, it can also lead to dermal invasion and behave similarly to other melanomas with the same Breslow thickness. Hence, surgery continues to be the cornerstone treatment. Wide excisions are often necessary, but challenges arise when these lesions manifest in cosmetically sensitive regions, limiting the feasibility and desirability of large excisions. Specialized approaches, including margin-controlled surgery and image-guided treatment with reflectance confocal microscopy, have been developed to address these issues. Other non-surgical treatments such as cryosurgery, imiquimod, radiotherapy, or photodynamic therapy, may also be used but commonly present with recurrent/persistent disease. Herein we comprehensively review the existing literature on the management of LM/LMM, and discus the potential new advances on managing this challenging skin cancer.
Collapse
Affiliation(s)
- Elena Carmona-Rocha
- Dermatology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Institut de Recerca Sant Pau (IR Sant Pau), Barcelona, Spain
- Autonomous University of Barcelona, Bellaterra, Spain
| | - Lluís Rusiñol
- Dermatology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Institut de Recerca Sant Pau (IR Sant Pau), Barcelona, Spain
- Autonomous University of Barcelona, Bellaterra, Spain
- Dermatology Department, Teknon Quirónsalud Medical Center, Barcelona, Spain
| | | | - Helena Iznardo
- Dermatology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Institut de Recerca Sant Pau (IR Sant Pau), Barcelona, Spain
- Autonomous University of Barcelona, Bellaterra, Spain
| | - Anna Mozos
- Anatomical Pathology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Cristina López-Sánchez
- Dermatology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Institut de Recerca Sant Pau (IR Sant Pau), Barcelona, Spain
- Autonomous University of Barcelona, Bellaterra, Spain
- Dermatology Department, Teknon Quirónsalud Medical Center, Barcelona, Spain
| | - Oriol Yélamos
- Dermatology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain -
- Institut de Recerca Sant Pau (IR Sant Pau), Barcelona, Spain
- Autonomous University of Barcelona, Bellaterra, Spain
- Dermatology Department, Teknon Quirónsalud Medical Center, Barcelona, Spain
| |
Collapse
|
6
|
Diet G, Lenoir C, Fontaine M, Boussingault L, Orte Cano C, Mtimet L, Liénard D, Sanak D, Moulart F, Bernardi D, Trepant AL, Perez-Anker J, Puig S, Malvehy J, Cinotti E, Tognetti L, Rubegni P, Perrot JL, Marmol VD, Suppa M. The Role of Line-Field Confocal Optical Coherence Tomography in Detecting Extramammary Paget Disease Recurrences: A Pilot Diagnostic Study. Diagnostics (Basel) 2024; 14:1562. [PMID: 39061699 PMCID: PMC11276029 DOI: 10.3390/diagnostics14141562] [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: 06/14/2024] [Revised: 07/12/2024] [Accepted: 07/16/2024] [Indexed: 07/28/2024] Open
Abstract
Extramammary Paget disease (EMPD) is an uncommon adenocarcinoma of apocrine gland-rich areas, presenting significant diagnostic challenges due to its nonspecific clinical appearance and frequent misidentification as benign, inflammatory skin conditions. Traditional diagnostic methods such as biopsy are invasive and uncomfortable, often required repeatedly due to high recurrence rates. Dermoscopy and non-invasive imaging techniques have been used but provide limited diagnostic accuracy due to their constraints in depth penetration and resolution. Recent advancements in imaging technologies, such as line-field confocal optical coherence tomography (LC-OCT), show promise in enhancing diagnostic precision while minimizing invasive procedures. LC-OCT merges high-resolution imaging with deep penetration capabilities, capturing detailed horizontal and vertical skin images akin to histopathology. This study evaluated the diagnostic performance of LC-OCT in detecting EMPD and its recurrence in 17 clinically suspicious anogenital regions, belonging to six patients. Data were collected prospectively at the patient's bedside by an LC-OCT expert with poor training for EMPD, and, then, reviewed retrospectively by an independent LC-OCT expert with adequate training for EMPD and no concerns about time. The prospective examination yielded 64.7% accuracy (11 true results out of 17 total cases), 71.4% sensitivity (10 true positives out of 14 actual positives), and 33.3% specificity (1 true negative out of 3 actual negatives). The retrospective analysis achieved 94.1% accuracy (16 true results out of 17 total cases), 100% sensitivity (14 true positives out of 14 actual positives), and 66.7% specificity (2 true positives out of 3 actual positives), with the only false positive case being a difficult-to-diagnose concomitant presentation of a lichen sclerosus et atrophicus. Despite the need for specialized training, our results suggest that LC-OCT represents a valuable tool for accurately identifying EMPD and improving its management by reducing unnecessary biopsies. Further studies are needed to standardize its clinical application.
Collapse
Affiliation(s)
- Gwendoline Diet
- Department of Dermatology, Hôpital Erasme, Université Libre de Bruxelles (ULB), HUB, 1070 Brussels, Belgium
| | - Clément Lenoir
- Department of Dermatology, Hôpital Erasme, Université Libre de Bruxelles (ULB), HUB, 1070 Brussels, Belgium
- Melanoma Unit, Hospital Clinic Barcelona, University of Barcelona, 08036 Barcelona, Spain
| | - Margot Fontaine
- Department of Dermatology, Hôpital Erasme, Université Libre de Bruxelles (ULB), HUB, 1070 Brussels, Belgium
| | - Lucas Boussingault
- Department of Dermatology, Hôpital Erasme, Université Libre de Bruxelles (ULB), HUB, 1070 Brussels, Belgium
- Department of Dermatology, Institut Jules Bordet, Université Libre de Bruxelles (ULB), HUB, 1070 Brussels, Belgium
| | - Carmen Orte Cano
- Department of Dermatology, Hôpital Erasme, Université Libre de Bruxelles (ULB), HUB, 1070 Brussels, Belgium
- Department of Dermatology, Institut Jules Bordet, Université Libre de Bruxelles (ULB), HUB, 1070 Brussels, Belgium
| | - Lyna Mtimet
- Department of Dermatology, Hôpital Erasme, Université Libre de Bruxelles (ULB), HUB, 1070 Brussels, Belgium
| | - Danielle Liénard
- Department of Dermatology, Hôpital Erasme, Université Libre de Bruxelles (ULB), HUB, 1070 Brussels, Belgium
- Department of Dermatology, Institut Jules Bordet, Université Libre de Bruxelles (ULB), HUB, 1070 Brussels, Belgium
| | - Dilara Sanak
- Department of Pathology, Erasme University Hospital, Université Libre de Bruxelles (ULB), 1070 Brussels, Belgium
| | - Florine Moulart
- Department of Pathology, Erasme University Hospital, Université Libre de Bruxelles (ULB), 1070 Brussels, Belgium
| | - Dana Bernardi
- Department of Pathology, Erasme University Hospital, Université Libre de Bruxelles (ULB), 1070 Brussels, Belgium
| | - Anne-Laure Trepant
- Department of Pathology, Erasme University Hospital, Université Libre de Bruxelles (ULB), 1070 Brussels, Belgium
| | - Javiera Perez-Anker
- Melanoma Unit, Hospital Clinic Barcelona, University of Barcelona, 08036 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Carlos III Health Institute, 28029 Barcelona, Spain
| | - Susana Puig
- Melanoma Unit, Hospital Clinic Barcelona, University of Barcelona, 08036 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Carlos III Health Institute, 28029 Barcelona, Spain
| | - Josep Malvehy
- Melanoma Unit, Hospital Clinic Barcelona, University of Barcelona, 08036 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Carlos III Health Institute, 28029 Barcelona, Spain
| | - Elisa Cinotti
- Unit of Dermatology, Department of Medical, Surgical and Neurological Sciences, University of Siena, 53100 Siena, Italy
- Groupe d’Imagerie Cutanée Non Invasive (GICNI) of the Société Française de Dermatologie (SFD), 42055 Paris, France
| | - Linda Tognetti
- Unit of Dermatology, Department of Medical, Surgical and Neurological Sciences, University of Siena, 53100 Siena, Italy
| | - Pietro Rubegni
- Unit of Dermatology, Department of Medical, Surgical and Neurological Sciences, University of Siena, 53100 Siena, Italy
| | - Jean-Luc Perrot
- Department of Dermatology, University Hospital of Saint-Etienne, 42055 Saint-Etienne, France
| | - Véronique Del Marmol
- Department of Dermatology, Hôpital Erasme, Université Libre de Bruxelles (ULB), HUB, 1070 Brussels, Belgium
- Department of Dermatology, Institut Jules Bordet, Université Libre de Bruxelles (ULB), HUB, 1070 Brussels, Belgium
| | - Mariano Suppa
- Department of Dermatology, Institut Jules Bordet, Université Libre de Bruxelles (ULB), HUB, 1070 Brussels, Belgium
- Groupe d’Imagerie Cutanée Non Invasive (GICNI) of the Société Française de Dermatologie (SFD), 42055 Paris, France
| |
Collapse
|
7
|
Michielon E, Motta AC, Ogien J, Oranje P, Waaijman T, Thakoersing V, Veldhorst S, de Gruijl TD, Gibbs S. Integration of line-field confocal optical coherence tomography and in situ microenvironmental mapping to investigate the living microenvironment of reconstructed human skin and melanoma models. J Dermatol Sci 2024:S0923-1811(24)00147-6. [PMID: 39043504 DOI: 10.1016/j.jdermsci.2024.07.001] [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: 02/19/2024] [Revised: 06/12/2024] [Accepted: 07/08/2024] [Indexed: 07/25/2024]
Abstract
BACKGROUND In tissue engineering, real-time monitoring of tumors and of the dynamics of the microenvironment within in vitro models has traditionally been hindered by the need to harvest the cultures to obtain material to analyze. Line-field confocal optical coherence tomography (LC-OCT) has proven to be useful in evaluating in vivo skin conditions, including melanoma, by capturing dynamic, three-dimensional (3D) information without the need for invasive procedures, such as biopsies. Additionally, the M-Duo Technology® developed by IMcoMET presents a unique opportunity for continuous in situ biomarker sampling, providing insights into local cellular behavior and interactions. OBJECTIVE This study aimed to validate the non-destructive mapping capabilities of two advanced methodologies (LC-OCT by DAMAE Medical and M-Duo Technology® by IMcoMET) to investigate the living microenvironment of in vitro reconstructed human skin (RhS) and melanoma-RhS (Mel-RhS). METHODS LC-OCT and M-Duo Technology® were compared to conventional analysis of the RhS and Mel-RhS microenvironments. RESULTS LC-OCT successfully visualized the distinct layers of the epidermis and tumor structures within the Mel-RhS, identifying keratinocytes, melanocytes, tumor nests, and fibroblasts. The M-Duo Technology® revealed differences in in situ cytokine (IL-6) and chemokine (CCL2, CXCL10, and IL-8) secretion between Mel-RhS and the control RhS. Notably, such differences were not detected through conventional investigation of secreted proteins in culture supernatants. CONCLUSION The combination of LC-OCT's high-resolution imaging and M-Duo Technology®'s in situ microenvironmental mapping has the potential to provide a synergistic platform for non-invasive, real-time analysis, allowing for prolonged observation of processes within Mel-RhS models without the need for culture disruption.
Collapse
Affiliation(s)
- Elisabetta Michielon
- Department of Molecular Cell Biology and Immunology, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, the Netherlands; Amsterdam institute for Infection and Immunity, Amsterdam University Medical Center, Vrije Universiteit, Amsterdam, the Netherlands; Cancer Center Amsterdam, Cancer Biology and Immunology Program, Amsterdam UMC, Vrije Universiteit, Amsterdam, the Netherlands
| | | | | | | | - Taco Waaijman
- Department of Molecular Cell Biology and Immunology, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, the Netherlands; Amsterdam institute for Infection and Immunity, Amsterdam University Medical Center, Vrije Universiteit, Amsterdam, the Netherlands
| | | | | | - Tanja D de Gruijl
- Amsterdam institute for Infection and Immunity, Amsterdam University Medical Center, Vrije Universiteit, Amsterdam, the Netherlands; Cancer Center Amsterdam, Cancer Biology and Immunology Program, Amsterdam UMC, Vrije Universiteit, Amsterdam, the Netherlands; Department of Medical Oncology, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Susan Gibbs
- Department of Molecular Cell Biology and Immunology, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, the Netherlands; Amsterdam institute for Infection and Immunity, Amsterdam University Medical Center, Vrije Universiteit, Amsterdam, the Netherlands; Cancer Center Amsterdam, Cancer Biology and Immunology Program, Amsterdam UMC, Vrije Universiteit, Amsterdam, the Netherlands; Department of Oral Cell Biology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit, Amsterdam, the Netherlands.
| |
Collapse
|
8
|
Tognetti L, Galluccio G, Oranges T, Pianigiani E, Ierardi F, Cinotti E, Rubegni P. Line-Field Optical Coherence Tomography: Usefulness in the Non-Invasive Differential Diagnosis of Congenital Alopecia of Infancy. Dermatol Pract Concept 2024; 14:dpc.1403a142. [PMID: 39122504 PMCID: PMC11314481 DOI: 10.5826/dpc.1403a142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/08/2024] [Indexed: 08/12/2024] Open
Abstract
INTRODUCTION Soon after birth, the clinical differential diagnosis between sebaceous of Jadassohn (NSJ), congenital triangular alopecia (CTA) and aplasia cutis congenita (ACC) may be challenging. A certain overlap of standard dermoscopic features can occur, especially in atypical cases, depending on scalp skin morphology and maturation age. The recently developed line-field confocal optical coherence tomography (LC-OCT) can provide morphological skin details with cellular resolution trough a rapid non-invasive examination. OBJECTIVES To assess the LC-OCT features of 6 cases of congenital alopecia of different aetiologies, with both typical and atypical clinical appearance. METHODS A non-invasive imaging examination combining standard dermoscopy, high-resolution videodermoscopy (HRVD) and LC-OCT was realized in 7 babies presenting for congenital alopecia with overlapping features, aged between 5 months and 5 years. RESULTS Based on the specific LC-OCT features, and supported by HRVD features, a diagnosis of NSJ, congenital triangular alopecia (CTA) and AC) were made in 4, 2 and 1 case, respectively. CONCLUSIONS The combined LC-OCT plus HRVD non-invasive imaging bring the advantage to have a real time diagnosis, to set the proper management and allows to avoid a skin biopsy in the perinatal age/first years of life at delicate skin site.
