Imaging of Mohs Micrographic Surgery Sections Using Full-Field Optical Coherence Tomography: A Pilot Study

Durkin, John; Fine, Jeffrey L.; Sam, Hakeem; Pugliano‐Mauro, Melissa; Ho, Jonhan

doi:10.1111/dsu.12419

Cited by 33 publications

(22 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The majority of studies identified in this review investigated margin delineation in OCT examination. Six of the 10 studies were STROBE B, three were STROBE C and one was STROBE A (Table ) …”

Section: Resultsmentioning

confidence: 99%

“…The study reports sensitivity, specificity and positive predictive value of 75%, 64% and 61%, respectively, based on 80 images obtained from 20 BCCs with four margins each . Similarly, full‐field (FF)‐OCT, which has a higher resolution than conventional OCT and HD‐OCT, correctly identified two of three BCC tumours when used ex vivo on frozen sections . Of note, all four margins were correctly identified in only 45% of tumours …”

Section: Resultsmentioning

confidence: 99%

“…Six of the 10 studies were STROBE B, three were STROBE C and one was STROBE A ( Table 3). [34][35][36][37][38][39][40][41][42][43] Most studies focused on the in vivo examination of Mohs micrographic surgery (MMS) margins prior to surgery using conventional OCT. [34][35][36][37] In the largest series, the OCT-predicted boundary was always within the MMS defect in onestage MMS, and OCT always correctly predicted the border to be beyond the initial planned MMS boundary in multistage MMS. 35 Similar results were observed in separate studies, 36,37 as well as in other case reports.…”

Section: Margin Delineation Of Basal Cell Carcinomamentioning

confidence: 99%

See 2 more Smart Citations

Systematic review of optical coherence tomography usage in the diagnosis and management of basal cell carcinoma

Cheng

Guitera

2015

Br J Dermatol

View full text Add to dashboard Cite

Optical coherence tomography (OCT) is a noninvasive imaging tool used in vivo in real time for diagnosis, treatment delineation and monitoring of basal cell carcinoma (BCC). Features of BCC on OCT have been widely described and reviewed. However, the diagnostic accuracy of OCT in these various applications is unclear. We systematically reviewed the literature to assess the accuracy of OCT in diagnosis and management of BCC using the Embase and Medline databases. In total 179 unique references were identified in the initial search, of which 22 studies with 556 histologically proven BCCs were eligible. Assessment of the quality of eligible studies was undertaken using the STROBE criteria. Data extraction and quality assessment were performed independently by the two authors. This systematic review provides an overview of the clinical applications of OCT in the diagnosis and management of BCC. OCT has been suggested to be useful in the diagnosis, treatment planning and treatment monitoring of BCC. As the technology improves and its utility increases, further studies with good methodological quality will be needed to implement OCT into daily practice.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Margin Delineation Of Basal Cell Carcinomamentioning

confidence: 99%

See 1 more Smart Citation

Systematic review of optical coherence tomography usage in the diagnosis and management of basal cell carcinoma

Cheng

Guitera

2015

Br J Dermatol

View full text Add to dashboard Cite

show abstract

“…10 In addition to these limitations, the preparation of frozen sections requires a specialized laboratory set-up and a trained Mohs technician, raising the overall cost of the Mohs surgery and pathology procedure. 4 To overcome the limitations of the frozen sectioning process and provide rapid histopathological evaluation of ex vivo fresh tissue, several optical imaging techniques are being explored, such as confocal mosaicking microscopy, 9,[11][12][13][14][15] fluorescence polarization, 16 multiphoton laser scanning microscopy, 17 fluorescence lifetime imaging, 18 Raman spectroscopy, 19 integrated autofluorescence and Raman scattering microscopy, 20 optical coherence tomography (OCT), 21 full-field OCT, 22 coherent antiStokes Raman scattering microscopy, 23 multimodal spectral imaging, 24 and terahertz spectral imaging. 25,26 Confocal mosaicking microscopy (CMM) is currently the furthest advanced, being implemented and validated in Mohs surgical settings in real time.…”

Section: Introductionmentioning

confidence: 99%

Implementation of fluorescence confocal mosaicking microscopy by “early adopter” Mohs surgeons and dermatologists: recent progress

