1
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Pathak GN, Sanabria B, Caetano VD, Rafiq B, Rao BK. Evaluation and treatment monitoring of actinic keratosis using line-field confocal optical coherence tomography. Skin Res Technol 2024; 30:e13726. [PMID: 38696227 PMCID: PMC11064923 DOI: 10.1111/srt.13726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 04/13/2024] [Accepted: 04/16/2024] [Indexed: 05/05/2024]
Affiliation(s)
- Gaurav N. Pathak
- Department of DermatologyRutgers Robert Wood Johnson Medical SchoolSomersetNew JerseyUSA
| | - Bianca Sanabria
- Department of DermatologyRutgers Robert Wood Johnson Medical SchoolSomersetNew JerseyUSA
| | | | | | - Babar K. Rao
- Department of DermatologyRutgers Robert Wood Johnson Medical SchoolSomersetNew JerseyUSA
- Rao DermatologyAtlantic HighlandsNew JerseyUSA
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2
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Dessinioti C, Liopyris K, Stratigos AJ. Diagnosis of invasive cutaneous squamous cell carcinoma, imaging and staging. Ital J Dermatol Venerol 2024; 159:118-127. [PMID: 38650493 DOI: 10.23736/s2784-8671.24.07670-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Abstract
The assessment of patients with a lesion raising the suspicion of an invasive cutaneous squamous cell carcinoma (cSCC) is a frequent clinical scenario. The management of patients with cSCC is a multistep approach, starting with the correct diagnosis. The two main diagnostic goals are to differentiate from other possible diagnoses and correctly recognize the lesion as cSCC, and then to determine the tumor spread (perform staging), that is if the patient has a common primary cSCC or a locally advanced cSCC, or a metastatic cSCC (with in-transit, regional lymph nodal, or rarely distant metastasis). The multistep diagnostic approach begins with the clinical characteristics of the primary cSCC, it is complemented with features with dermoscopy and, if available, reflectance confocal microscopy and is confirmed with histopathology. The tumor spread is assessed by physical examination and, in some cases, ultrasound and/or computed tomography or magnetic resonance imaging, mainly to investigate for regional lymph node metastasis or for local infiltration into deeper structures. In the last step, the clinical, histologic and radiologic findings are incorporated into staging systems.
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Affiliation(s)
- Clio Dessinioti
- First Department of Dermatology-Venereology, National and Kapodistrian University of Athens, Andreas Sygros Hospital, Athens, Greece
| | - Konstantinos Liopyris
- First Department of Dermatology-Venereology, National and Kapodistrian University of Athens, Andreas Sygros Hospital, Athens, Greece
| | - Alexander J Stratigos
- First Department of Dermatology-Venereology, National and Kapodistrian University of Athens, Andreas Sygros Hospital, Athens, Greece -
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3
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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] [What about the content of this article? (0)] [Affiliation(s)] [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.
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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
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4
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Kandolf L, Peris K, Malvehy J, Mosterd K, Heppt MV, Fargnoli MC, Berking C, Arenberger P, Bylaite-Bučinskiene M, Del Marmol V, Dirschka T, Dreno B, Forsea AM, Harwood CA, Hauschild A, Heerfordt IM, Kauffman R, Kelleners Smeeths N, Lallas A, Lebbe C, Leiter U, Longo C, Mijušković Ž, Pellacani G, Puig S, Saiag P, Šitum M, Stockfleth E, Salavastru C, Stratigos A, Zalaudek I, Garbe C. European consensus-based interdisciplinary guideline for diagnosis, treatment and prevention of actinic keratoses, epithelial UV-induced dysplasia and field cancerization on behalf of European Association of Dermato-Oncology, European Dermatology Forum, European Academy of Dermatology and Venereology and Union of Medical Specialists (Union Européenne des Médecins Spécialistes). J Eur Acad Dermatol Venereol 2024. [PMID: 38451047 DOI: 10.1111/jdv.19897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 01/23/2024] [Indexed: 03/08/2024]
Abstract
A collaboration of multidisciplinary experts from the European Association of Dermato-Oncology, the European Dermatology Forum, the European Academy of Dermatology and Venereology, and the European Union of Medical Specialists was formed to develop European recommendations on AK diagnosis and treatment, based on current literature and expert consensus. This guideline addresses the epidemiology, diagnostics, risk stratification and treatments in immunocompetent as well as immunosuppressed patients. Actinic keratoses (AK) are potential precursors of cutaneous squamous cell carcinoma (cSCC) and display typical histopathologic and immunohistochemical features of this malignancy in an early stage. They can develop into cSSC in situ and become invasive in a low percentage of cases. AK is the most frequent neoplasia in white populations, frequently occurring within a cancerous field induced by ultraviolet radiation. Since it cannot be predicted, which lesion will progress to cSCC and when treatment is usually recommended. The diagnosis of AK and field cancerization is made by clinical examination. Dermatoscopy, confocal microscopy, optical coherence tomography or line-field confocal-OCT can help in the differential diagnosis of AK and other skin neoplasms. A biopsy is indicated in clinically and/or dermatoscopically suspicious and/or treatment-refractory lesions. The choice of treatment depends on patients' and lesion characteristics. For single non-hyperkeratotic lesions, the treatment can be started upon patient's request with destructive treatments or topical treatments. For multiple lesions, field cancerization treatment is advised with topical treatments and photodynamic therapy. Preventive measures such as sun protection, self-examination and repeated field cancerization treatments of previously affected skin areas in high-risk patients are advised.