Collapse
Affiliation(s)
- Linda Tognetti
- Dermatology Unit, Department of Medical, Surgical and Neurological Science, Dermatology Section, University of Siena, S. Maria alle Scotte Hospital, Siena, Italy
| | - Giulia Galluccio
- Dermatology Unit, Department of Medical, Surgical and Neurological Science, Dermatology Section, University of Siena, S. Maria alle Scotte Hospital, Siena, Italy
| | | | - Elisa Pianigiani
- Dermatology Unit, Department of Medical, Surgical and Neurological Science, Dermatology Section, University of Siena, S. Maria alle Scotte Hospital, Siena, Italy
| | - Francesca Ierardi
- Dermatology Unit, Department of Medical, Surgical and Neurological Science, Dermatology Section, University of Siena, S. Maria alle Scotte Hospital, Siena, Italy
| | - Elisa Cinotti
- Dermatology Unit, Department of Medical, Surgical and Neurological Science, Dermatology Section, University of Siena, S. Maria alle Scotte Hospital, Siena, Italy
| | - Pietro Rubegni
- Dermatology Unit, Department of Medical, Surgical and Neurological Science, Dermatology Section, University of Siena, S. Maria alle Scotte Hospital, Siena, Italy
| |
Collapse
|
9
|
Schuh S. [Diagnosis and treatment monitoring of basal cell carcinoma in one step: BCC one-stop shop : In vivo and ex vivo monitoring of basal cell carcinoma margins]. DERMATOLOGIE (HEIDELBERG, GERMANY) 2024; 75:587-591. [PMID: 38935289 DOI: 10.1007/s00105-024-05378-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/03/2024] [Indexed: 06/28/2024]
Affiliation(s)
- Sandra Schuh
- Klinik für Dermatologie und Allergologie, Sauerbruchstr. 6, 86179, Augsburg, Deutschland.
| |
Collapse
|
10
|
Deußing M, Ruini C, Nutz M, Kerl‐French K, Hartmann D, French LE, Daxenberger F, Sattler EC. Illuminating characteristic patterns of inflammatory dermatoses: A comprehensive dual-imaging approach using Optical coherence tomography and Line-field confocal optical coherence tomography. Skin Res Technol 2024; 30:e13833. [PMID: 38961692 PMCID: PMC11222661 DOI: 10.1111/srt.13833] [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: 04/07/2024] [Accepted: 06/11/2024] [Indexed: 07/05/2024]
Abstract
BACKGROUND Inflammatory skin diseases, such as psoriasis, atopic eczema, and contact dermatitis pose diagnostic challenges due to their diverse clinical presentations and the need for rapid and precise diagnostic assessment. OBJECTIVE While recent studies described non-invasive imaging devices such as Optical coherence tomography and Line-field confocal OCT (LC-OCT) as possible techniques to enable real-time visualization of pathological features, a standardized analysis and validation has not yet been performed. METHODS One hundred forty lesions from patients diagnosed with atopic eczema (57), psoriasis (50), and contact dermatitis (33) were imaged using OCT and LC-OCT. Statistical analysis was employed to assess the significance of their characteristic morphologic features. Additionally, a decision tree algorithm based on Gini's coefficient calculations was developed to identify key attributes and criteria for accurately classifying the disease groups. RESULTS Descriptive statistics revealed distinct morphologic features in eczema, psoriasis, and contact dermatitis lesions. Multivariate logistic regression demonstrated the significance of these features, providing a robust differentiation between the three inflammatory conditions. The decision tree algorithm further enhanced classification accuracy by identifying optimal attributes for disease discrimination, highlighting specific morphologic criteria as crucial for rapid diagnosis in the clinical setting. CONCLUSION The combined approach of descriptive statistics, multivariate logistic regression, and a decision tree algorithm provides a thorough understanding of the unique aspects associated with each inflammatory skin disease. This research offers a practical framework for lesion classification, enhancing the interpretability of imaging results for clinicians.
Collapse
Affiliation(s)
- Maximilian Deußing
- Department of Dermatology and AllergyLMU University HospitalLMU MunichMunichGermany
| | - Cristel Ruini
- Department of Dermatology and AllergyLMU University HospitalLMU MunichMunichGermany
- Dermatology ClinicDepartment of Clinical InternalAnesthesiological and Cardiovascular SciencesSapienza University of RomeRomeItaly
| | - Marie Nutz
- Department of Dermatology and AllergyLMU University HospitalLMU MunichMunichGermany
| | - Karin Kerl‐French
- Department of Dermatology and AllergyLMU University HospitalLMU MunichMunichGermany
| | - Daniela Hartmann
- Department of Dermatology and AllergyLMU University HospitalLMU MunichMunichGermany
| | - Lars E. French
- Department of Dermatology and AllergyLMU University HospitalLMU MunichMunichGermany
- Department of Dermatology & Cutaneous SurgeryMiller School of MedicineUniversity of MiamiMiamiFloridaUSA
| | - Fabia Daxenberger
- Department of Dermatology and AllergyLMU University HospitalLMU MunichMunichGermany
| | - Elke C. Sattler
- Department of Dermatology and AllergyLMU University HospitalLMU MunichMunichGermany
| |
Collapse
|
11
|
Fünfer K, Mozaffari M, Mayer O, Schlingmann S, Welzel J, Schuh S. One-Stop Shop: Diagnosis and Treatment of Basal Cell Carcinoma in One Step. J Clin Med 2024; 13:3830. [PMID: 38999395 PMCID: PMC11242514 DOI: 10.3390/jcm13133830] [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: 05/24/2024] [Revised: 06/22/2024] [Accepted: 06/24/2024] [Indexed: 07/14/2024] Open
Abstract
Monitoring the tumor margins of basal cell carcinomas is still a challenge in everyday clinical practice. Usually, the clinical margins of the tumor are marked by the naked eye or, even better, with dermoscopy before surgery and then examined in detail after the operation using histological examination. In order to achieve tumor freedom, several surgical steps are sometimes necessary, meaning that patients spend longer periods in hospital and the healthcare system is burdened more as a result. One way to improve this is the one-stop shop method, which requires precise diagnostics and margin marking before and during surgery so that tumor freedom can be achieved after just one surgery. For this reason, the current status of the diagnosis and treatment of basal cell carcinomas before and after surgery is to be examined following extensive literature research using devices and methods that have already been tested in order to determine how a simplified process of tumor margin control of basal cell carcinomas can be made possible both in vivo and ex vivo.
Collapse
Affiliation(s)
- Kristina Fünfer
- Department of Dermatology and Allergology, University Hospital, 86179 Augsburg, Germany
| | - Marco Mozaffari
- Department of Dermatology and Allergology, University Hospital, 86179 Augsburg, Germany
| | - Oliver Mayer
- Department of Dermatology and Allergology, University Hospital, 86179 Augsburg, Germany
| | - Sophia Schlingmann
- Department of Dermatology and Allergology, University Hospital, 86179 Augsburg, Germany
| | - Julia Welzel
- Department of Dermatology and Allergology, University Hospital, 86179 Augsburg, Germany
| | - Sandra Schuh
- Department of Dermatology and Allergology, University Hospital, 86179 Augsburg, Germany
| |
Collapse
|
12
|
Soglia S, Pérez-Anker J, Albero R, Alós L, Berot V, Castillo P, Cinotti E, Del Marmol V, Fakih A, García A, Lenoir C, Monnier J, Perrot JL, Puig S, Rubegni P, Skowron F, Suppa M, Tognetti L, Venturini M, Malvehy J. Understanding the anatomy of dermoscopy of melanocytic skin tumours: Correlation in vivo with line-field optical coherence tomography. J Eur Acad Dermatol Venereol 2024; 38:1191-1201. [PMID: 38131528 DOI: 10.1111/jdv.19771] [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: 06/03/2023] [Accepted: 11/21/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND Early melanoma detection is the main factor affecting prognosis and survival. For that reason, non-invasive technologies have been developed to provide a more accurate diagnosis. Recently, line-field confocal optical coherence tomography (LC-OCT) was developed to provide an in vivo, imaging device, with deep penetration and cellular resolution in three dimensions. Combining the advantages of conventional OCT and reflectance confocal microscopy, this tool seems to be particularly suitable for melanocytic lesions. OBJECTIVES The objective of this study was to identify and describe the correlation between specific dermoscopic criteria and LC-OCT features in three dimensions associated with melanocytic lesions. METHODS Dermoscopic and LC-OCT images of 126 melanocytic lesions were acquired in three different centres. The following dermoscopic criteria have been considered: reticular pattern, dots and globules, structureless areas, blue-whitish veil, regression structures, negative network, homogeneous pattern, streaks and blotches. RESULTS 69 (55%) benign and 57 (45%) malignant lesions were analysed. A regular reticular pattern was found associated in the 75% of the cases with the presence of elongated rete ridges with pigmented cells along the basal layer, while atypical reticular pattern showed an irregular organization of rete ridges with melanocytic hyperplasia, broadened and fused ridges and elongated nests. Both typical and atypical dots and globules were found associated with melanocytic nests in the dermis or at the dermoepidermal junction (DEJ), as well as with keratin cysts/pseudocysts. Grey globules corresponded to the presence of melanin-containing dermal inflammatory cells (melanophages) within the papillae. Structureless brown/black areas correlated with alterations of the DEJ. We observed the same DEJ alterations, but with the presence of dermal melanophages, in 36% of the cases of blue/white/grey structureless areas. A description of each LC-OCT/dermoscopy correlation was made. CONCLUSIONS LC-OCT permitted for the first time to perform an in vivo, 3D correlation between dermoscopic criteria and pathological-like features of melanocytic lesions.
Collapse
Affiliation(s)
- S Soglia
- Melanoma Unit, Dermatology Department, Hospital Clínic de Barcelona, Barcelona, Spain
- Department of Dermatology, University of Brescia, Brescia, Italy
| | - J Pérez-Anker
- Melanoma Unit, Dermatology Department, Hospital Clínic de Barcelona, Barcelona, Spain
| | - R Albero
- Pathology Department, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - L Alós
- Pathology Department, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - V Berot
- Dermatology Department, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - P Castillo
- Pathology Department, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - E Cinotti
- Dermatology Unit, Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy
- Groupe d'Imagerie Cutanée Non Invasive (GICNI) of the Société Française de Dermatologie, Paris, France
| | - V Del Marmol
- Department of Dermatology, Hôpital Erasme, HUB, Université Libre de Bruxelles, Brussels, Belgium
| | - A Fakih
- Dermatology Department, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - A García
- Pathology Department, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - C Lenoir
- Department of Dermatology, Hôpital Erasme, HUB, Université Libre de Bruxelles, Brussels, Belgium
| | - J Monnier
- Dermatology Department, AP-HM, Aix-Marseille University, Marseille, France
| | - J L Perrot
- Dermatology Department, University Hospital of Saint-Etienne, Saint-Etienne, France
- Groupe d'Imagerie Cutanée Non Invasive (GICNI) of the Société Française de Dermatologie, Paris, France
- Laboratoire de tribologie des systèmes UMR CNRS 5513, Saint-Etienne, France
| | - S Puig
- Melanoma Unit, Dermatology Department, Hospital Clínic de Barcelona, Barcelona, Spain
- Universitat de Barcelona, Barcelona, Spain
- IDIBAPS, Barcelona, Belgium
| | - P Rubegni
- Dermatology Unit, Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy
| | - F Skowron
- Dermatology Department, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - M Suppa
- Groupe d'Imagerie Cutanée Non Invasive (GICNI) of the Société Française de Dermatologie, Paris, France
- Department of Dermatology, Hôpital Erasme, HUB, Université Libre de Bruxelles, Brussels, Belgium
- Department of Dermato-Oncology, Institut Jules Bordet, HUB, Université Libre de Bruxelles, Brussels, Belgium
| | - L Tognetti
- Dermatology Unit, Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy
| | - M Venturini
- Department of Dermatology, University of Brescia, Brescia, Italy
| | - J Malvehy
- Melanoma Unit, Dermatology Department, Hospital Clínic de Barcelona, Barcelona, Spain
- Universitat de Barcelona, Barcelona, Spain
- IDIBAPS, Barcelona, Belgium
| |
Collapse
|
13
|
Grove GL, Jacobsen K, Maartensson NL, Haedersdal M. Subclinical effects of botulinum toxin A and microwave thermolysis for axillary hyperhidrosis: A descriptive study with line-field confocal optical coherence tomography and histology. Exp Dermatol 2024; 33:e15110. [PMID: 38884423 DOI: 10.1111/exd.15110] [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: 01/18/2024] [Revised: 04/22/2024] [Accepted: 05/14/2024] [Indexed: 06/18/2024]
Abstract
Botulinum toxin A (BTX) and microwave thermolysis (MWT) are standard axillary hyperhidrosis treatments, but comparison of their subclinical effects is lacking. Line-field confocal optical coherence tomography (LC-OCT) is a promising non-invasive imaging tool for visualizing tissue-interactions. This study aimed to describe subclinical effects of BTX and MWT for axillary hyperhidrosis with LC-OCT-imaging compared to histology. This study derived from an intra-individual, randomized, controlled trial, treating axillary hyperhidrosis with BTX versus MWT. Subclinical effects based on LC-OCT images from baseline and 6-month follow-up (n = 8 patients) were evaluated and compared to corresponding histological samples. At baseline, LC-OCT visualized eccrine pores at the skin surface and ducts in the upper dermis (500 μm), but not deeper-lying sweat glands. Histology identified entire sweat glands. Six months post-treatment, LC-OCT revealed no detectable morphology changes in any BTX-treated axillae (100%), while recognizing obstructed eccrine pores and atrophy of eccrine ducts in most MWT-treated axillae (75%). Histology corroborated LC-OCT findings, while also showing substantial changes to entire sweat glands. LC-OCT enabled visualization of subclinical alterations of superficial eccrine ducts after MWT and unchanged morphology after BTX. LC-OCT is a promising tool for non-invasive assessment of treatment-specific tissue-interactions that can be complementary to histology.