2017

View full text Add to dashboard Cite

Manu Jain, Milind Rajadhyaksha, Kishwer Nehal, "Implementation of fluorescence confocal mosaicking microscopy by "early adopter" Mohs surgeons and dermatologists: recent progress," J. Abstract. Confocal mosaicking microscopy (CMM) enables rapid imaging of large areas of fresh tissue ex vivo without the processing that is necessary for conventional histology. When performed in fluorescence mode using acridine orange (nuclear specific dye), it enhances nuclei-to-dermis contrast that enables detection of all types of basal cell carcinomas (BCCs), including micronodular and thin strands of infiltrative types. So far, this technique has been mostly validated in research settings for the detection of residual BCC tumor margins with high sensitivity of 89% to 96% and specificity of 99% to 89%. Recently, CMM has advanced to implementation and testing in clinical settings by "early adopter" Mohs surgeons, as an adjunct to frozen section during Mohs surgery. We summarize the development of CMM guided imaging of ex vivo skin tissues from bench to bedside. We also present its current state of application in routine clinical workflow not only for the assessment of residual BCC margins in the Mohs surgical setting but also for some melanocytic lesions and other skin conditions in clinical dermatology settings. Last, we also discuss the potential limitations of this technology as well as future developments. As this technology advances further, it may serve as an adjunct to standard histology and enable rapid surgical pathology of skin cancers at the bedside.

show abstract

“…As compared to confocal systems, FFOCT further holds the advantage not to require lasers or fast scanning elements; the technique can be integrated in a simple setup. The FFOCT has already been evaluated in the pathology laboratory in various preclinical studies on human skin, 24,25 pulmonary, 26 urologic, 27 and gastrointestinal tissue, 28 retina and cornea, 29,30 and brain. 31 Recently, a preclinical study was performed on breast tissue samples 32 and achieved sensitivity of 92% and specificity of 77%.…”

Section: Introductionmentioning

confidence: 99%

Assessment of Sentinel Node Biopsies With Full-Field Optical Coherence Tomography

Grieve

Mouslim

Assayag

et al. 2015

Technol Cancer Res Treat

View full text Add to dashboard Cite

Current techniques for the intraoperative analysis of sentinel lymph nodes during breast cancer surgery present drawbacks such as time and tissue consumption. Full-field optical coherence tomography is a novel noninvasive, high-resolution, fast imaging technique. This study investigated the use of full-field optical coherence tomography as an alternative technique for the intraoperative analysis of sentinel lymph nodes. Seventy-one axillary lymph nodes from 38 patients at Tenon Hospital were imaged minutes after excision with full-field optical coherence tomography in the pathology laboratory, before being handled for histological analysis. A pathologist performed a blind diagnosis (benign/malignant), based on the full-field optical coherence tomography images alone, which resulted in a sensitivity of 92% and a specificity of 83% (n ¼ 65 samples). Regular feedback was given during the blind diagnosis, with thorough analysis of the images, such that features of normal and suspect nodes were identified in the images and compared with histology. A nonmedically trained imaging expert also performed a blind diagnosis aided by the reading criteria defined by the pathologist, which resulted in 85% sensitivity and 90% specificity (n ¼ 71 samples). The number of false positives of the pathologist was reduced by 3 in a second blind reading a few months later. These results indicate that following adequate training, full-field optical coherence tomography can be an effective noninvasive diagnostic tool for extemporaneous sentinel node biopsy qualification.

show abstract

Imaging of Mohs Micrographic Surgery Sections Using Full-Field Optical Coherence Tomography: A Pilot Study

Abstract: Malignancy in Mohs sections can correctly be identified or excluded using FF-OCT. Although not ready for clinical use in its current state, FF-OCT has the potential to be incorporated into the Mohs workflow in the future.

Cited by 33 publications

References 26 publications

Systematic review of optical coherence tomography usage in the diagnosis and management of basal cell carcinoma

Systematic review of optical coherence tomography usage in the diagnosis and management of basal cell carcinoma

Implementation of fluorescence confocal mosaicking microscopy by “early adopter” Mohs surgeons and dermatologists: recent progress

Assessment of Sentinel Node Biopsies With Full-Field Optical Coherence Tomography

Contact Info

Product

Resources

About