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Affiliation(s)
- Lidija Kandolf
- Department of Dermatology, Faculty of Medicine, University of Defence, Military Medical Academy, Belgrade, Serbia
| | - Ketty Peris
- UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche Addominali ed Endrocrino Metaboliche, Fondazione Policlinico Universitario A. Gemelli - IRCCS, Rome, Italy
- Dermatologia, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Josep Malvehy
- Dermatology Department of Hospital Clinic of Barcelona, IDIBAPS, CIBER de Enfermedades Raras, Instituto Carlos III, University of Barcelona, Barcelona, Spain
| | - Klara Mosterd
- Department of Dermatology, Maastricht University Medical Centre+ Comprehensive Cancer Centre, Maastricht, The Netherlands
- GROW-School for Oncology and Reproduction, Maastricht University, Maastricht, The Netherlands
| | - Markus V Heppt
- Department of Dermatology, Uniklinikum Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
- Comprehensive Cancer Center Erlangen-European Metropolitan Area of Nuremberg (CC ER-EMN), Erlangen, Germany
| | - Maria Concetta Fargnoli
- Dermatology, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Carola Berking
- Department of Dermatology, Uniklinikum Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
- Comprehensive Cancer Center Erlangen-European Metropolitan Area of Nuremberg (CC ER-EMN), Erlangen, Germany
| | - Petr Arenberger
- Department of Dermatovenereology, Third Faculty of Medicine, Charles University and University Hospital of Kralovske Vinohrady, Prague, Czech Republic
| | - Matilda Bylaite-Bučinskiene
- Clinic of Infectious Diseases and Dermatovenereology, Centre of Dermatovenereology, Vilnius University, Vilnius, Lithuania
| | - Veronique Del Marmol
- Department of Dermatology, University Hospital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Thomas Dirschka
- Faculty of Health, University Witten-Herdecke, Witten, Germany
- CentroDerm Clinic, Wuppertal, Germany
| | - Brigitte Dreno
- Nantes Université, INSERM, CNRS, Immunology and New Concepts in ImmunoTherapy, INCIT, UMR 1302/EMR6001, Nantes, France
| | - Ana-Maria Forsea
- Department of Oncologic Dermatology, Elias University Hospital Bucharest, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Catherine A Harwood
- Centre for Cell Biology and Cutaneous Research, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Axel Hauschild
- Department of Dermatology, University Hospital (UKSH), Kiel, Germany
| | - Ida Marie Heerfordt
- Department of Dermatology, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Roland Kauffman
- Department of Dermatology, Venereology and Allergology, Frankfurt University Hospital, Frankfurt, Germany
| | - Nicole Kelleners Smeeths
- Department of Dermatology, Maastricht University Medical Centre+ Comprehensive Cancer Centre, Maastricht, The Netherlands
- GROW-School for Oncology and Reproduction, Maastricht University, Maastricht, The Netherlands
| | - Aimilios Lallas
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | - Celeste Lebbe
- Université Paris Cite, AP-HP Dermato-oncology, Cancer institute APHP, Nord Paris cité, INSERM U976, Saint Louis Hospital, Paris, France
| | - Ulrike Leiter
- Centre for Dermatooncology, Department of Dermatology, Eberhard Karls University, Tuebingen, Germany
| | - Caterina Longo
- Skin Cancer Center, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Željko Mijušković
- Department of Dermatology, Faculty of Medicine, University of Defence, Military Medical Academy, Belgrade, Serbia
| | - Giovanni Pellacani
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - Susana Puig
- Dermatology Department of Hospital Clinic of Barcelona, IDIBAPS, CIBER de Enfermedades Raras, Instituto Carlos III, University of Barcelona, Barcelona, Spain
| | - Philippe Saiag
- Department of General and Oncologic Dermatology, Ambroise Paré Hospital, APHP, & EA 4340 "Biomarkers in Cancerology and Hemato-Oncology", UVSQ, Université Paris-Saclay, Boulogne-Billancourt, France
| | - Mirna Šitum
- Department of Dermatology and Venereology, Sestre Milosrdnice University Hospital Center, Zagreb, Croatia
| | - Eggert Stockfleth
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
| | - Carmen Salavastru
- Department of Pediatric Dermatology, Colentina Clinical Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Alexander Stratigos
- 1st Department of Dermatology-Venereology, National and Kapodistrian University of Athens, Andreas Sygros Hospital, Athens, Greece
| | - Iris Zalaudek
- Dermatology Clinic, Maggiore Hospital, Department of Medical Sciences, University of Trieste, Trieste, Italy
| | - Claus Garbe
- Centre for Dermatooncology, Department of Dermatology, Eberhard Karls University, Tuebingen, Germany
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5
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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] [What about the content of this article? (0)] [Affiliation(s)] [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.