Collapse
Affiliation(s)
- Gabriela Lladó Grove
- Department of Dermatology, Copenhagen University Hospital-Bispebjerg, Copenhagen, Denmark
| | - Kevin Jacobsen
- Department of Dermatology, Copenhagen University Hospital-Bispebjerg, Copenhagen, Denmark
| | - Nina Loeth Maartensson
- Department of Pathology, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Merete Haedersdal
- Department of Dermatology, Copenhagen University Hospital-Bispebjerg, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| |
Collapse
|
14
|
Thamm JR, Welzel J, Schuh S. Diagnosis and therapy of actinic keratosis. J Dtsch Dermatol Ges 2024; 22:675-690. [PMID: 38456369 DOI: 10.1111/ddg.15288] [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: 01/31/2023] [Accepted: 09/28/2023] [Indexed: 03/09/2024]
Abstract
Actinic keratosis (AK) is considered a chronic and recurring in situ skin neoplasia, with a possible transformation into invasive squamous cell carcinoma (SCC). Among others, predominant risk factors for development of AK are UV-light exposure and immunosuppression. Basal epidermal keratinocyte atypia (AK I) and proliferation (PRO score) seem to drive malignant transformation, rather than clinical appearance of AK (Olsen I-III). Due to the invasiveness of punch biopsy, those histological criteria are not regularly assessed. Non-invasive imaging techniques, such as optical coherence tomography (OCT), reflectance confocal microscopy (RCM) and line-field confocal OCT (LC-OCT) are helpful to distinguish complex cases of AK, Bowen's disease, and SCC. Moreover, LC-OCT can visualize the epidermis and the papillary dermis at cellular resolution, allowing real-time PRO score assessment. The decision-making for implementation of therapy is still based on clinical risk factors, ranging from lesion- to field-targeted and ablative to non-ablative regimens, but in approximately 85% of the cases a recurrence of AK can be observed after a 1-year follow-up. The possible beneficial use of imaging techniques for a non-invasive follow-up of AK to detect recurrence or invasive progression early on should be subject to critical evaluation in further studies.
Collapse
Affiliation(s)
- Janis Raphael Thamm
- Department of Dermatology and Allergology, University Hospital Augsburg, Augsburg, Germany
| | - Julia Welzel
- Department of Dermatology and Allergology, University Hospital Augsburg, Augsburg, Germany
| | - Sandra Schuh
- Department of Dermatology and Allergology, University Hospital Augsburg, Augsburg, Germany
| |
Collapse
|
15
|
Thamm JR, Welzel J, Schuh S. Diagnose und Therapie aktinischer Keratosen. J Dtsch Dermatol Ges 2024; 22:675-691. [PMID: 38730534 DOI: 10.1111/ddg.15288_g] [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: 01/31/2023] [Accepted: 09/28/2023] [Indexed: 05/13/2024]
Abstract
Actinic keratosis (AK) is considered a chronic and recurring in situ skin neoplasia, with a possible transformation into invasive squamous cell carcinoma (SCC). Among others, predominant risk factors for development of AK are UV-light exposure and immunosuppression. Basal epidermal keratinocyte atypia (AK I) and proliferation (PRO Score) seem to drive malignant turnover, rather than clinical appearance of AK (Olsen I-III). Due to the invasiveness of punch biopsy, those histological criteria are not regularly assessed. Non-invasive imaging techniques, such as optical coherence tomography (OCT), reflectance confocal microscopy (RCM) and line-field confocal OCT (LC-OCT) are helpful to distinguish complex cases of AK, Bowen's disease and SCC. Moreover, LC-OCT can visualize the epidermis and the papillary dermis at cellular resolution, allowing real-time PRO Score assessment. The decision-making for implementation of therapy is still based on clinical risk factors, ranging from lesion- to field-targeted and ablative to non-ablative regimes, but in approximately 85% of the cases a recurrence of AK can be observed after a 1-year follow-up. The possible beneficial use of imaging techniques for a non-invasive follow-up of AK to detect recurrence or invasive progression early on should be subject to critical evaluation in further studies.
Collapse
Affiliation(s)
| | - Julia Welzel
- Klinik für Dermatologie und Allergologie, Universitätsklinikum Augsburg
| | - Sandra Schuh
- Klinik für Dermatologie und Allergologie, Universitätsklinikum Augsburg
| |
Collapse
|
16
|
Winetraub Y, Van Vleck A, Yuan E, Terem I, Zhao J, Yu C, Chan W, Do H, Shevidi S, Mao M, Yu J, Hong M, Blankenberg E, Rieger KE, Chu S, Aasi S, Sarin KY, de la Zerda A. Noninvasive virtual biopsy using micro-registered optical coherence tomography (OCT) in human subjects. SCIENCE ADVANCES 2024; 10:eadi5794. [PMID: 38598626 PMCID: PMC11006228 DOI: 10.1126/sciadv.adi5794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 03/07/2024] [Indexed: 04/12/2024]
Abstract
Histological hematoxylin and eosin-stained (H&E) tissue sections are used as the gold standard for pathologic detection of cancer, tumor margin detection, and disease diagnosis. Producing H&E sections, however, is invasive and time-consuming. While deep learning has shown promise in virtual staining of unstained tissue slides, true virtual biopsy requires staining of images taken from intact tissue. In this work, we developed a micron-accuracy coregistration method [micro-registered optical coherence tomography (OCT)] that can take a two-dimensional (2D) H&E slide and find the exact corresponding section in a 3D OCT image taken from the original fresh tissue. We trained a conditional generative adversarial network using the paired dataset and showed high-fidelity conversion of noninvasive OCT images to virtually stained H&E slices in both 2D and 3D. Applying these trained neural networks to in vivo OCT images should enable physicians to readily incorporate OCT imaging into their clinical practice, reducing the number of unnecessary biopsy procedures.
Collapse
Affiliation(s)
- Yonatan Winetraub
- Department of Structural Biology, Stanford University, Stanford, CA 94305, USA
- Molecular Imaging Program at Stanford, Stanford, CA 94305, USA
- The Bio-X Program, Stanford, CA 94305, USA
- Biophysics Program at Stanford, Stanford, CA 94305, USA
| | - Aidan Van Vleck
- Department of Structural Biology, Stanford University, Stanford, CA 94305, USA
| | - Edwin Yuan
- Department of Structural Biology, Stanford University, Stanford, CA 94305, USA
- Molecular Imaging Program at Stanford, Stanford, CA 94305, USA
- Department of Applied Physics, Stanford University, Stanford, CA 94305, USA
| | - Itamar Terem
- Department of Structural Biology, Stanford University, Stanford, CA 94305, USA
- Molecular Imaging Program at Stanford, Stanford, CA 94305, USA
- Department of Electrical Engineering, Stanford University, Stanford, CA 94305, USA
| | - Jinjing Zhao
- Department of Structural Biology, Stanford University, Stanford, CA 94305, USA
| | - Caroline Yu
- Department of Structural Biology, Stanford University, Stanford, CA 94305, USA
- Molecular Imaging Program at Stanford, Stanford, CA 94305, USA
| | - Warren Chan
- Department of Dermatology, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Hanh Do
- Department of Dermatology, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Saba Shevidi
- Department of Structural Biology, Stanford University, Stanford, CA 94305, USA
- Molecular Imaging Program at Stanford, Stanford, CA 94305, USA
| | - Maiya Mao
- Department of Structural Biology, Stanford University, Stanford, CA 94305, USA
- Molecular Imaging Program at Stanford, Stanford, CA 94305, USA
| | - Jacqueline Yu
- Department of Structural Biology, Stanford University, Stanford, CA 94305, USA
- Molecular Imaging Program at Stanford, Stanford, CA 94305, USA
| | - Megan Hong
- Department of Structural Biology, Stanford University, Stanford, CA 94305, USA
- Molecular Imaging Program at Stanford, Stanford, CA 94305, USA
| | - Erick Blankenberg
- Department of Structural Biology, Stanford University, Stanford, CA 94305, USA
- Molecular Imaging Program at Stanford, Stanford, CA 94305, USA
| | - Kerri E. Rieger
- Department of Pathology, Stanford University School of Medicine and Stanford Cancer Institute, Stanford, CA 94305, USA
| | - Steven Chu
- The Bio-X Program, Stanford, CA 94305, USA
- Biophysics Program at Stanford, Stanford, CA 94305, USA
- Departments of Physics and Molecular and Cellular Physiology, Energy, Science and Engineering Stanford University, Stanford, CA 94305, USA
| | - Sumaira Aasi
- Department of Dermatology, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Kavita Y. Sarin
- Department of Dermatology, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Adam de la Zerda
- Department of Structural Biology, Stanford University, Stanford, CA 94305, USA
- Molecular Imaging Program at Stanford, Stanford, CA 94305, USA
- The Bio-X Program, Stanford, CA 94305, USA
- Biophysics Program at Stanford, Stanford, CA 94305, USA
- Department of Electrical Engineering, Stanford University, Stanford, CA 94305, USA
- The Chan Zuckerberg Biohub, San Francisco, CA 94158, USA
| |
Collapse
|
17
|
Jacobsen K, Ortner VK, Wenande E, Sahu A, Paasch U, Haedersdal M. Line-field confocal optical coherence tomography in dermato-oncology: A literature review towards harmonized histopathology-integrated terminology. Exp Dermatol 2024; 33:e15057. [PMID: 38623958 DOI: 10.1111/exd.15057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 02/28/2024] [Accepted: 03/03/2024] [Indexed: 04/17/2024]
Abstract
Non-invasive diagnostics like line-field confocal optical coherence tomography (LC-OCT) are being implemented in dermato-oncology. However, unification of terminology in LC-OCT is lacking. By reviewing the LC-OCT literature in the field of dermato-oncology, this study aimed to develop a unified terminological glossary integrated with traditional histopathology. A PRISMA-guided literature-search was conducted for English-language publications on LC-OCT of actinic keratosis (AK), keratinocyte carcinoma (KC), and malignant melanoma (MM). Study characteristics and terminology were compiled. To harmonize LC-OCT terminology and integrate with histopathology, synonymous terms for image features of AK, KC, and MM were merged by two authors, organized by skin layer and lesion-type. A subset of key LC-OCT image-markers with histopathological correlates that in combination were typical of AK, squamous cell carcinoma in situ (SCCis), invasive squamous cell carcinoma (SCC), basal cell carcinoma (BCC), and MM in traditional histopathology, were selected from the glossary by an experienced dermatopathologist. Seventeen observational studies of AK (7 studies), KC (13 studies), MM (7 studies) utilizing LC-OCT were included, with 117 terms describing either AK, KC, or MM. These were merged to produce 45 merged-terms (61.5% reduction); 5 assigned to the stratum corneum (SC), 23 to the viable epidermis, 2 to dermo-epidermal junction (DEJ) and 15 to the dermis. For each lesion, mandatory key image-markers were a well-defined DEJ and presence of mild/moderate but not severe epidermal dysplasia for AK, severe epidermal dysplasia and well-defined DEJ for SCCis, interrupted DEJ and/or dermal broad infiltrative strands for invasive SCC, dermal lobules connected and/or unconnected to the epidermis for BCC, as well as single atypical melanocytes and/or nest of atypical melanocytes in the epidermis or dermis for MM. This review compiles evidence on LC-OCT in dermato-oncology, providing a harmonized histopathology-integrated terminology and key image-markers for each lesion. Further evaluation is required to determine the clinical value of these findings.
Collapse
Affiliation(s)
- Kevin Jacobsen
- Department of Dermatology, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Vinzent Kevin Ortner
- Department of Dermatology, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Emily Wenande
- Department of Dermatology, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Aditi Sahu
- Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | | | - Merete Haedersdal
- Department of Dermatology, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| |
Collapse
|
18
|
Nissen AHK, Vergmann AS. Clinical Utilisation of Wide-Field Optical Coherence Tomography and Angiography: A Narrative Review. Ophthalmol Ther 2024; 13:903-915. [PMID: 38372953 PMCID: PMC10912399 DOI: 10.1007/s40123-024-00905-2] [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: 01/05/2024] [Accepted: 02/05/2024] [Indexed: 02/20/2024] Open
Abstract
Many important abnormalities of the vitreous, retina and choroid are predominantly located in the peripheral retina. In some retinal diseases with both central and peripheral manifestations, pathological structural or vascular changes can be apparent in the periphery before they are detectable in the central retina. Conventional optical coherence tomography (OCT) and optical coherence tomography angiography (OCT-A) imaging only cover the most posterior 30° of the retina. Wide-field OCT (WF-OCT), though offering detailed cross-sectional imaging of the peripheral retina, is not yet systematically used in clinical practice. This narrative review provides a presentation of the utilisation of WF-OCT and WF-OCT-A in the diagnosis and monitoring of a variety of ophthalmological diseases and discusses the advantages and limitations of the technology. With the rapidly developing technology, multiple WF-OCT and WF-OCT-A devices are now commercially available and enable the clinician to obtain scans within a field of view up to 200°. As detailed in this review, several studies have shown promising results in the application of WF-OCT and WF-OCT-A in diseases of the retina, choroid and vitreous, such as retinal vein occlusion, diabetic retinopathy, ocular oncology, paediatric ophthalmology, uveitis and lesions of the vitreo-retinal interface. In conclusion, WF-OCT and WF-OCT-A can reliably produce high-quality, non-invasive images of the vitreous, retinal, and choroidal structures and vascularity covering the posterior pole as well as the mid and far periphery. These methods can be a valuable part of a multimodal imaging approach in the management of a variety of ocular conditions. Future studies are warranted to investigate the patient outcome benefits of implementation of WF-OCT and WF-OCT-A imaging in a real-life clinical setting.
Collapse
Affiliation(s)
- Anne Helene K Nissen
- Research Unit of Ophthalmology, Department of Ophthalmology, Odense University Hospital, J. B. Winsløws Vej 4, 5000, Odense C, Denmark
| | - Anna Stage Vergmann
- Research Unit of Ophthalmology, Department of Ophthalmology, Odense University Hospital, J. B. Winsløws Vej 4, 5000, Odense C, Denmark.
