Effect of Reflectance Confocal Microscopy for Suspect Lesions on Diagnostic Accuracy in Melanoma

Pellacani, Giovanni; Farnetani, Francesca; Ciardo, Silvana; Chester, Johanna; Kaleci, Shaniko; Mazzoni, Laura; Bassoli, Sara; Casari, Alice; Pampena, Riccardo; Mirra, Marica; Lai, Michela; Magi, Serena; Mandel, Victor Desmond; Matteo, S. Di; Colombo, Giorgio L; Stanganelli, Ignazio; Longo, Caterina

doi:10.1001/jamadermatol.2022.1570

Cited by 45 publications

(34 citation statements)

References 36 publications

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“…The main RCM clinical application is the evaluation of equivocal skin lesions with a low-to-moderate pretest probability of malignancy after dermoscopy assessment ( Figure 7 and Figure 8 ) [ 20 , 32 ]. In a recent prospective multicenter randomized trial, adjunctive use of RCM for suspect lesions reduced unnecessary excisions and assured the removal of aggressive melanomas at baseline in a real-life, clinical decision-making application in referral centers with RCM [ 88 ].…”

Section: Techniquesmentioning

confidence: 99%

Diagnostics Using Non-Invasive Technologies in Dermatological Oncology

Soglia

Pérez-Ánker

Guede

et al. 2022

Cancers

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The growing incidence of skin cancer, with its associated mortality and morbidity, has in recent years led to the developing of new non-invasive technologies, which allow an earlier and more accurate diagnosis. Some of these, such as digital photography, 2D and 3D total-body photography and dermoscopy are now widely used and others, such as reflectance confocal microscopy and optical coherence tomography, are limited to a few academic and referral skin cancer centers because of their cost or the long training period required. Health care professionals involved in the treatment of patients with skin cancer need to know the implications and benefits of new non-invasive technologies for dermatological oncology. In this article we review the characteristics and usability of the main diagnostic imaging methods available today.

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Section: Techniquesmentioning

confidence: 99%

Diagnostics Using Non-Invasive Technologies in Dermatological Oncology

Soglia

Pérez-Ánker

Guede

et al. 2022

Cancers

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“…Mye tyder på at slike lesjoner snarere bør betraktes som risikofaktorer for melanom enn som forstadier til melanom (23). Det er imidlertid forbedre indikasjonsstillingen for eksisjon av pigmenterte hudlesjoner (24,25). I fremtiden kan bruk av kunstig intelligens og maskinlaeri Kunnskapen om patogenesen ved melanom og andre melanocytaere hudlesjoner er sterkt økende (27).…”

Section: Inkludert Dysplastisk Nevusunclassified

Histopathologic reassessment of melanoma and other melanocytic skin lesions excised in 2009 and 2018–2019

Gjersvik¹,

Veierød²,

Thompson³

et al. 2022

Tidsskriftet

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Institu for klinisk medisin Universitetet i Oslo og Seksjon for hudsykdommer Oslo universitetssykehus Forfa erbidrag: idé, utforming og design, datainnsamling, analyse av data, tolking av data, li eratursøk, utarbeiding og revisjon av manuskript og godkj Pe er Gjersvik er dr.med., spesialist i hud-og veneriske sykdommer og professor. Forfa eren har fylt ut ICMJE-skjemaet og oppgir ingen interessekonflikter.Oslo senter for biostatistikk og epidemiologi og Avdeling for biostatistikk Institu for medisinske basalfag Universitetet i Oslo Forfa erbidrag: idé, utforming og design, analyse av data, tolking av data, utarbeiding og revisjon av manuskript og godkjenning av innsendt manuskrip Marit B. Veierød er ph.d. og professor i medisinsk statistikk. Forfa eren har fylt ut ICMJE-skjemaet og oppgir ingen interessekonflikter.Avdeling for patologi Oslo universitetssykehus, Ullevål sykehus Forfa erbidrag: datainnsamling, tolking av data, utarbeiding og revisjon av manuskript og godkjenning av innsendt manuskriptversjon. Alec Thompson er spesialist i patologi og overlege. Han er varamedlem av Norsk melanomgruppe. Forfa eren har fylt ut ICMJE-skjemaet og oppgir ingen interessekonflikter.

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“…All lesions, where a diagnosis of melanoma was delayed, were thinner than 0.5 mm. " [23] Castro et al, after studying 110 lesions that were clinically and dermoscopically suspicious of superficial spreading melanoma, reported three RCM features that showed statistically significant association with melanomas and they included "peripheral hotspot at the dermo-epidermal junction (defined as 1 mm × 1 mm area of the lesion where atypical cells are more aggregated), " "nucleated roundish cells at the dermo-epidermal junction, " and "sheet of cells. " [24] Handheld RCM is used to determine the tumor extent before definitive surgery.…”

Section: Melanomamentioning

confidence: 99%

Confocal microscopy – Working principle and applications in dermatology

Jayamohanan¹

2022

JSSTD

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Confocal microscopy (CFM) is a novel, non-invasive tool with diagnostic and prognostic value. It has utility in a wide array of dermatological conditions, tele-dermatopathology, and dermatological research. The image contrast is imparted by the differential refractive properties of subcellular structures. Certain stains are also used to accentuate the image contrast. CFM enables the visualization of tissues both in vivo and ex vivo (after excision). Both reflectance (in vivo and ex vivo) and fluorescence modes (ex vivo) of CFM are utilized for imaging. One can view 3D images with a near histological resolution, but with a limited depth of penetration. CFM has reduced the number of biopsies required in the evaluation of skin cancers. However, conventional histopathology remains the gold standard in tumor diagnosis. The in vivo reflectance mode CFM has found applications in dermato-oncology, inflammatory dermatoses, cutaneous infections and infestations, skin aging, and pigmentary disorders. The ex vivo CFM facilitates the immediate perioperative examination of excised tissues. The limited depth of view, photobleaching (in fluorescence mode CFM), high cost, and steep learning curve are the disadvantages. The future of CFM appears promising with the introduction of modified microscopes, the use of specific stains, and the incorporation of artificial intelligence.

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Effect of Reflectance Confocal Microscopy for Suspect Lesions on Diagnostic Accuracy in Melanoma

Abstract: This randomized clinical trial tests the hypothesis that reflectance confocal microscopy reduces unnecessary lesion excision by more than 30% and identifies all melanoma lesions larger than 0.5 mm at baseline.

Cited by 45 publications

References 36 publications

Diagnostics Using Non-Invasive Technologies in Dermatological Oncology

Diagnostics Using Non-Invasive Technologies in Dermatological Oncology

Histopathologic reassessment of melanoma and other melanocytic skin lesions excised in 2009 and 2018–2019

Confocal microscopy – Working principle and applications in dermatology

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