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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
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6
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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 2023. [PMID: 38131528 DOI: 10.1111/jdv.19771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [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.
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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
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7
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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] [What about the content of this article? (0)] [Affiliation(s)] [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.
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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
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8
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Orte Cano C, Suppa M, del Marmol V. Where Artificial Intelligence Can Take Us in the Management and Understanding of Cancerization Fields. Cancers (Basel) 2023; 15:5264. [PMID: 37958437 PMCID: PMC10649750 DOI: 10.3390/cancers15215264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 09/22/2023] [Accepted: 09/27/2023] [Indexed: 11/15/2023] Open
Abstract
Squamous cell carcinoma and its precursor lesion actinic keratosis are often found together in areas of skin chronically exposed to sun, otherwise called cancerisation fields. The clinical assessment of cancerisation fields and the correct diagnosis of lesions within these fields is usually challenging for dermatologists. The recent adoption of skin cancer diagnostic imaging techniques, particularly LC-OCT, helps clinicians in guiding treatment decisions of cancerization fields in a non-invasive way. The combination of artificial intelligence and non-invasive skin imaging opens up many possibilities as AI can perform tasks impossible for humans in a reasonable amount of time. In this text we review past examples of the application of AI to dermatological images for actinic keratosis/squamous cell carcinoma diagnosis, and we discuss about the prospects of the application of AI for the characterization and management of cancerization fields.
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Affiliation(s)
- Carmen Orte Cano
- Department of Dermatology, Hôpital Erasme, HUB, Université Libre de Bruxelles, 808 Route de Lennik, 1070 Brussels, Belgium
- Department of Dermato-Oncology, Institut Jules Bordet, HUB, Université Libre de Bruxelles, 1070 Brussels, Belgium
| | - Mariano Suppa
- Department of Dermatology, Hôpital Erasme, HUB, Université Libre de Bruxelles, 808 Route de Lennik, 1070 Brussels, Belgium
- Department of Dermato-Oncology, Institut Jules Bordet, HUB, Université Libre de Bruxelles, 1070 Brussels, Belgium
- Groupe d’Imagerie Cutanée Non Invasive (GICNI), Société Française de Dermatologie (SFD), 75008 Paris, France
| | - Véronique del Marmol
- Department of Dermatology, Hôpital Erasme, HUB, Université Libre de Bruxelles, 808 Route de Lennik, 1070 Brussels, Belgium
- Department of Dermato-Oncology, Institut Jules Bordet, HUB, Université Libre de Bruxelles, 1070 Brussels, Belgium
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9
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Soglia S, Pérez-Anker J, Fraghì A, Ariasi C, La Rosa G, Lenoir C, Suppa M, Calzavara-Pinton PG, Venturini M. Line-field confocal optical coherence tomography and reflectance confocal microscopy of Merkel cell carcinoma. J Eur Acad Dermatol Venereol 2023; 37:e1223-e1225. [PMID: 37191203 DOI: 10.1111/jdv.19211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Accepted: 05/10/2023] [Indexed: 05/17/2023]
Affiliation(s)
- S Soglia
- Department of Dermatology, University of Brescia, Brescia, Italy
| | - J Pérez-Anker
- Melanoma Unit, Dermatology Department, Hospital Clínic de Barcelona, IDIBAPS, Universitat de Barcelona, Barcelona, Spain
| | - A Fraghì
- Department of Dermatology, University of Brescia, Brescia, Italy
| | - C Ariasi
- Department of Dermatology, University of Brescia, Brescia, Italy
| | - G La Rosa
- Department of Dermatology, University of Brescia, Brescia, Italy
| | - C Lenoir
- Department of Dermatology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - M Suppa
- Department of Dermatology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
- Department of Dermatology, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
- Groupe d'Imagerie Cutanée Non Invasive (GICNI) of the Société Française de Dermatologie (SFD), Paris, France
| | | | - M Venturini
- Department of Dermatology, University of Brescia, Brescia, Italy
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10
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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] [What about the content of this article? (0)] [Affiliation(s)] [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.
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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
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11
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Atak MF, Farabi B, Navarrete-Dechent C, Rubinstein G, Rajadhyaksha M, Jain M. Confocal Microscopy for Diagnosis and Management of Cutaneous Malignancies: Clinical Impacts and Innovation. Diagnostics (Basel) 2023; 13:diagnostics13050854. [PMID: 36899999 PMCID: PMC10001140 DOI: 10.3390/diagnostics13050854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 02/10/2023] [Accepted: 02/20/2023] [Indexed: 02/25/2023] Open
Abstract
Cutaneous malignancies are common malignancies worldwide, with rising incidence. Most skin cancers, including melanoma, can be cured if diagnosed correctly at an early stage. Thus, millions of biopsies are performed annually, posing a major economic burden. Non-invasive skin imaging techniques can aid in early diagnosis and save unnecessary benign biopsies. In this review article, we will discuss in vivo and ex vivo confocal microscopy (CM) techniques that are currently being utilized in dermatology clinics for skin cancer diagnosis. We will discuss their current applications and clinical impact. Additionally, we will provide a comprehensive review of the advances in the field of CM, including multi-modal approaches, the integration of fluorescent targeted dyes, and the role of artificial intelligence for improved diagnosis and management.