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark.
| |
Collapse
|
19
|
Jacobsen K, Wenande E, Ortner VK, Schmidt G, Haedersdal M. Operationsplanung mit Line‐Field optischer konfokaler Kohärenztomographie bei rezidivierendem infiltrativem Basalzellkarzinom: Visualisierung des subklinischen Tumors zur Anpassung der Ränder. J Dtsch Dermatol Ges 2024; 22:462-465. [PMID: 38450967 DOI: 10.1111/ddg.15330_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 11/14/2023] [Indexed: 03/08/2024]
Affiliation(s)
- Kevin Jacobsen
- Department of Dermatology, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Emily Wenande
- Department of Dermatology, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Vinzent Kevin Ortner
- Department of Dermatology, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Grethe Schmidt
- Department of Plastic Surgery and Burns Treatment, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Merete Haedersdal
- Department of Dermatology, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen, Denmark
| |
Collapse
|
20
|
Jacobsen K, Wenande E, Ortner VK, Schmidt G, Haedersdal M. Surgical planning with line-field confocal optical coherence tomography for recurrent infiltrative basal cell carcinoma: visualizing subclinical tumor for margin adjustment. J Dtsch Dermatol Ges 2024; 22:462-465. [PMID: 38396266 DOI: 10.1111/ddg.15330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 11/14/2023] [Indexed: 02/25/2024]
Affiliation(s)
- Kevin Jacobsen
- Department of Dermatology, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Emily Wenande
- Department of Dermatology, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Vinzent Kevin Ortner
- Department of Dermatology, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Grethe Schmidt
- Department of Plastic Surgery and Burns Treatment, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Merete Haedersdal
- Department of Dermatology, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen, Denmark
| |
Collapse
|
21
|
Palmisano G, Orte Cano C, Fontaine M, Lenoir C, Cinotti E, Tognetti L, Rubegni P, Perez-Anker J, Puig S, Malvehy J, Perrot JL, Del Marmol V, Peris K, Suppa M. Dermoscopic criteria explained by LC-OCT: Negative maple leaf-like areas. J Eur Acad Dermatol Venereol 2024; 38:e271-e273. [PMID: 37876332 DOI: 10.1111/jdv.19588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 10/19/2023] [Indexed: 10/26/2023]
Affiliation(s)
- Gerardo Palmisano
- Department of Dermatology, Hôpital Erasme, HUB, Université Libre de Bruxelles, Brussels, Belgium
- Department of Dermatology, Catholic University of the Sacred Heart, Rome, Italy
| | - Carmen Orte Cano
- Department of Dermatology, Hôpital Erasme, HUB, Université Libre de Bruxelles, Brussels, Belgium
- Department of Dermato-Oncology, Institut Jules Bordet, HUB, Université Libre de Bruxelles, Brussels, Belgium
| | - Margot Fontaine
- Department of Dermatology, Hôpital Erasme, HUB, Université Libre de Bruxelles, Brussels, Belgium
- Department of Dermato-Oncology, Institut Jules Bordet, HUB, Université Libre de Bruxelles, Brussels, Belgium
| | - Clément Lenoir
- Department of Dermatology, Hôpital Erasme, HUB, Université Libre de Bruxelles, Brussels, Belgium
- Department of Dermato-Oncology, Institut Jules Bordet, HUB, Université Libre de Bruxelles, Brussels, Belgium
| | - Elisa Cinotti
- Groupe d'Imagerie Cutanée Non Invasive (GICNI) of the Société Française de Dermatologie (SFD), Paris, France
- Dermatology Unit, Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy
| | - Linda Tognetti
- Dermatology Unit, Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy
| | - Pietro Rubegni
- Dermatology Unit, Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy
| | - Javiera Perez-Anker
- Melanoma Unit, Hospital Clinic Barcelona, University of Barcelona, Barcelona, Spain
- CIBER de Enfermedades Raras, Instituto de Salud Carlos III, Barcelona, Spain
| | - Susana Puig
- Melanoma Unit, Hospital Clinic Barcelona, University of Barcelona, Barcelona, Spain
- CIBER de Enfermedades Raras, Instituto de Salud Carlos III, Barcelona, Spain
| | - Josep Malvehy
- Melanoma Unit, Hospital Clinic Barcelona, University of Barcelona, Barcelona, Spain
- CIBER de Enfermedades Raras, Instituto de Salud Carlos III, Barcelona, Spain
| | - Jean-Luc Perrot
- Department of Dermatology, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - Véronique Del Marmol
- Department of Dermatology, Hôpital Erasme, HUB, Université Libre de Bruxelles, Brussels, Belgium
| | - Ketty Peris
- Department of Dermatology, Catholic University of the Sacred Heart, Rome, Italy
- UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche Addominali ed Endocrino-Metaboliche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Mariano Suppa
- Department of Dermatology, Hôpital Erasme, HUB, Université Libre de Bruxelles, Brussels, Belgium
- Department of Dermato-Oncology, Institut Jules Bordet, HUB, Université Libre de Bruxelles, Brussels, Belgium
- Groupe d'Imagerie Cutanée Non Invasive (GICNI) of the Société Française de Dermatologie (SFD), Paris, France
| |
Collapse
|
22
|
Cinotti E, Barbarossa L, Cortonesi G, Lamberti A, La Marca F, Tognetti L, Rubegni P, Perrot JL. Non-Invasive Imaging for the Diagnosis of Genital Warts and Their Imitators. J Clin Med 2024; 13:1345. [PMID: 38592196 PMCID: PMC10932056 DOI: 10.3390/jcm13051345] [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: 01/15/2024] [Revised: 02/07/2024] [Accepted: 02/22/2024] [Indexed: 04/10/2024] Open
Abstract
Genital warts are the most frequent sexually transmitted disease. Their clinical diagnosis is not always easy, and invasive skin biopsies for histological examination should be performed in these cases. The aim of the study was to investigate the use of non-invasive imaging techniques for the diagnosis of genital warts and their imitators. We retrospectively evaluated dermoscopy, reflectance confocal microscopy (RCM), and line-filed confocal microscopy (LC-OCT) images of nine patients with 19 warts of the mucous membranes and five patients with lesions that clinically mimic genital warts, including 12 molluscum contagiosum, 1 Fordyce's spot and one case of multiple acquired lymphangiomas. Most genital warts (15; 79%) showed dilated vessels surrounded by a whitish halo at dermoscopy. RCM and the new device LC-OCT could identify near histologic features such as the presence of hyperkeratosis, acanthosis, papillomatosis and enlarged vessels in all genital warts. However, the identification of koilocytes, which are the hallmark for the diagnosis of warts, was still difficult using both techniques. Non-invasive imaging techniques could also offer clues for the correct diagnosis of the imitators. This study confirmed the usefulness of dermoscopy in recognizing a precise pattern in warts and showed the potential use of RCM and LC-OCT to add additional findings to the clinical and dermoscopic examination.
Collapse
Affiliation(s)
- Elisa Cinotti
- Dermatology Section, Department of Medical, Surgical, and Neurological Sciences, Santa Maria Alle Scotte Hospital, 53100 Siena, Italy; (E.C.); (G.C.); (A.L.); (F.L.M.); (L.T.); (P.R.)
| | - Lorenzo Barbarossa
- Dermatology Section, Department of Medical, Surgical, and Neurological Sciences, Santa Maria Alle Scotte Hospital, 53100 Siena, Italy; (E.C.); (G.C.); (A.L.); (F.L.M.); (L.T.); (P.R.)
| | - Giulio Cortonesi
- Dermatology Section, Department of Medical, Surgical, and Neurological Sciences, Santa Maria Alle Scotte Hospital, 53100 Siena, Italy; (E.C.); (G.C.); (A.L.); (F.L.M.); (L.T.); (P.R.)
| | - Arianna Lamberti
- Dermatology Section, Department of Medical, Surgical, and Neurological Sciences, Santa Maria Alle Scotte Hospital, 53100 Siena, Italy; (E.C.); (G.C.); (A.L.); (F.L.M.); (L.T.); (P.R.)
| | - Francesca La Marca
- Dermatology Section, Department of Medical, Surgical, and Neurological Sciences, Santa Maria Alle Scotte Hospital, 53100 Siena, Italy; (E.C.); (G.C.); (A.L.); (F.L.M.); (L.T.); (P.R.)
| | - Linda Tognetti
- Dermatology Section, Department of Medical, Surgical, and Neurological Sciences, Santa Maria Alle Scotte Hospital, 53100 Siena, Italy; (E.C.); (G.C.); (A.L.); (F.L.M.); (L.T.); (P.R.)
| | - Pietro Rubegni
- Dermatology Section, Department of Medical, Surgical, and Neurological Sciences, Santa Maria Alle Scotte Hospital, 53100 Siena, Italy; (E.C.); (G.C.); (A.L.); (F.L.M.); (L.T.); (P.R.)
| | - Jean Luc Perrot
- Department of Dermatology, University Hospital of Saint-Etienne, 42100 Saint-Etienne, France;
| |
Collapse
|
23
|
Jdid R, Pedrazzani M, Lejeune F, Fischman S, Cazorla G, Forestier S, Khalifa YB. Skin dark spot mapping and evaluation of brightening product efficacy using Line-field Confocal Optical Coherence Tomography (LC-OCT). Skin Res Technol 2024; 30:e13623. [PMID: 38385854 PMCID: PMC10883256 DOI: 10.1111/srt.13623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 02/05/2024] [Indexed: 02/23/2024]
Abstract
BACKGROUND Facial dark spots remain a significant challenge for the cosmetic industry, in terms of providing effective treatment. Using Line-field Confocal Optical Coherence Tomography (LC-OCT), we investigated the internal structural features of photo-aging spot areas and evaluated the efficacy of a skin-brightening cosmetic product. MATERIALS AND METHODS Twenty-six Asian female volunteers, aged between 29 and 65 years, applied a cosmetic product on their entire face twice a day for 2 months. LC-OCT was used to evaluate the dermal-epidermal junction (DEJ) undulation and the volume density of melanin in the epidermis at D0 and D56. Skin brightening and redness were also assessed by photography (SkinCam). RESULTS Using LC-OCT technology, various microscopic dark spot morphologies, spanning from minimally deformed DEJ to complex DEJ patterns, were identified. Dark spots characterized by slight deformities in the DEJ were predominantly observed in the youngest age group, while older volunteers displayed a wavier pattern. Furthermore, a total of 44 spots were monitored to evaluate the brightening product efficacy. A statistically significant reduction in melanin volumetric density of 7.3% in the spots and 12.3% in their surrounding area was observed after 56 days of product application. In line with these results, an analysis of color parameters using SkinCam reveals a significant increase in brightening and decrease in redness in both pigmented spots and the surrounding skin following application. CONCLUSIONS LC-OCT proves to be a valuable tool for in-depth dark spots characterization and assessment of skin brightening products, enabling various applications in the field of dermatological sciences.
Collapse
Affiliation(s)
- Randa Jdid
- Chanel Parfums BeautéInnovation Recherche et DéveloppementPantinFrance
| | | | - François Lejeune
- Chanel Parfums BeautéInnovation Recherche et DéveloppementPantinFrance
| | | | - Gabriel Cazorla
- Chanel Parfums BeautéInnovation Recherche et DéveloppementPantinFrance
| | - Sandra Forestier
- Chanel Parfums BeautéInnovation Recherche et DéveloppementPantinFrance
| | | |
Collapse
|
24
|
Razi S, Raquepo TM, Rao B. Analyzing the in vivo cutaneous effects of diode laser treatment using line-field confocal optical coherence tomography. J Cosmet Dermatol 2024; 23:717-719. [PMID: 37724469 DOI: 10.1111/jocd.16005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Revised: 09/09/2023] [Accepted: 09/13/2023] [Indexed: 09/20/2023]
Affiliation(s)
- Shazli Razi
- Department of Dermatology and Pathology, Rao Dermatology, New York, USA
- Department of Internal Medicine, Jersey Shore University Medical Center, Neptune, New Jersey, USA
| | - Tricia Mae Raquepo
- Center for Dermatology, Rutgers Robert Wood Johnson Medical School, Piscataway, New Jersey, USA
| | - Babar Rao
- Department of Dermatology and Pathology, Rao Dermatology, New York, USA
- Center for Dermatology, Rutgers Robert Wood Johnson Medical School, Piscataway, New Jersey, USA
- Department of Dermatology, Weill Cornell Medicine, New York, New York, USA
| |
Collapse
|
25
|
Olesen UH, Foged C, Jacobsen K, Ortner VK, Fredman G, Paasch U, Haedersdal M. Line-field confocal optical coherence tomography for in vivo visualization of morphological characteristics of squamous cell carcinoma in a murine model. Lasers Surg Med 2024; 56:14-18. [PMID: 38129971 DOI: 10.1002/lsm.23750] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 12/05/2023] [Accepted: 12/07/2023] [Indexed: 12/23/2023]
Abstract
OBJECTIVES Non-invasive imaging with line-field confocal optical coherence tomography (LC-OCT) can support the diagnosis of squamous cell carcinoma (SCC) through visualization of morphological characteristics specific to skin cancer. We aimed to visualize prominent morphological characteristics of SCC using LC-OCT in a well-established murine SCC model. MATERIALS AND METHODS Nine hairless mice were exposed to ultraviolet radiation three times weekly for 9 months to induce SCC development. Visible SCC tumors (n = 9) were imaged with LC-OCT and the presence of 10 well-described morphological characteristics of SCC were evaluated in the scans by two physicians with adjudication by a third. RESULTS Overall, murine morphological characteristics resembled corresponding features previously reported in human SCCs. Interrupted dermal-epidermal junction occurred in 100% of tumors. In epidermis, the most frequently observed characteristics were severe epidermal dysplasia (100%) and tumor budding (89%). Common dermal characteristics included broad strands (100%) and collagen alterations (78%). CONCLUSION LC-OCT imaging can be used to non-invasively visualize morphological characteristics specific to SCC in an in vivo preclinical model.
Collapse
Affiliation(s)
- Uffe H Olesen
- Department of Dermatology, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark
| | - Camilla Foged
- Department of Dermatology, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark
| | - Kevin Jacobsen
- Department of Dermatology, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark
| | - Vinzent K Ortner
- Department of Dermatology, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark
| | - Gabriella Fredman
- Department of Dermatology, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark
| | - Uwe Paasch
- Department of Dermatology, Venereology and Allergy, University of Leipzig, Leipzig, Germany
| | - Merete Haedersdal
- Department of Dermatology, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| |
Collapse
|
26
|
Wolswijk T, Nelemans PJ, Adan F, Abdul Hamid M, Mosterd K. 'Pitfalls for differentiating basal cell carcinoma from non-basal cell carcinoma on optical coherence tomography: A clinical series'. J Dermatol 2024; 51:40-47. [PMID: 37927296 DOI: 10.1111/1346-8138.17020] [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: 09/19/2023] [Revised: 10/12/2023] [Accepted: 10/16/2023] [Indexed: 11/07/2023]
Abstract
Optical coherence tomography (OCT), a non-invasive diagnostic modality, may replace biopsy for diagnosing basal cell carcinoma (BCC) if a high-confidence BCC diagnosis can be established. In other cases, biopsy remains necessary to establish a histopathological diagnosis and treatment regimen. It is, therefore, essential that OCT assessors have a high specificity for differentiating BCC from non-BCC lesions. To establish high-confidence BCC diagnoses, specific morphological BCC characteristics on OCT are used. This study aimed to review several cases of non-BCC lesions that were misclassified as BCC by experienced OCT assessors, thereby providing insight into the causes of these misclassifications and how they may be prevented. The study population consisted of patients who had a histopathologically-verified non-BCC lesion. Patients from Maastricht University Medical Center+ from February 2021 to April 2021 were included in the study. Two independent OCT assessors assessed OCT scans. One OCT assessor recorded the presence or absence of validated morphological BCC characteristics. A false-positive OCT test result was defined as certainty of BCC presence in a non-BCC lesion. The frequency of misclassifications and the presence or absence of morphological BCC features are discussed. A total of 124 patients with non-BCC lesions were included. Six patients were misclassified by both OCT assessors and are discussed in more detail. Histopathological diagnoses were squamous cell carcinoma (n = 2/21), actinic keratosis (n = 2/29), squamous cell carcinoma in situ/Bowen's disease (n = 1/16), or interphase dermatitis (n = 1/4). In all misclassified cases, multiple, apparent morphological BCC characteristics on OCT were present. Most non-BCC lesions are recognized as such by OCT assessors. However, there remains a small risk that a high-confidence BCC diagnosis is established in non-BCC lesions wherein features mimicking validated BCC characteristics are present. Misclassification may be prevented by careful delineation of epidermal layers and good differentiation between dermal ovoid structures typical of BCC versus squamous cell carcinoma.
Collapse
Affiliation(s)
- Tom Wolswijk
- Department of Dermatology, Maastricht University Medical Center+, Maastricht, The Netherlands
- GROW Research Institute for Oncology and Reproduction, Maastricht University, Maastricht, The Netherlands
| | - Patty J Nelemans
- Department of Epidemiology, Maastricht University, Maastricht, The Netherlands
| | - Fieke Adan
- Department of Dermatology, Maastricht University Medical Center+, Maastricht, The Netherlands
- GROW Research Institute for Oncology and Reproduction, Maastricht University, Maastricht, The Netherlands
| | - Myrurgia Abdul Hamid
- Department of Pathology, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Klara Mosterd
- Department of Dermatology, Maastricht University Medical Center+, Maastricht, The Netherlands
- GROW Research Institute for Oncology and Reproduction, Maastricht University, Maastricht, The Netherlands
| |
Collapse
|
27
|
Aktas D, Palmisano G, Cinotti E, Tognetti L, Perrot JL, Perez-Anker J, Rubegni P, Puig S, Malvehy J, Peris K, Del Marmol V, Suppa M. The role of line-field confocal optical coherence tomography in the differential diagnosis of infiltrative basal cell carcinoma with scar-like lesions: A case series. J Eur Acad Dermatol Venereol 2023; 37:e1396-e1398. [PMID: 37458229 DOI: 10.1111/jdv.19337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 07/11/2023] [Indexed: 07/28/2023]
Affiliation(s)
- Dina Aktas
- Department of Dermatology, Hôpital Erasme, HUB, Université Libre de Bruxelles, Brussels, Belgium
| | - Gerardo Palmisano
- Department of Dermatology, Catholic University of the Sacred Heart, Rome, Italy
| | - Elisa Cinotti
- Dermatology Unit, Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy
- Groupe d'Imagerie Cutanée Non Invasive (GICNI) of the Société Française de Dermatologie (SFD), Paris, France
| | - Linda Tognetti
- Dermatology Unit, Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy
| | - Jean-Luc Perrot
- Department of Dermatology, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - Javiera Perez-Anker
- Melanoma Unit, Hospital Clinic Barcelona, University of Barcelona, Barcelona, Spain
- CIBER de enfermedades raras, Instituto de Salud Carlos III, Barcelona, Spain
| | - Pietro Rubegni
- Dermatology Unit, Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy
| | - Susana Puig
- Melanoma Unit, Hospital Clinic Barcelona, University of Barcelona, Barcelona, Spain
- CIBER de enfermedades raras, Instituto de Salud Carlos III, Barcelona, Spain
| | - Josep Malvehy
- Melanoma Unit, Hospital Clinic Barcelona, University of Barcelona, Barcelona, Spain
- CIBER de enfermedades raras, Instituto de Salud Carlos III, Barcelona, Spain
| | - Ketty Peris
- Department of Dermatology, Catholic University of the Sacred Heart, Rome, Italy
| | - Veronique Del Marmol
- Department of Dermatology, Hôpital Erasme, HUB, Université Libre de Bruxelles, Brussels, Belgium
- Department of Dermatology, Institut Jules Bordet, HUB, Université Libre de Bruxelles, HUB, Brussels, Belgium
| | - Mariano Suppa
- Department of Dermatology, Hôpital Erasme, HUB, Université Libre de Bruxelles, Brussels, Belgium
- Groupe d'Imagerie Cutanée Non Invasive (GICNI) of the Société Française de Dermatologie (SFD), Paris, France
- Department of Dermatology, Institut Jules Bordet, HUB, Université Libre de Bruxelles, HUB, Brussels, Belgium
| |
Collapse
|
28
|
Latriglia F, Ogien J, Tavernier C, Fischman S, Suppa M, Perrot JL, Dubois A. Line-Field Confocal Optical Coherence Tomography (LC-OCT) for Skin Imaging in Dermatology. Life (Basel) 2023; 13:2268. [PMID: 38137869 PMCID: PMC10744435 DOI: 10.3390/life13122268] [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: 09/29/2023] [Revised: 11/09/2023] [Accepted: 11/20/2023] [Indexed: 12/24/2023] Open
Abstract
Line-field confocal optical coherence tomography (LC-OCT) is a non-invasive optical imaging technique based on a combination of the principles of optical coherence tomography and reflectance confocal microscopy with line-field illumination, which can generate cell-resolved images of the skin in vivo. This article reports on the LC-OCT technique and its application in dermatology. The principle of the technique is described, and the latest technological innovations are presented. The technology has been miniaturized to fit within an ergonomic handheld probe, allowing for the easy access of any skin area on the body. The performance of the LC-OCT device in terms of resolution, field of view, and acquisition speed is reported. The use of LC-OCT in dermatology for the non-invasive detection, characterization, and therapeutic follow-up of various skin pathologies is discussed. Benign and malignant melanocytic lesions, non-melanocytic skin tumors, such as basal cell carcinoma, squamous cell carcinoma and actinic keratosis, and inflammatory and infectious skin conditions are considered. Dedicated deep learning algorithms have been developed for assisting in the analysis of LC-OCT images of skin lesions.
Collapse
Affiliation(s)
- Flora Latriglia
- DAMAE Medical, 75013 Paris, France
- Laboratoire Charles Fabry, Centre National de la Recherche Scientifique, Institut d’Optique Graduate School, Université Paris-Saclay, 91127 Palaiseau, France
| | | | | | | | - Mariano Suppa
- Department of Dermatology, Erasme Hospital, Université Libre de Bruxelles (ULB), 1070 Anderlecht, Belgium
- Department of Dermatology, Jules Bordet Institute, Université Libre de Bruxelles (ULB), 1070 Anderlecht, Belgium
- Groupe d’Imagerie Cutanée Non Invasive (GICNI) of the Société Française de Dermatologie (SFD), 75008 Paris, France;
| | - Jean-Luc Perrot
- Groupe d’Imagerie Cutanée Non Invasive (GICNI) of the Société Française de Dermatologie (SFD), 75008 Paris, France;
- University Hospital of Saint-Etienne, 42100 Saint-Etienne, France
| | - Arnaud Dubois
- DAMAE Medical, 75013 Paris, France
- Laboratoire Charles Fabry, Centre National de la Recherche Scientifique, Institut d’Optique Graduate School, Université Paris-Saclay, 91127 Palaiseau, France
| |
Collapse
|
29
|
Hobelsberger S, Steininger J, Bauer A, Beissert S, Gellrich FF. Line-field confocal optical coherence tomography for the diagnosis of onychomycosis in comparison with healthy nails: A case series. J Eur Acad Dermatol Venereol 2023; 37:e1234-e1236. [PMID: 37256913 DOI: 10.1111/jdv.19233] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Accepted: 05/23/2023] [Indexed: 06/02/2023]
Affiliation(s)
- Sarah Hobelsberger
- Department of Dermatology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Julian Steininger
- Department of Dermatology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Andrea Bauer
- Department of Dermatology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Stefan Beissert
- Department of Dermatology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Frank Friedrich Gellrich
- Department of Dermatology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| |
Collapse
|
30
|
Romero R, Zhao J, Stratton D, Marcelino K, Sugimura M, Nichols A, Gonzalez S, Jain M, Curiel-Lewandrowski C, Kang D. Handheld cross-polarised microscope for imaging individual pigmented cells in human skin in vivo. J Microsc 2023; 292:47-55. [PMID: 37698068 DOI: 10.1111/jmi.13225] [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: 05/09/2023] [Revised: 08/11/2023] [Accepted: 09/07/2023] [Indexed: 09/13/2023]
Abstract
We present the development of a simple, handheld cross-polarised microscope (CPM) and demonstration of imaging individual pigmented cells in human skin in vivo. In the CPM device, the cross-polarised detection approach is used to reduce the specular reflection from the skin surface and preferentially detect multiply-scattered light. The multiply-scattered light works as back illumination from within the tissue towards the skin surface, and superficial pigment such as intraepidermal melanin absorbs some spectral bands of the multiply-scattered light and cast coloured shadows. Since the light that interacted with the superficial pigment only needs to travel a short distance before it exits the skin surface, microscopic details of the pigment can be preserved. The CPM device uses a water-immersion objective lens with a high numerical aperture to image the microscopic details with minimal spherical aberrations and a small depth of focus. Preliminary results from a pilot study of imaging skin lesions in vivo showed that the CPM device could reveal three-dimensional distribution of pigmented cells and intracellular distribution of pigment. Co-registered CPM and reflectance confocal microscopy images showed good correspondence between dark, brown cells in CPM images and bright, melanin-containing cells in reflectance confocal microscopy images.
Collapse
Affiliation(s)
- Rafael Romero
- Department of Biomedical Engineering, University of Arizona, Tucson, Arizona
| | - Jingwei Zhao
- College of Optical Sciences, University of Arizona, Tucson, Arizona
| | - Delaney Stratton
- Division of Dermatology, College of Medicine-Tucson, University of Arizona, Tucson, Arizona, United States
| | | | - Momoka Sugimura
- College of Optical Sciences, University of Arizona, Tucson, Arizona
| | - Alia Nichols
- College of Optical Sciences, University of Arizona, Tucson, Arizona
| | - Salvador Gonzalez
- Department of Medicine and Medical Specialties, Alcalá University of Madrid, Madrid, Spain
| | - Manu Jain
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, United States
| | - Clara Curiel-Lewandrowski
- Division of Dermatology, College of Medicine-Tucson, University of Arizona, Tucson, Arizona, United States
| | - Dongkyun Kang
- Department of Biomedical Engineering, University of Arizona, Tucson, Arizona
- College of Optical Sciences, University of Arizona, Tucson, Arizona
| |
Collapse
|
31
|
Razi S, Raquepo TM, Truong TM, Rao B. Analyzing the effects of a chemical peel on post-inflammatory hyperpigmentation using line-field confocal optical coherence tomography. Skin Res Technol 2023; 29:e13496. [PMID: 37881055 PMCID: PMC10556406 DOI: 10.1111/srt.13496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 09/25/2023] [Accepted: 09/27/2023] [Indexed: 10/27/2023]
Affiliation(s)
- Shazli Razi
- Rao DermatologyAtlantic HighlandsNew JerseyUSA
- Department of Internal MedicineJersey Shore University Medical CenterNeptuneNew JerseyUSA
| | - Tricia Mae Raquepo
- Center for DermatologyRutgers Robert Wood Johnson Medical SchoolSomersetNew JerseyUSA
| | - Thu Minh Truong
- Rao DermatologyAtlantic HighlandsNew JerseyUSA
- Center for DermatologyRutgers Robert Wood Johnson Medical SchoolSomersetNew JerseyUSA
| | - Babar Rao
- Rao DermatologyAtlantic HighlandsNew JerseyUSA
- Center for DermatologyRutgers Robert Wood Johnson Medical SchoolSomersetNew JerseyUSA
- Department of DermatologyWeill Cornell MedicineNew YorkNew YorkUSA
| |
Collapse
|
32
|
Donelli C, Suppa M, Tognetti L, Perrot JL, Calabrese L, Pérez-Anker J, Malvehy J, Rubegni P, Cinotti E. Line-Field Confocal Optical Coherence Tomography for the Diagnosis of Skin Carcinomas: Real-Life Data over Three Years. Curr Oncol 2023; 30:8853-8864. [PMID: 37887539 PMCID: PMC10604937 DOI: 10.3390/curroncol30100639] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Revised: 09/21/2023] [Accepted: 09/26/2023] [Indexed: 10/28/2023] Open
Abstract
Line-field confocal optical coherence tomography (LC-OCT) can help the clinical diagnosis of skin diseases. The present study aimed to evaluate the sensitivity, specificity, and diagnostic accuracy of LC-OCT for the diagnosis of the most frequent non-melanoma skin cancers (NMSCs), i.e., basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). Comparing LC-OCT diagnostic performances with those of dermoscopy, histopathological examination was used as a gold standard. For every study endpoint, the diagnostic ability of LC-OCT revealed superiority over the dermoscopic examination. In particular, a significant increase in specificity was observed. Sensitivity, specificity, and diagnostic accuracy of dermoscopy and LC-OCT for the diagnosis of malignancy were, respectively, 0.97 (CI 0.94-0.99), 0.43 (CI 0.36-0.51), and 0.77 (CI 0.72-0.81) for dermoscopy and 0.99 (CI 0.97-1.00), 0.90 (CI 0.84-0.94), and 0.96 (CI 0.93-0.97) for LC-OCT. The positive predictive value (PPV) resulted in 0.74 (CI 0.69-0.78) for dermoscopy and 0.94 (CI 0.91-0.97) for LC-OCT, and the negative predictive value (NPV) was 0.89 (CI 0.81-0.95) for dermoscopy and 0.98 (CI 0.95-1.00) for LC-OCT. Finally, our real-life study showed a potentially important role of LC-OCT in the non-invasive diagnosis of NMSCs, especially BCC. The real-time imaging technique could spare unnecessary biopsies with an increased sensitivity, a much higher specificity, and better accuracy than clinical assessment with dermoscopy alone.