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Affiliation(s)
- Mehmet Fatih Atak
- Department of Dermatology, New York Medical College, Metropolitan Hospital, New York, NY 10029, USA
| | - Banu Farabi
- Department of Dermatology, New York Medical College, Metropolitan Hospital, New York, NY 10029, USA
| | - Cristian Navarrete-Dechent
- Department of Dermatology, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago 8331150, Chile
| | | | - Milind Rajadhyaksha
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Manu Jain
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
- Dermatology Service, Department of Medicine, Weill Cornell Medicine, New York, NY 10021, USA
- Correspondence: ; Tel.: +1-(646)-608-3562
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12
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Ahmady S, Wolswijk T, Nelemans PJ, Adan F, Vernemmen AIP, Winnepenninckx V, Kelleners‐Smeets NWJ, Mosterd K. Measuring tumor depth of Bowen's disease by optical coherence tomography. Skin Res Technol 2023; 29:e13282. [PMID: 36823507 PMCID: PMC10155791 DOI: 10.1111/srt.13282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 01/07/2023] [Indexed: 02/05/2023]
Affiliation(s)
- Shima Ahmady
- Department of DermatologyMaastricht University Medical Center+MaastrichtThe Netherlands
- GROW Research Institute for Oncology and ReproductionMaastricht UniversityMaastrichtThe Netherlands
| | - Tom Wolswijk
- Department of DermatologyMaastricht University Medical Center+MaastrichtThe Netherlands
- GROW Research Institute for Oncology and ReproductionMaastricht UniversityMaastrichtThe Netherlands
| | | | - Fieke Adan
- Department of DermatologyMaastricht University Medical Center+MaastrichtThe Netherlands
- GROW Research Institute for Oncology and ReproductionMaastricht UniversityMaastrichtThe Netherlands
| | | | | | - Nicole Wilhelmina Johanna Kelleners‐Smeets
- Department of DermatologyMaastricht University Medical Center+MaastrichtThe Netherlands
- GROW Research Institute for Oncology and ReproductionMaastricht UniversityMaastrichtThe Netherlands
| | - Klara Mosterd
- Department of DermatologyMaastricht University Medical Center+MaastrichtThe Netherlands
- GROW Research Institute for Oncology and ReproductionMaastricht UniversityMaastrichtThe Netherlands
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13
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Verzì AE, Broggi G, Caltabiano R, Micali G, Lacarrubba F. Line-field confocal optical coherence tomography of lentigo maligna with horizontal and vertical histopathologic correlations. J Cutan Pathol 2023; 50:118-122. [PMID: 36056910 PMCID: PMC10087826 DOI: 10.1111/cup.14321] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 07/26/2022] [Accepted: 08/28/2022] [Indexed: 01/24/2023]
Abstract
Lentigo maligna (LM) is a subtype of in situ melanoma that classically presents in elderly patients as a slowly growing lesion on sun-exposed areas that may evolve to invasive melanoma. Line-field confocal optical coherence tomography (LC-OCT) is a new non-invasive technique for a real-time, vertical, and horizontal skin imaging with high resolution close to conventional histopathology. We present the LC-OCT features of an LM of the nose in a 49-year-old white man along with their horizontal and vertical histopathological correlations. LC-OCT was able to detect in vivo, in both horizontal and vertical imaging, the main microscopic features typical of LM by showing, in the epidermis and around the hair follicles, the presence of large, bright roundish, or dendritic atypical cells, with evident nuclei, corresponding to atypical melanocytes with a tendency toward folliculotropism. A strong correspondence between LC-OCT images and vertical and horizontal histopathological sections was observed. Our study, although limited to a single case, is indicative of the great potential of LC-OCT to improve the non-invasive diagnosis of LM.
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Affiliation(s)
| | - Giuseppe Broggi
- Department "G.F. Ingrassia," Section of Anatomic Pathology, University of Catania, Catania, Italy
| | - Rosario Caltabiano
- Department "G.F. Ingrassia," Section of Anatomic Pathology, University of Catania, Catania, Italy
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14
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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] [What about the content of this article? (0)] [Affiliation(s)] [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.
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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
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15
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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: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [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.