Collapse
Affiliation(s)
- Carolina Donelli
- Department of Medical, Surgical and Neurological Sciences, Dermatology Section, University of Siena, 53100 Siena, Italy
| | - Mariano Suppa
- Groupe d'Imagerie Cutanée Non Invasive (GICNI), Société Française de Dermatologie (SFD), 75008 Paris, France
- Department of Dermatology, Hôpital Erasme, Université Libre de Bruxelles, 1050 Brussels, Belgium
| | - Linda Tognetti
- Department of Medical, Surgical and Neurological Sciences, Dermatology Section, University of Siena, 53100 Siena, Italy
| | - Jean Luc Perrot
- Groupe d'Imagerie Cutanée Non Invasive (GICNI), Société Française de Dermatologie (SFD), 75008 Paris, France
- Department of Dermatology, University Hospital of St-Etienne, 42270 Saint-Etienne, France
| | - Laura Calabrese
- Department of Medical, Surgical and Neurological Sciences, Dermatology Section, University of Siena, 53100 Siena, Italy
| | - Javiera Pérez-Anker
- Melanoma Unit, Dermatology Department, Hospital Clínic de Barcelona, IDIBAPS, Universitat de Barcelona, 08001 Barcelona, Spain
- CIBER de Enfermedades Raras, Instituto de Salud Carlos III, 08007 Barcelona, Spain
| | - Josep Malvehy
- Melanoma Unit, Dermatology Department, Hospital Clínic de Barcelona, IDIBAPS, Universitat de Barcelona, 08001 Barcelona, Spain
- CIBER de Enfermedades Raras, Instituto de Salud Carlos III, 08007 Barcelona, Spain
| | - Pietro Rubegni
- Department of Medical, Surgical and Neurological Sciences, Dermatology Section, University of Siena, 53100 Siena, Italy
| | - Elisa Cinotti
- Department of Medical, Surgical and Neurological Sciences, Dermatology Section, University of Siena, 53100 Siena, Italy
- Groupe d'Imagerie Cutanée Non Invasive (GICNI), Société Française de Dermatologie (SFD), 75008 Paris, France
| |
Collapse
|
33
|
Del Río-Sancho S, Gallay C, Ventéjou S, Christen-Zaech S. In vivo evaluation of skin of children with LC-OCT: An objective assessment. J Eur Acad Dermatol Venereol 2023; 37:1897-1905. [PMID: 37147895 DOI: 10.1111/jdv.19163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 03/28/2023] [Indexed: 05/07/2023]
Abstract
BACKGROUND Several non-invasive skin imaging methods have been developed in recent years. Line-field confocal optical coherence tomography (LC-OCT) is one of them, leading to the best compromise in terms of resolution and penetration depth. Skin biopsies are an essential technique in paediatric dermatology, but they are a major stressful event for the child and their parents. Current LC-OCT studies have not been dedicated to a paediatric population. If, however, LC-OCT proves to be helpful in children, it may help guide and decrease a certain number of skin biopsies. OBJECTIVES (1) To evaluate the feasibility of using LC-OCT in paediatric patients, and (2) to assess the maturation of skin structures in children over time with this method. METHODS In vivo LC-OCT images were collected on six specific body regions (forehead, forearm, chest, back, dorsum of the hand and palmar surface) and in six age groups (between the ages of 0 and 16 years). RESULTS In all body areas and age groups assessed, 9 of 10 images were rated as good-to-excellent, the only exception were the images acquired on the palmar surface. LC-OCT allowed visualizing very well the skin structures up to a penetration of 500 μm. We observed that the body regions located on the upper extremities of the body (forearm, dorsum of the hand and palmar surface) showed both a maturation on their structure and differences in thickness with respect to the other regions evaluated. CONCLUSIONS LC-OCT can easily be used for non-invasive imaging of children's skin and allows to document progressive skin changes in the different age groups. It may be a useful asset for imaging and diagnosing superficial skin disorders and as such reducing the number of invasive procedures while increasing the speed of diagnosis in the paediatric population.
Collapse
Affiliation(s)
- S Del Río-Sancho
- Laser Dermatology Consultation, Division of Dermatology and Venereology, Geneva University Hospitals, Geneva, Switzerland
| | - C Gallay
- Pediatric Dermatology Unit, Departments of Dermatology & Venereology and Pediatrics, University Hospital Lausanne, University of Lausanne, Lausanne, Switzerland
| | - S Ventéjou
- Pediatric Dermatology Unit, Departments of Dermatology & Venereology and Pediatrics, University Hospital Lausanne, University of Lausanne, Lausanne, Switzerland
| | - S Christen-Zaech
- Pediatric Dermatology Unit, Departments of Dermatology & Venereology and Pediatrics, University Hospital Lausanne, University of Lausanne, Lausanne, Switzerland
| |
Collapse
|
34
|
Bonnier F, Pedrazzani M, Fischman S, Viel T, Lavoix A, Pegoud D, Nili M, Jimenez Y, Ralambondrainy S, Cauchard JH, Korichi R. Line-field confocal optical coherence tomography coupled with artificial intelligence algorithms to identify quantitative biomarkers of facial skin ageing. Sci Rep 2023; 13:13881. [PMID: 37620374 PMCID: PMC10449778 DOI: 10.1038/s41598-023-40340-0] [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: 04/25/2023] [Accepted: 08/09/2023] [Indexed: 08/26/2023] Open
Abstract
Quantitative biomarkers of facial skin ageing were studied from one hundred healthy Caucasian female volunteers, aged 20-70 years, using in vivo 3D Line-field Confocal Optical Coherence Tomography (LC-OCT) imaging coupled with Artificial Intelligence (AI)-based quantification algorithms. Layer metrics, i.e. stratum corneum thickness (SC), viable epidermal thickness and Dermal-Epidermal Junction (DEJ) undulation, as well as cellular metrics were measured for the temple, cheekbone and mandible. For all three investigated facial areas, minimal age-related variations were observed in the thickness of the SC and viable epidermis layers. A flatter and more homogeneous epidermis (decrease in the standard deviation of the number of layers means), a less dense cellular network with fewer cells per layer (decrease in cell surface density), and larger and more heterogeneous nuclei within each layer (increase in nuclei volume and their standard deviation) were found with significant variations with age. The higher atypia scores further reflected the heterogeneity of nuclei throughout the viable epidermis. The 3D visualisation of fine structures in the skin at the micrometric resolution and the 1200 µm × 500 µm field of view achieved with LC-OCT imaging enabled to compute relevant quantitative biomarkers for a better understanding of skin biology and the ageing process in vivo.
Collapse
Affiliation(s)
- Franck Bonnier
- LVMH Recherche, 185 Avenue de Verdun, 45804, Saint Jean de Braye, France.
| | | | | | - Théo Viel
- DAMAE Medical, 14 Rue Sthrau, 75013, Paris, France
| | - Agnes Lavoix
- DERMATECH, 8 Rue Jacqueline Auriol, 69008, Lyon, France
| | - Didier Pegoud
- DERMATECH, 8 Rue Jacqueline Auriol, 69008, Lyon, France
| | - Meryem Nili
- DERMATECH, 8 Rue Jacqueline Auriol, 69008, Lyon, France
| | | | | | | | - Rodolphe Korichi
- LVMH Recherche, 185 Avenue de Verdun, 45804, Saint Jean de Braye, France
| |
Collapse
|
35
|
Revin DG, Byers RA, Duan MQ, Li W, Matcher SJ. Visible-light optical coherence tomography platform for the characterization of the skin barrier. BIOMEDICAL OPTICS EXPRESS 2023; 14:3914-3923. [PMID: 37799680 PMCID: PMC10549730 DOI: 10.1364/boe.494356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 06/16/2023] [Accepted: 06/27/2023] [Indexed: 10/07/2023]
Abstract
We demonstrate a free-space, trolley-mountable Fourier domain visible-light optical coherence tomography (OCT) system for studying the stratum corneum in non-palmar human skin. An axial resolution of 1 µm in tissue and at least -75 dB sensitivity have been achieved. High-quality B-scans, containing 1600 A-scans, are acquired at a rate of 39 Hz. Images from the dorsal hand, ventral wrist and ventral forearm areas are obtained, with a clearly resolved stratum corneum layer (typically 5-15 µm thick) presenting as a hypoechogenic dark layer below the bright entrance signal, similar to that found in palmar skin with traditional OCT systems. We find that the appearance of the stratum corneum layer strongly depends on its water content, becoming brighter after occlusive hydration.
Collapse
Affiliation(s)
- Dmitry G. Revin
- Department of Electronic and Electrical Engineering,
University of Sheffield, Sir Frederick Mappin Building, Sheffield, S1 3JD, UK
| | - Robert A. Byers
- Dermatology Research, Department of Infection and Immunity and Cardiovascular Disease, University of Sheffield, Beech Hill Road, Sheffield, S10 2RX, UK
| | - Meng Q. Duan
- Department of Electronic and Electrical Engineering,
University of Sheffield, Sir Frederick Mappin Building, Sheffield, S1 3JD, UK
| | - Wei Li
- Department of Electronic and Electrical Engineering,
University of Sheffield, Sir Frederick Mappin Building, Sheffield, S1 3JD, UK
- Currently with the Department of Radiology, the First Affiliated Hospital, Jinan University, No.613, Huangpu West Road, Tianhe District, Guangzhou, 510627, Guangdong, China
| | - Stephen J. Matcher
- Department of Electronic and Electrical Engineering,
University of Sheffield, Sir Frederick Mappin Building, Sheffield, S1 3JD, UK
| |
Collapse
|
36
|
Wolswijk T, Sanak D, Lenoir C, Cinotti E, Tognetti L, Rubegni P, Perez‐Anker J, Puig S, Malvehy J, Perrot J, Mosterd K, del Marmol V, Suppa M. Line-field confocal optical coherence tomography can help differentiating melanoma from pigmented basal cell carcinoma: A case report. Skin Res Technol 2023; 29:e13376. [PMID: 37357657 PMCID: PMC10267609 DOI: 10.1111/srt.13376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Accepted: 05/17/2023] [Indexed: 06/27/2023]
Affiliation(s)
- Tom Wolswijk
- Department of DermatologyMaastricht University Medical Center+MaastrichtThe Netherlands
- GROW Research Institute for Oncology and ReproductionMaastricht UniversityMaastrichtThe Netherlands
| | - Dilara Sanak
- Department of DermatologyHôpital Erasme, HUB, Université Libre de BruxellesBrusselsBelgium
| | - Clément Lenoir
- Department of DermatologyHôpital Erasme, HUB, Université Libre de BruxellesBrusselsBelgium
- Department of DermatologyInstitut Jules Bordet, HUB, Université Libre de BruxellesBrusselsBelgium
| | - Elisa Cinotti
- Groupe d'Imagerie Cutanée Non Invasive (GICNI) of the Société Française de DermatologieParisFrance
- Dermatology UnitDepartment of MedicalSurgical and Neurological SciencesUniversity of SienaSienaItaly
| | - Linda Tognetti
- Dermatology UnitDepartment of MedicalSurgical and Neurological SciencesUniversity of SienaSienaItaly
| | - Pietro Rubegni
- Dermatology UnitDepartment of MedicalSurgical and Neurological SciencesUniversity of SienaSienaItaly
| | - Javiera Perez‐Anker
- Melanoma UnitHospital Clinic BarcelonaUniversity of BarcelonaBarcelonaSpain
- CIBER de Enfermedades RarasInstituto de Salud Carlos IIIBarcelonaSpain
| | - Susana Puig
- Melanoma UnitHospital Clinic BarcelonaUniversity of BarcelonaBarcelonaSpain
- CIBER de Enfermedades RarasInstituto de Salud Carlos IIIBarcelonaSpain
| | - Josep Malvehy
- Melanoma UnitHospital Clinic BarcelonaUniversity of BarcelonaBarcelonaSpain
- CIBER de Enfermedades RarasInstituto de Salud Carlos IIIBarcelonaSpain
| | - Jean‐Luc Perrot
- Groupe d'Imagerie Cutanée Non Invasive (GICNI) of the Société Française de DermatologieParisFrance
- Department of DermatologyUniversity Hospital of Saint‐EtienneSaint‐EtienneFrance
| | - Klara Mosterd
- Department of DermatologyMaastricht University Medical Center+MaastrichtThe Netherlands
- GROW Research Institute for Oncology and ReproductionMaastricht UniversityMaastrichtThe Netherlands
| | - Véronique del Marmol
- Department of DermatologyHôpital Erasme, HUB, Université Libre de BruxellesBrusselsBelgium
- Department of DermatologyInstitut Jules Bordet, HUB, Université Libre de BruxellesBrusselsBelgium
| | - Mariano Suppa
- Department of DermatologyHôpital Erasme, HUB, Université Libre de BruxellesBrusselsBelgium
- Department of DermatologyInstitut Jules Bordet, HUB, Université Libre de BruxellesBrusselsBelgium
- Groupe d'Imagerie Cutanée Non Invasive (GICNI) of the Société Française de DermatologieParisFrance
| |
Collapse
|
37
|
Ogien J, Tavernier C, Fischman S, Dubois A. Line-field confocal optical coherence tomography (LC-OCT): principles and practical use. Ital J Dermatol Venerol 2023; 158:171-179. [PMID: 37278495 DOI: 10.23736/s2784-8671.23.07613-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Line-field confocal optical coherence tomography (LC-OCT) is a non-invasive optical imaging technique based on a combination of the optical principles of optical coherence tomography and reflectance confocal microscopy with line-field illumination, which can generate cell-resolved images of the skin, in vivo, in vertical section, horizontal section and in three dimensions. This article reviews the optical principles of LC-OCT, including low coherence interferometry, confocal filtering and line-field arrangement. The optical setup allowing for the acquisition of color images of the skin surface in parallel with LC-OCT images, without compromising LC-OCT performance, is also presented. Practical use of LC-OCT is demonstrated through an overview of the workflow of examining a patient using a commercial handheld LC-OCT probe (deepLive™, DAMAE Medical), from creating the patient record in the software, acquiring the images, to reviewing and interpreting the images. LC-OCT can generate a significant amount of data, making automated deep learning algorithms particularly relevant for assisting in the analysis of LC-OCT images. A review of algorithms developed for skin layer segmentation, keratinocyte nuclei segmentation, and automatic detection of atypical keratinocyte nuclei is provided.
Collapse
Affiliation(s)
| | | | | | - Arnaud Dubois
- DAMAE Medical, Paris, France
- Laboratoire Charles Fabry, Institut d'Optique Graduate School, Paris-Saclay University, Palaiseau, France
| |
Collapse
|
38
|
Lee J, Beirami MJ, Ebrahimpour R, Puyana C, Tsoukas M, Avanaki K. Optical coherence tomography confirms non-malignant pigmented lesions in phacomatosis pigmentokeratotica using a support vector machine learning algorithm. Skin Res Technol 2023; 29:e13377. [PMID: 37357662 PMCID: PMC10228288 DOI: 10.1111/srt.13377] [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: 03/13/2023] [Accepted: 05/19/2023] [Indexed: 06/27/2023]
Abstract
INTRODUCTION Phacomatosis pigmentokeratotica (PPK), an epidermal nevus syndrome, is characterized by the coexistence of nevus spilus and nevus sebaceus. Within the nevus spilus, an extensive range of atypical nevi of different morphologies may manifest. Pigmented lesions may fulfill the ABCDE criteria for melanoma, which may prompt a physician to perform a full-thickness biopsy. MOTIVATION Excisions result in pain, mental distress, and physical disfigurement. For patients with a significant number of nevi with morphologic atypia, it may not be physically feasible to biopsy a large number of lesions. Optical coherence tomography (OCT) is a non-invasive imaging modality that may be used to visualize non-melanoma and melanoma skin cancers. MATERIALS AND METHOD In this study, we used OCT to image pigmented lesions with morphologic atypia in a patient with PPK and assessed their quantitative optical properties compared to OCT cases of melanoma. We implement a support vector machine learning algorithm with Gabor wavelet transformation algorithm during post-image processing to extract optical properties and calculate attenuation coefficients. RESULTS The algorithm was trained and tested to extract and classify textural data. CONCLUSION We conclude that implementing this post-imaging machine learning algorithm to OCT images of pigmented lesions in PPK has been able to successfully confirm benign optical properties. Additionally, we identified remarkable differences in attenuation coefficient values and tissue optical characteristics, further defining separating benign features of pigmented lesions in PPK from malignant features.
Collapse
Affiliation(s)
- Jenna Lee
- Department of DermatologyUniversity of Illinois‐ChicagoChicagoIllinoisUSA
| | - Mohammad Javad Beirami
- Center for Cognitive ScienceInstitute for Convergence Science and Technology (ICST)Sharif University of TechnologyTehranIslamic Republic of Iran
| | - Reza Ebrahimpour
- Center for Cognitive ScienceInstitute for Convergence Science and Technology (ICST)Sharif University of TechnologyTehranIslamic Republic of Iran
- Department of Computer EngineeringShahid Rajaee Teacher Training UniversityTehranIslamic Republic of Iran
- School of Cognitive SciencesInstitute for Research in Fundamental Sciences (IPM)TehranIslamic Republic of Iran
| | - Carolina Puyana
- Department of DermatologyUniversity of Illinois‐ChicagoChicagoIllinoisUSA
| | - Maria Tsoukas
- Department of DermatologyUniversity of Illinois‐ChicagoChicagoIllinoisUSA
| | - Kamran Avanaki
- Department of DermatologyUniversity of Illinois‐ChicagoChicagoIllinoisUSA
- Department of Biomedical EngineeringUniversity of Illinois‐ChicagoChicagoIllinoisUSA
| |
Collapse
|
39
|
Yang Y, Xu F, Chen J, Tao C, Li Y, Chen Q, Tang S, Lee HK, Shen W. Artificial intelligence-assisted smartphone-based sensing for bioanalytical applications: A review. Biosens Bioelectron 2023; 229:115233. [PMID: 36965381 DOI: 10.1016/j.bios.2023.115233] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 02/23/2023] [Accepted: 03/13/2023] [Indexed: 03/18/2023]
Abstract
Artificial intelligence (AI) has received great attention since the concept was proposed, and it has developed rapidly in recent years with applications in many fields. Meanwhile, newer iterations of smartphone hardware technologies which have excellent data processing capabilities have leveraged on AI capabilities. Based on the desirability for portable detection, researchers have been investigating intelligent analysis by combining smartphones with AI algorithms. Various examples of the application of AI algorithm-based smartphone detection and analysis have been developed. In this review, we give an overview of this field, with a particular focus on bioanalytical detection applications. The applications are presented in terms of hardware design, software algorithms, and specific application areas. We also discuss the existing limitations of AI-based smartphone detection and analytical approaches, and their future prospects. The take-home message of our review is that the application of AI in the field of detection analysis is restricted by the limitations of the smartphone's hardware as well as the model building of AI for detection targets with insufficient data. Nevertheless, at this juncture, while bioanalytical diagnostics and health monitoring have set the pace for AI-based smartphone applicability, the future should see the technology making greater inroads into other fields. In relation to the latter, it is likely that the ordinary or average person will play a greater participatory role.
Collapse
Affiliation(s)
- Yizhuo Yang
- School of Environmental and Chemical Engineering, Jiangsu University of Science and Technology, Zhenjiang, 212003, Jiangsu Province, China
| | - Fang Xu
- School of Environmental and Chemical Engineering, Jiangsu University of Science and Technology, Zhenjiang, 212003, Jiangsu Province, China
| | - Jisen Chen
- School of Environmental and Chemical Engineering, Jiangsu University of Science and Technology, Zhenjiang, 212003, Jiangsu Province, China
| | - Chunxu Tao
- School of Environmental and Chemical Engineering, Jiangsu University of Science and Technology, Zhenjiang, 212003, Jiangsu Province, China
| | - Yunxin Li
- School of Environmental and Chemical Engineering, Jiangsu University of Science and Technology, Zhenjiang, 212003, Jiangsu Province, China
| | - Quansheng Chen
- College of Ocean Food and Biological Engineering, Jimei University, Xiamen, 361021, Fujian Province, China
| | - Sheng Tang
- School of Environmental and Chemical Engineering, Jiangsu University of Science and Technology, Zhenjiang, 212003, Jiangsu Province, China.
| | - Hian Kee Lee
- School of Environmental and Chemical Engineering, Jiangsu University of Science and Technology, Zhenjiang, 212003, Jiangsu Province, China; Department of Chemistry, National University of Singapore, 3 Science Drive 3, Singapore, 117543, Singapore.
| | - Wei Shen
- School of Environmental and Chemical Engineering, Jiangsu University of Science and Technology, Zhenjiang, 212003, Jiangsu Province, China.
| |
Collapse
|
40
|
Atak MF, Farabi B, Navarrete-Dechent C, Rubinstein G, Rajadhyaksha M, Jain M. Confocal Microscopy for Diagnosis and Management of Cutaneous Malignancies: Clinical Impacts and Innovation. Diagnostics (Basel) 2023; 13:diagnostics13050854. [PMID: 36899999 PMCID: PMC10001140 DOI: 10.3390/diagnostics13050854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 02/10/2023] [Accepted: 02/20/2023] [Indexed: 02/25/2023] Open
Abstract
Cutaneous malignancies are common malignancies worldwide, with rising incidence. Most skin cancers, including melanoma, can be cured if diagnosed correctly at an early stage. Thus, millions of biopsies are performed annually, posing a major economic burden. Non-invasive skin imaging techniques can aid in early diagnosis and save unnecessary benign biopsies. In this review article, we will discuss in vivo and ex vivo confocal microscopy (CM) techniques that are currently being utilized in dermatology clinics for skin cancer diagnosis. We will discuss their current applications and clinical impact. Additionally, we will provide a comprehensive review of the advances in the field of CM, including multi-modal approaches, the integration of fluorescent targeted dyes, and the role of artificial intelligence for improved diagnosis and management.
Collapse
Affiliation(s)
- Mehmet Fatih Atak
- Department of Dermatology, New York Medical College, Metropolitan Hospital, New York, NY 10029, USA
| | - Banu Farabi
- Department of Dermatology, New York Medical College, Metropolitan Hospital, New York, NY 10029, USA
| | - Cristian Navarrete-Dechent
- Department of Dermatology, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago 8331150, Chile
| | | | - Milind Rajadhyaksha
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Manu Jain
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
- Dermatology Service, Department of Medicine, Weill Cornell Medicine, New York, NY 10021, USA
- Correspondence: ; Tel.: +1-(646)-608-3562
| |
Collapse
|
41
|
Thamm JR, Welzel J, Schuh S. Line-field confocal optical coherence tomography, optical coherence tomography and reflectance confocal microscopy in a case of cutaneous sarcoidosis. J Eur Acad Dermatol Venereol 2023; 37:e739-e741. [PMID: 36682041 DOI: 10.1111/jdv.18897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 01/16/2023] [Indexed: 01/23/2023]
Affiliation(s)
- Janis Raphael Thamm
- Department of Dermatology and Allergology, University Hospital Augsburg, Augsburg, Germany
| | - Julia Welzel
- Department of Dermatology and Allergology, University Hospital Augsburg, Augsburg, Germany
| | - Sandra Schuh
- Department of Dermatology and Allergology, University Hospital Augsburg, Augsburg, Germany
| |
Collapse
|
42
|
Cinotti E, Brunetti T, Cartocci A, Tognetti L, Suppa M, Malvehy J, Perez-Anker J, Puig S, Perrot JL, Rubegni P. Diagnostic Accuracy of Line-Field Confocal Optical Coherence Tomography for the Diagnosis of Skin Carcinomas. Diagnostics (Basel) 2023; 13:diagnostics13030361. [PMID: 36766466 PMCID: PMC9914674 DOI: 10.3390/diagnostics13030361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 01/09/2023] [Accepted: 01/12/2023] [Indexed: 01/21/2023] Open
Abstract
Line-field confocal optical coherence tomography (LC-OCT) is a new, noninvasive imaging technique for the diagnosis of skin cancers. A total of 243 benign (54%) and malignant (46%) skin lesions were consecutively enrolled from 27 August 2020, to 6 October 2021 at the Dermatology Department of the University Hospital of Siena, Italy. Dermoscopic- and LC-OCT-based diagnoses were given by an expert dermatologist and compared with the ground truth. Considering all types of malignant skin tumours (79 basal cell carcinomas (BCCs), 22 squamous cell carcinomas, and 10 melanomas), a statistically significant increase (p = 0.013) in specificity was observed from dermoscopy (0.73, CI 0.64-0.81) to LC-OCT (0.87, CI 0.79-0.93) while sensitivity was the same with the two imaging techniques (0.95 CI 0.89-0.98 for dermoscopy and 0.95 CI 0.90-0.99 for LC-OCT). The increase in specificity was mainly driven by the ability of LC-OCT to differentiate BCCs from other diagnoses. In conclusion, our real-life study showed that LC-OCT can play an important role in helping the noninvasive diagnosis of malignant skin neoplasms and especially of BCCs. LC-OCT could be positioned after the dermoscopic examination, to spare useless biopsy of benign lesions without decreasing sensitivity.
Collapse
Affiliation(s)
- Elisa Cinotti
- Department of Medical, Surgical and Neurological Sciences, Dermatology Section, University of Siena, 53100 Siena, Italy
- Groupe d’Imagerie Cutanée Non Invasive (GICNI), Société Française de Dermatologie (SFD), 75008 Paris, France
- Correspondence: ; Tel.: +39-0577-585-428; Fax: +39-0577-585-484
| | - Tullio Brunetti
- Department of Medical, Surgical and Neurological Sciences, Dermatology Section, University of Siena, 53100 Siena, Italy
| | - Alessandra Cartocci
- Department of Medical, Surgical and Neurological Sciences, Dermatology Section, University of Siena, 53100 Siena, Italy
| | - Linda Tognetti
- Department of Medical, Surgical and Neurological Sciences, Dermatology Section, University of Siena, 53100 Siena, Italy
| | - Mariano Suppa
- Groupe d’Imagerie Cutanée Non Invasive (GICNI), Société Française de Dermatologie (SFD), 75008 Paris, France
- Department of Dermatology, Hôpital Erasme, Université Libre de Bruxelles, 1050 Brussels, Belgium
| | - Josep Malvehy
- Melanoma Unit, Hospital Clinic Barcelona, University of Barcelona, 08007 Barcelona, Spain
- CIBER de Enfermedades Raras, Instituto de Salud Carlos III, 08007 Barcelona, Spain
| | - Javiera Perez-Anker
- Melanoma Unit, Hospital Clinic Barcelona, University of Barcelona, 08007 Barcelona, Spain
- CIBER de Enfermedades Raras, Instituto de Salud Carlos III, 08007 Barcelona, Spain
| | - Susanna Puig
- Melanoma Unit, Hospital Clinic Barcelona, University of Barcelona, 08007 Barcelona, Spain
- CIBER de Enfermedades Raras, Instituto de Salud Carlos III, 08007 Barcelona, Spain
| | - Jean Luc Perrot
- Department of Dermatology, University Hospital of St-Etienne, 42270 Saint-Etienne, France
| | - Pietro Rubegni
- Department of Medical, Surgical and Neurological Sciences, Dermatology Section, University of Siena, 53100 Siena, Italy
| |
Collapse
|
43
|
Olesen UH, Jacobsen K, Lerche CM, Haedersdal M. Repeated exposure to fractional CO 2 laser delays squamous cell carcinoma formation and prevents clinical and subclinical photodamage visualized by line-field confocal optical coherence tomography and histology. Lasers Surg Med 2023; 55:73-81. [PMID: 36229986 PMCID: PMC10092156 DOI: 10.1002/lsm.23613] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 09/26/2022] [Accepted: 09/26/2022] [Indexed: 02/02/2023]
Abstract
OBJECTIVES Ablative fractional laser (AFL) is a well-established modality for treating ultraviolet radiation (UVR)-induced skin photodamage. We aimed to investigate the potential of AFL to delay squamous cell carcinoma (SCC) formation and prevent photodamage in a preclinical UVR-induced SCC model. MATERIALS AND METHODS Hairless C3.Cg-Hrhr /TifBomTac mice (n = 50) were exposed to UVR three times weekly throughout the study. UV-exposed mice were randomized to two groups that received dorsal CO2 AFL (10 mJ/mb, 10% density) or no treatment. AFL was performed every other week for a total of 16 weeks (nine treatments in total). The primary outcome was time to tumor occurrence. In a subset of mice on Day 150, prevention of clinical photodamage was assessed by examination of skin tightness and dyspigmentation. Concomitantly, assessment of subclinical photoprevention based on normalization of keratinocyte dysplasia, dermo-fiber morphology (collagen and elastin fibers), and skin thickness, was performed using line-field confocal optical coherence tomography (LC-OCT) and histology. RESULTS Repeated AFL treatments delayed SCC tumor development compared to UVR control mice by 12, 19, and 30 days for first, second, and third tumors, respectively (p ≤ 0.0017). Compared to UVR controls, AFL prevented photodamage both clinically and subclinically, based on LC-OCT and histology. In the epidermal layer, AFL imparted photopreventative effects including reduced dyspigmentation and keratinocyte dysplasia (1 vs. 2.5, p = 0.0079) and partial normalization of the epidermal thickness (p < 0.0001). In the dermis, AFL led to twofold greater skin tightness (p = 0.0079), improved dermo-fiber structure, and dermal thickness (p = 0.0011). CONCLUSION In conclusion, repeated AFL treatments of UVR-exposed skin significantly delayed SCC tumor formation and prevented clinical and imaging-assessed subclinical signs of photodamage, indicating a potential for AFL in prevention strategies for SCC and photodamage in high-risk populations.