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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
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16
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Soglia S, Pérez-Anker J, Lobos Guede N, Giavedoni P, Puig S, Malvehy J. Diagnostics Using Non-Invasive Technologies in Dermatological Oncology. Cancers (Basel) 2022; 14:cancers14235886. [PMID: 36497368 PMCID: PMC9738560 DOI: 10.3390/cancers14235886] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 11/23/2022] [Accepted: 11/24/2022] [Indexed: 12/02/2022] Open
Abstract
The growing incidence of skin cancer, with its associated mortality and morbidity, has in recent years led to the developing of new non-invasive technologies, which allow an earlier and more accurate diagnosis. Some of these, such as digital photography, 2D and 3D total-body photography and dermoscopy are now widely used and others, such as reflectance confocal microscopy and optical coherence tomography, are limited to a few academic and referral skin cancer centers because of their cost or the long training period required. Health care professionals involved in the treatment of patients with skin cancer need to know the implications and benefits of new non-invasive technologies for dermatological oncology. In this article we review the characteristics and usability of the main diagnostic imaging methods available today.
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Affiliation(s)
- Simone Soglia
- Melanoma Unit, Dermatology Department, Hospital Clínic de Barcelona, IDIBAPS, Universitat de Barcelona, 08001 Barcelona, Spain
- Department of Dermatology, University of Brescia, 25121 Brescia, Italy
| | - Javiera Pérez-Anker
- Melanoma Unit, Dermatology Department, Hospital Clínic de Barcelona, IDIBAPS, Universitat de Barcelona, 08001 Barcelona, Spain
- Correspondence: ; Tel.: +34-932-275-400
| | - Nelson Lobos Guede
- Melanoma Unit, Dermatology Department, Hospital Clínic de Barcelona, IDIBAPS, Universitat de Barcelona, 08001 Barcelona, Spain
| | - Priscila Giavedoni
- Melanoma Unit, Dermatology Department, Hospital Clínic de Barcelona, IDIBAPS, Universitat de Barcelona, 08001 Barcelona, Spain
| | - Susana Puig
- Melanoma Unit, Dermatology Department, Hospital Clínic de Barcelona, IDIBAPS, Universitat de Barcelona, 08001 Barcelona, Spain
| | - Josep Malvehy
- Melanoma Unit, Dermatology Department, Hospital Clínic de Barcelona, IDIBAPS, Universitat de Barcelona, 08001 Barcelona, Spain
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17
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Yang L, Chen Y, Ling S, Wang J, Wang G, Zhang B, Zhao H, Zhao Q, Mao J. Research progress on the application of optical coherence tomography in the field of oncology. Front Oncol 2022; 12:953934. [PMID: 35957903 PMCID: PMC9358962 DOI: 10.3389/fonc.2022.953934] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 06/29/2022] [Indexed: 11/25/2022] Open
Abstract
Optical coherence tomography (OCT) is a non-invasive imaging technique which has become the “gold standard” for diagnosis in the field of ophthalmology. However, in contrast to the eye, nontransparent tissues exhibit a high degree of optical scattering and absorption, resulting in a limited OCT imaging depth. And the progress made in the past decade in OCT technology have made it possible to image nontransparent tissues with high spatial resolution at large (up to 2mm) imaging depth. On the one hand, OCT can be used in a rapid, noninvasive way to detect diseased tissues, organs, blood vessels or glands. On the other hand, it can also identify the optical characteristics of suspicious parts in the early stage of the disease, which is of great significance for the early diagnosis of tumor diseases. Furthermore, OCT imaging has been explored for imaging tumor cells and their dynamics, and for the monitoring of tumor responses to treatments. This review summarizes the recent advances in the OCT area, which application in oncological diagnosis and treatment in different types: (1) superficial tumors:OCT could detect microscopic information on the skin’s surface at high resolution and has been demonstrated to help diagnose common skin cancers; (2) gastrointestinal tumors: OCT can be integrated into small probes and catheters to image the structure of the stomach wall, enabling the diagnosis and differentiation of gastrointestinal tumors and inflammation; (3) deep tumors: with the rapid development of OCT imaging technology, it has shown great potential in the diagnosis of deep tumors such in brain tumors, breast cancer, bladder cancer, and lung cancer.
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Affiliation(s)
- Linhai Yang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, Center for Molecular Imaging and Translational Medicine, Department of Laboratory Medicine, School of Public Health, Shenzhen Research Institute of Xiamen University, Xiamen University, Xiamen, China
| | - Yulun Chen
- School of Medicine, Xiamen University, Xiamen, China
| | - Shuting Ling
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, Center for Molecular Imaging and Translational Medicine, Department of Laboratory Medicine, School of Public Health, Shenzhen Research Institute of Xiamen University, Xiamen University, Xiamen, China
| | - Jing Wang
- Department of Imaging, School of Medicine, Xiamen Cardiovascular Hospital of Xiamen University, Xiamen University, Xiamen, China
| | - Guangxing Wang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, Center for Molecular Imaging and Translational Medicine, Department of Laboratory Medicine, School of Public Health, Shenzhen Research Institute of Xiamen University, Xiamen University, Xiamen, China
| | - Bei Zhang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, Center for Molecular Imaging and Translational Medicine, Department of Laboratory Medicine, School of Public Health, Shenzhen Research Institute of Xiamen University, Xiamen University, Xiamen, China
| | - Hengyu Zhao
- Department of Imaging, School of Medicine, Xiamen Cardiovascular Hospital of Xiamen University, Xiamen University, Xiamen, China
- *Correspondence: Hengyu Zhao, ; Qingliang Zhao, ; Jingsong Mao,
| | - Qingliang Zhao
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, Center for Molecular Imaging and Translational Medicine, Department of Laboratory Medicine, School of Public Health, Shenzhen Research Institute of Xiamen University, Xiamen University, Xiamen, China
- *Correspondence: Hengyu Zhao, ; Qingliang Zhao, ; Jingsong Mao,
| | - Jingsong Mao
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, Center for Molecular Imaging and Translational Medicine, Department of Laboratory Medicine, School of Public Health, Shenzhen Research Institute of Xiamen University, Xiamen University, Xiamen, China
- Department of Radiology, Xiamen Key Laboratory of Endocrine-Related Cancer Precision Medicine, Xiang’an Hospital of Xiamen University, Xiamen, China
- *Correspondence: Hengyu Zhao, ; Qingliang Zhao, ; Jingsong Mao,
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18
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Tognetti L, Cinotti E, Falcinelli F, Miracco C, Suppa M, Perrot JL, Rubegni P. Line-field confocal optical coherence tomography: a new tool for non-invasive differential diagnosis of pustular skin disorders. J Eur Acad Dermatol Venereol 2022; 36:1873-1883. [PMID: 35694879 PMCID: PMC9544527 DOI: 10.1111/jdv.18324] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 04/29/2022] [Indexed: 12/24/2022]
Abstract
Background The spectrum of pustular skin disorders (PSD) is large and particularly challenging, including inflammatory, infectious and amicrobial diseases. Moreover, although pustules represent the unifying clinical feature, they can be absent or not fully developed in the early stage of the disease. The line‐field confocal optical coherence tomography (LC‐OCT) is a recently developed imaging technique able to perform a non‐invasive, in vivo, examination of the epidermis and upper dermis, reaching very high image resolution and virtual histology. Objectives We aimed to investigate the potentialities of LC‐OCT in the non‐invasive differential diagnosis of a series of 11 PSD with different aetiology, microscopic features, body location and incidence rates. Materials and Methods Complete LC‐OCT imaging (i.e. 2D/3D frames, videos) was performed on a total of 19 patients (10 females and 9 males) aged between 35 and 79 years. Images were blindly evaluated and compared with corresponding histopathologic findings. Results The LC‐OCT imaging was able to detect with high accuracy the pustule structure including shape, margins, morphology and cellular content, along with peculiar epidermal and adnexal alterations in each condition, including: Acute Generalized Exanthematous Pustulosis, Generalized pustular psoriasis, Generalized pustular figurate erythema, Subcorneal Pustular Dermatosis, Intraepidermal IgA pustulosis, Palmoplantar pustulosis, Palmoplantar pustular psoriasis. Herpetic whitlow, Acrodermatitis continua of Hallopeau, Vesicopustular Sweet syndrome and Vesicopustular Eosinophilic cellulitis, with pustular appearance, were also compared. Conclusions The new LC‐OCT can represent a rapid, non‐invasive and painless tool which can help differentiating among PSD of different aetiology and microscopic morphology in clinical mimickers in daily practice.
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Affiliation(s)
- L Tognetti
- Dermatology Unit and Skin Bank, Department of Medical, Surgical and Neurosciences, Siena University Hospital, Siena, Italy
| | - E Cinotti
- Dermatology Unit and Skin Bank, Department of Medical, Surgical and Neurosciences, Siena University Hospital, Siena, Italy.,Groupe d'Imagerie Cutanée Non-Invasive (GICNI) of the Société Française de Dermatologie (SFD), Paris, France
| | - F Falcinelli
- Dermatology Unit and Skin Bank, Department of Medical, Surgical and Neurosciences, Siena University Hospital, Siena, Italy
| | - C Miracco
- Department of Medicine, Surgery and Neurosciences Pathological Anatomy Section, University of Siena, Siena, Italy
| | - M Suppa
- Groupe d'Imagerie Cutanée Non-Invasive (GICNI) of the Société Française de Dermatologie (SFD), Paris, France.,Department of Dermatology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium.,Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - J-L Perrot
- Groupe d'Imagerie Cutanée Non-Invasive (GICNI) of the Société Française de Dermatologie (SFD), Paris, France.,Dermatology Unit, University Hospital of St-Etienne, Saint Etienne, France
| | - P Rubegni
- Dermatology Unit and Skin Bank, Department of Medical, Surgical and Neurosciences, Siena University Hospital, Siena, Italy
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19
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Guida S, Alma A, Shaniko K, Chester J, Ciardo S, Proietti I, Giuffrida R, Zalaudek I, Manfredini M, Longo C, Farnetani F, Pellacani G. Non-Melanoma Skin Cancer Clearance after Medical Treatment Detected with Noninvasive Skin Imaging: A Systematic Review and Meta-Analysis. Cancers (Basel) 2022; 14:2836. [PMID: 35740502 DOI: 10.3390/cancers14122836] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 05/24/2022] [Accepted: 06/05/2022] [Indexed: 12/03/2022] Open