Collapse
Affiliation(s)
- Uffe H. Olesen
- Department of DermatologyCopenhagen University Hospital—BispebjergCopenhagenDenmark
| | - Kevin Jacobsen
- Department of DermatologyCopenhagen University Hospital—BispebjergCopenhagenDenmark
| | - Catharina M. Lerche
- Department of DermatologyCopenhagen University Hospital—BispebjergCopenhagenDenmark
- Department of PharmacyUniversity of CopenhagenCopenhagenDenmark
| | - Merete Haedersdal
- Department of DermatologyCopenhagen University Hospital—BispebjergCopenhagenDenmark
| |
Collapse
|
44
|
Cinotti E, Bertello M, Cartocci A, Fiorani D, Tognetti L, Solmi V, Cappilli S, Peris K, Perrot JL, Suppa M, Del Marmol V, Rubegni P. Comparison of reflectance confocal microscopy and line-field optical coherence tomography for the identification of keratinocyte skin tumours. Skin Res Technol 2023; 29:e13215. [PMID: 36424847 PMCID: PMC9838760 DOI: 10.1111/srt.13215] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 10/01/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Reflectance confocal microscopy (RCM) and line-field confocal optical coherence tomography (LC-OCT) are non-invasive imaging devices that can help in the clinical diagnosis of actinic keratosis (AK) and cutaneous squamous cell carcinoma (SCC). No studies are available on the comparison between these two technologies for the identification of the different features of keratinocyte skin tumours. OBJECTIVES To compare RCM and LC-OCT findings in AK and SCC. METHODS A retrospective multicenter study was conducted. Tumours were imaged with RCM and LC-OCT devices before surgery, and the diagnosis was confirmed by histological examinations. LC-OCT and RCM criteria for AK/SCC were identified, and their presence/absence was evaluated in all study lesions. Gwet AC1 concordance index was calculated to compare RCM and LC-OCT. RESULTS We included 52 patients with 33 AKs and 19 SCCs. Irregular epidermis was visible in most tumours and with a good degree of agreement between RCM and LC-OCT (Gwet's AC1 0.74). Parakeratosis, dyskeratotic keratinocytes and both linear dilated and glomerular vessels were better visible at LC-OCT than RCM (p < 0.001). Erosion/ulceration was identified with both methods in more than half of the cases with a good degree of agreement (Gwet AC1 0.62). CONCLUSIONS Our results suggest that both LC-OCT and hand-held RCM can help clinicians in the identification of AK and SCC, providing an in vivo and non-invasive identification of an irregular epidermis. LC-OCT proved to be more effective in identifying parakeratosis, dyskeratotic keratinocytes and vessels in this series.
Collapse
Affiliation(s)
- Elisa Cinotti
- Dermatology Unit, Department of Medical, Surgical and Neurological Sciences, Università degli Studi di Siena, Siena, Italy.,Groupe d'Imagerie non invasive de la Société Française de Dermatologie, Paris, France
| | - Martina Bertello
- Dermatology Unit, Department of Medical, Surgical and Neurological Sciences, Università degli Studi di Siena, Siena, Italy
| | | | - Diletta Fiorani
- Dermatology Unit, Department of Medical, Surgical and Neurological Sciences, Università degli Studi di Siena, Siena, Italy
| | - Linda Tognetti
- Dermatology Unit, Department of Medical, Surgical and Neurological Sciences, Università degli Studi di Siena, Siena, Italy
| | - Valentina Solmi
- Dermatology Unit, Department of Medical, Surgical and Neurological Sciences, Università degli Studi di Siena, Siena, Italy
| | - Simone Cappilli
- Dermatology Unit, Department of Medicine and Traslational Surgery, Catholic University of Sacred Heart, Rome, Italy.,Dermatology Unit, Department of Medical and Surgical Sciences, A. Gemelli University Hospital Foundation - IRCCS, Rome, Italy
| | - Ketty Peris
- Dermatology Unit, Department of Medicine and Traslational Surgery, Catholic University of Sacred Heart, Rome, Italy.,Dermatology Unit, Department of Medical and Surgical Sciences, A. Gemelli University Hospital Foundation - IRCCS, Rome, Italy
| | - Jean Luc Perrot
- Groupe d'Imagerie non invasive de la Société Française de Dermatologie, Paris, France.,Department of Dermatology, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - Mariano Suppa
- Groupe d'Imagerie non invasive de la Société Française de Dermatologie, Paris, France.,Department of Dermatology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium.,Department of Dermatology, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - Veronique Del Marmol
- Department of Dermatology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Pietro Rubegni
- Dermatology Unit, Department of Medical, Surgical and Neurological Sciences, Università degli Studi di Siena, Siena, Italy
| |
Collapse
|
45
|
Breugnot J, Rouaud-Tinguely P, Gilardeau S, Rondeau D, Bordes S, Aymard E, Closs B. Utilizing deep learning for dermal matrix quality assessment on in vivo line-field confocal optical coherence tomography images. Skin Res Technol 2023; 29:e13221. [PMID: 36366860 PMCID: PMC9838780 DOI: 10.1111/srt.13221] [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: 08/22/2022] [Accepted: 10/08/2022] [Indexed: 11/13/2022]
Abstract
BACKGROUND Line-field confocal optical coherence tomography (LC-OCT) is an imaging technique providing non-invasive "optical biopsies" with an isotropic spatial resolution of ∼1 μm and deep penetration until the dermis. Analysis of obtained images is classically performed by experts, thus requiring long and fastidious training and giving operator-dependent results. In this study, the objective was to develop a new automated method to score the quality of the dermal matrix precisely, quickly, and directly from in vivo LC-OCT images. Once validated, this new automated method was applied to assess photo-aging-related changes in the quality of the dermal matrix. MATERIALS AND METHODS LC-OCT measurements were conducted on the face of 57 healthy Caucasian volunteers. The quality of the dermal matrix was scored by experts trained to evaluate the fibers' state according to four grades. In parallel, these images were used to develop the deep learning model by adapting a MobileNetv3-Small architecture. Once validated, this model was applied to the study of dermal matrix changes on a panel of 36 healthy Caucasian females, divided into three groups according to their age and photo-exposition. RESULTS The deep learning model was trained and tested on a set of 15 993 images. Calculated on the test data set, the accuracy score was 0.83. As expected, when applied to different volunteer groups, the model shows greater and deeper alteration of the dermal matrix for old and photoexposed subjects. CONCLUSIONS In conclusion, we have developed a new method that automatically scores the quality of the dermal matrix on in vivo LC-OCT images. This accurate model could be used for further investigations, both in the dermatological and cosmetic fields.
Collapse
|
46
|
Viscoelasticity assessment of tumoral skin with the use of a novel contact-free palpation methodology based upon surface waves. Sci Rep 2022; 12:18716. [PMID: 36333449 PMCID: PMC9636432 DOI: 10.1038/s41598-022-23483-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 11/01/2022] [Indexed: 11/06/2022] Open
Abstract
The ensuing pilot investigation sheds new light on characterizing tumoral and non-tumoral human skin mechanical properties that will not only assist the dermatologist's diagnosis but also could constitute the creation of an Artificial Intelligence database for upcoming research. A modern, non-invasive, and contact-free methodology-UNDERSKIN-was developed, and hinges upon Fourier transform computations that permit the analysis of surface wave dispersion with a specific skin inversion model and viscoelastic model. It yields a detailed look at how particle movements of the medium propagate throughout its near sub-surface, hence a novel knowledge of the mechanical responses of skin tumors. The research results display the tumors' viscoelastic responses alongside their respective healthy skin outcomes for each skin layer as well as the dermatologist's touch analysis. Although dermatologists are capable of sensing and having a fair overall assessment of what they are palpating, they are unable heretofore to quantify it and inform where the firmness or softness derives from, which it is necessary to be acquainted with so as to perform an accurate diagnosis, prognosis, treatment, future surgery, and teledermatology.
Collapse
|
47
|
Colboc H, Moguelet P, Letavernier E, Frochot V, Bernaudin JF, Weil R, Rouzière S, Senet P, Bachmeyer C, Laporte N, Lucas I, Descamps V, Amode R, Brunet-Possenti F, Kluger N, Deschamps L, Dubois A, Reguer S, Somogyi A, Medjoubi K, Refregiers M, Daudon M, Bazin D. Pathologies related to abnormal deposits in dermatology: a physico-chemical approach. CR CHIM 2022. [DOI: 10.5802/crchim.153] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
|
48
|
Choi W, Kang M, Hong JH, Katz O, Lee B, Kim GH, Choi Y, Choi W. Flexible-type ultrathin holographic endoscope for microscopic imaging of unstained biological tissues. Nat Commun 2022; 13:4469. [PMID: 35918348 PMCID: PMC9345988 DOI: 10.1038/s41467-022-32114-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 07/18/2022] [Indexed: 12/20/2022] Open
Abstract
Ultrathin lensless fibre endoscopes offer minimally invasive investigation, but they mostly operate as a rigid type due to the need for prior calibration of a fibre probe. Furthermore, most implementations work in fluorescence mode rather than label-free imaging mode, making them unsuitable for general medical diagnosis. Herein, we report a fully flexible ultrathin fibre endoscope taking 3D holographic images of unstained tissues with 0.85-μm spatial resolution. Using a bare fibre bundle as thin as 200-μm diameter, we design a lensless Fourier holographic imaging configuration to selectively detect weak reflections from biological tissues, a critical step for label-free endoscopic reflectance imaging. A unique algorithm is developed for calibration-free holographic image reconstruction, allowing us to image through a narrow and curved passage regardless of fibre bending. We demonstrate endoscopic reflectance imaging of unstained rat intestine tissues that are completely invisible to conventional endoscopes. The proposed endoscope will expedite a more accurate and earlier diagnosis than before with minimal complications.
Collapse
Affiliation(s)
- Wonjun Choi
- Center for Molecular Spectroscopy and Dynamics, Institute for Basic Science, Seoul, Republic of Korea.,Department of Physics, Korea University, Seoul, Republic of Korea
| | - Munkyu Kang
- Center for Molecular Spectroscopy and Dynamics, Institute for Basic Science, Seoul, Republic of Korea.,Department of Physics, Korea University, Seoul, Republic of Korea
| | - Jin Hee Hong
- Center for Molecular Spectroscopy and Dynamics, Institute for Basic Science, Seoul, Republic of Korea.,Department of Physics, Korea University, Seoul, Republic of Korea
| | - Ori Katz
- Department of Applied Physics, The Selim and Rachel Benin School of Computer Science & Engineering, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Byunghak Lee
- Korea Electrotechnology Research Institute, Ansan, Korea.,B2LAB co., ltd, Pohang-si, Gyeongsangbuk, Korea
| | - Guang Hoon Kim
- Korea Electrotechnology Research Institute, Ansan, Korea
| | - Youngwoon Choi
- Department of Bioengineering, Korea University, Seoul, Republic of Korea. .,Interdisciplinary Program in Precision Public Health, Korea University, Seoul, Republic of Korea.
| | - Wonshik Choi
- Center for Molecular Spectroscopy and Dynamics, Institute for Basic Science, Seoul, Republic of Korea. .,Department of Physics, Korea University, Seoul, Republic of Korea.
| |
Collapse
|
49
|
Xue W, Ogien J, Bulkin P, Coutrot AL, Dubois A. Mirau-based line-field confocal optical coherence tomography for three-dimensional high-resolution skin imaging. JOURNAL OF BIOMEDICAL OPTICS 2022; 27:086002. [PMID: 35962466 PMCID: PMC9374567 DOI: 10.1117/1.jbo.27.8.086002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 07/29/2022] [Indexed: 06/15/2023]
Abstract
SIGNIFICANCE Line-field confocal optical coherence tomography (LC-OCT) is a recently introduced high-resolution imaging modality based on a combination of low-coherence optical interferometry and reflectance confocal optical microscopy with line illumination and line detection. Capable of producing three-dimensional (3D) images of the skin with cellular resolution, in vivo, LC-OCT has been mainly applied in dermatology and dermo-cosmetology. The LC-OCT devices capable of acquiring 3D images reported so far are based on a Linnik interferometer using two identical microscope objectives. In this configuration, LC-OCT cannot be designed to be a very compact and light device, and the image acquisition speed is limited. AIM The objective of this work was to develop a more compact and lighter LC-OCT device that is capable of acquiring images faster without significant degradation of the resolution and with optimized detection sensitivity. APPROACH We developed an LC-OCT device based on a Mirau interferometer using a single objective. Dynamic adjustment of the camera frequency during the depth scan is implemented, using a faster camera and a more powerful light source. The reflectivity of the beam-splitter in the Mirau interferometer was optimized to maximize the detection sensitivity. A galvanometer scanner was incorporated into the device for scanning the illumination line laterally. A stack of adjacent B-scans, constituting a 3D image, can thus be acquired. RESULTS The device is able to acquire and display B-scans at 17 fps. 3D images with a quasi-isotropic resolution of ∼1.5 μm (1.3, 1.9, and 1.1 μm in the x , y, and z directions, respectively) over a field of 940 μm × 600 μm × 350 μm (x × y × z) can be obtained. 3D imaging of human skin at cellular resolution, in vivo, is reported. CONCLUSIONS The acquisition rate of the B-scans, at 17 fps, is unprecedented in LC-OCT. Compared with the conventional LC-OCT devices based on a Linnik interferometer, the reported Mirau-based LC-OCT device can acquire B-scans ∼2 times faster. With potential advantages in terms of compactness and weight, a Mirau-based device could easily be integrated into a smaller and lighter handheld probe for use by dermatologists in their daily medical practice.
Collapse
Affiliation(s)
- Weikai Xue
- Université Paris-Saclay, Institut d’Optique Graduate School, CNRS, Laboratoire Charles Fabry, Palaiseau, France
| | | | - Pavel Bulkin
- LPICM, CNRS, Ecole Polytechnique, Institut Polytechnique de Paris, Palaiseau, France
| | - Anne-Lise Coutrot
- Université Paris-Saclay, Institut d’Optique Graduate School, CNRS, Laboratoire Charles Fabry, Palaiseau, France
| | - Arnaud Dubois
- Université Paris-Saclay, Institut d’Optique Graduate School, CNRS, Laboratoire Charles Fabry, Palaiseau, France
- DAMAE Medical, Paris, France
| |
Collapse
|
50
|
Current Topics in the Diagnostic Approach to Skin Diseases. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12157576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The introduction of novel, non-invasive techniques capable of improving the diagnostic accuracy and sensibility of both inflammatory and neoplastic cutaneous diseases has always been one of the most practical objectives of dermatological research [...]
Collapse
|