Abstract
Simple Summary Non-melanoma skin cancers (NMSC) represent about one-third of all malignancies. While surgery is the current gold standard treatment, many nonsurgical approaches are available for selected cases. Currently, there are no studies concerning the overall impact of dermoscopy, optical coherence tomography (OCT) and reflectance confocal microscopy (RCM) for NMSC treatment monitoring. Therefore, we aim to review the current literature and provide an updated summary of noninvasive skin imaging in NMSC medical treatment management and the diagnostic accuracy of the most advanced technologies. Abstract Background/Objectives: Non-melanoma skin cancer (NMSC) treated with nonsurgical therapies can be monitored with noninvasive skin imaging. The precision of dermoscopy, reflectance confocal microscopy (RCM) and optical coherence tomography (OCT) in detecting clearance is unclear. We aim to report the proportion of persisting tumors identified with noninvasive technologies available in the literature. Methods: A systematic literature search was conducted on the PubMed and Cochrane Public Library Databases for articles published prior to November 2021. Statistical analyses were conducted with MedCalc 14.8.1 software. Results: A total of eight studies (352 lesions) reporting noninvasive imaging for NMSC clearance following nonsurgical treatment were included. Most (n = 7) reported basal cell carcinoma (BCC), and one study reported squamous cell carcinoma (SCC) clearance. A meta-analysis of the BCC clearance revealed that the summary effect for RCM was higher, as compared to the other techniques. Interestingly, the sensitivity and specificity for OCT were 86.4% (95% CI: 65.1–97.1) and 100% (95% CI: 94.8–100.0), respectively, whilst, for RCM, they reached 100% (95%CI: 86.8–100) and 72.5% (95% CI: 64.4–79.7), respectively. Conclusions: Routine clinical examination and dermoscopy underperform when employed for NMSC clearance monitoring, although they represent the first approach to the patient. OCT and RCM seem to improve the detection of persistent BCC after medical treatment.
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20
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Verzì AE, Broggi G, Micali G, Sorci F, Caltabiano R, Lacarrubba F. Line-field confocal optical coherence tomography of psoriasis, eczema and lichen planus: a case series with histopathological correlation. J Eur Acad Dermatol Venereol 2022; 36:1884-1889. [PMID: 35666617 PMCID: PMC9540560 DOI: 10.1111/jdv.18293] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Accepted: 05/18/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND Line-field confocal optical coherence tomography (LC-OCT) is a novel, non-invasive technique that provides in vivo, high-resolution images in both vertical and horizontal sections. OBJECTIVES The aim of the study was to evaluate LC-OCT imaging in some inflammatory disorders and to correlate the resulting features with histopathology. METHODS The retrospective study included patients with histopathological confirmed diagnosis of plaque psoriasis, atopic eczema and lichen planus, who were imaged with LC-OCT before the biopsy. LC-OCT was performed with the commercially available LC-OCT device. RESULTS A total of 15 adult patients with histopathologically proven plaque psoriasis (N: 5), atopic eczema (N: 5) and lichen planus (N: 5) were included. In all cases, LC-OCT allowed the in vivo recognition of the main microscopic features of the examined inflammatory skin disease, with a strong correlation with histopathology. CONCLUSIONS Although future studies on larger series of patients are necessary, LC-OCT, based on these preliminary findings, may represent a promising tool in inflammatory skin disorders with potential applications including enhanced diagnosis, biopsy guidance, follow-up and treatment monitoring.
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Affiliation(s)
- A E Verzì
- Dermatology Clinic, University of Catania, Catania, Italy
| | - G Broggi
- Dermatology Clinic, University of Catania, Catania, Italy.,Department "G.F. Ingrassia", Section of Anatomic Pathology, University of Catania, Catania, Italy
| | - G Micali
- Dermatology Clinic, University of Catania, Catania, Italy
| | - F Sorci
- Dermatology Clinic, University of Catania, Catania, Italy
| | - R Caltabiano
- Dermatology Clinic, University of Catania, Catania, Italy.,Department "G.F. Ingrassia", Section of Anatomic Pathology, University of Catania, Catania, Italy
| | - F Lacarrubba
- Dermatology Clinic, University of Catania, Catania, Italy
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21
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Waszczuk L, Ogien J, Perrot JL, Dubois A. Co-localized line-field confocal optical coherence tomography and confocal Raman microspectroscopy for three-dimensional high-resolution morphological and molecular characterization of skin tissues ex vivo. Biomed Opt Express 2022; 13:2467-2487. [PMID: 35519243 PMCID: PMC9045904 DOI: 10.1364/boe.450993] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 02/22/2022] [Accepted: 03/02/2022] [Indexed: 05/25/2023]
Abstract
Line-field confocal optical coherence tomography (LC-OCT) is an optical modality that provides three-dimensional (3D) images of the skin at cellular resolution. Confocal Raman microspectroscopy (CRM) is a label-free optical technique that can provide point measurement of the molecular content of the skin. This work presents a method to co-localize LC-OCT and CRM acquisitions for morpho-molecular analysis of ex vivo skin tissues at cellular level. The co-localization method allows acquisition of Raman spectra at specific locations in a sample identified from a 3D LC-OCT image, with an accuracy of ± 20 µm. The method was applied to the characterization of tattooed skin biopsies with adverse tattoo reactions. LC-OCT images allowed to target specific regions in the biopsies where the presence of tattoo ink was revealed by detection of the Raman signature of ink pigments. Micrometer-sized foreign bodies of various materials as well as inflammatory cells were also identified within the biopsies. From these results, we demonstrate the value of the LC-OCT-CRM co-localization method and its potential for future ex vivo analysis of suspicious skin lesions.
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Affiliation(s)
- Léna Waszczuk
- Université Paris-Saclay, Institut d’Optique Graduate School, CNRS, Laboratoire Charles Fabry, Palaiseau 91127, France
- DAMAE Medical, Paris 75013, France
| | | | - Jean-Luc Perrot
- University Hospital of Saint-Etienne, Department of Dermatology, 42055 Saint-Etienne, France
| | - Arnaud Dubois
- Université Paris-Saclay, Institut d’Optique Graduate School, CNRS, Laboratoire Charles Fabry, Palaiseau 91127, France
- DAMAE Medical, Paris 75013, France
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22
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Durante G, Broseghini E, Comito F, Naddeo M, Milani M, Salamon I, Campione E, Dika E, Ferracin M. Circulating microRNA biomarkers in melanoma and non-melanoma skin cancer. Expert Rev Mol Diagn 2022; 22:305-318. [PMID: 35235479 DOI: 10.1080/14737159.2022.2049243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Skin cancer is the most common type of cancer and is classified in melanoma and non-melanoma cancers, which include basal cell, squamous cell and Merkel cell carcinoma. Specific microRNAs are dysregulated in each skin cancer type. MicroRNAs act as oncogene or tumor suppressor gene regulators and are actively released from tumor cells in the circulation. Cell-free microRNAs serve many, and possibly yet unexplored, functional roles, but their presence and abundance in the blood has been investigated as disease biomarker. Indeed, specific microRNAs can be isolated and quantified in the blood, usually in serum or plasma fractions, where they are uncommonly stable. MicroRNA levels reflect underlying conditions and have been associated with skin cancer presence, stage, evolution, or therapy efficacy. AREAS COVERED In this review, we summarize the state of the art on circulating microRNAs detectable in skin cancer patients including all the studies that performed microRNA identification and quantification in the circulation using appropriate sample size and statistics and providing detailed methodology, with a specific focus on diagnostic and prognostic biomarkers. EXPERT OPINION Circulating microRNAs display a relevant biomarker potential. We expect the development of methodological guidelines and standardized protocols for circulating miRNA quantification in clinical settings.
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Affiliation(s)
- Giorgio Durante
- Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, Bologna, Italy
| | - Elisabetta Broseghini
- Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, Bologna, Italy
| | - Francesca Comito
- Oncology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Maria Naddeo
- Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, Bologna, Italy
| | - Massimo Milani
- Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, Bologna, Italy.,R&D Cantabria Labs, Difa Cooper, Italy
| | - Irene Salamon
- Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, Bologna, Italy
| | - Elena Campione
- Dermatology Unit, Department of Systems Medicine, Tor Vergata University Hospital, Rome, Italy
| | - Emi Dika
- Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, Bologna, Italy.,Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Manuela Ferracin
- Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, Bologna, Italy
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23
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Cappilli S, Cinotti E, Lenoir C, Tognetti L, Perez‐Anker J, Rubegni P, Puig S, Malvehy J, Perrot JL, del Marmol V, Peris K, Suppa M. Line‐field confocal optical coherence tomography of basosquamous carcinoma: A case series with histopathological correlation. J Eur Acad Dermatol Venereol 2022; 36:1214-1218. [DOI: 10.1111/jdv.18038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 02/15/2022] [Indexed: 11/29/2022]
Affiliation(s)
- S Cappilli
- Università Cattolica del Sacro Cuore, Dermatologia Rome Italy
- Department of Dermatology Hôpital Erasme Université Libre de Bruxelles Brussels Belgium
| | - E Cinotti
- Dermatology Unit Department of Medical Surgical and Neurological Sciences University of Siena Siena Italy
- Groupe d’Imagerie Cutanée Non Invasive (GICNI) of the Société Française de Dermatologie (SFD) Paris France
| | - C Lenoir
- Department of Dermatology Hôpital Erasme Université Libre de Bruxelles Brussels Belgium
| | - L Tognetti
- Dermatology Unit Department of Medical Surgical and Neurological Sciences University of Siena Siena Italy
| | - J Perez‐Anker
- Melanoma Unit Hospital Clinic Barcelona University of Barcelona Barcelona Spain
- CIBER de enfermedades raras Instituto de Salud Carlos III Barcelona Spain
| | - P Rubegni
- Dermatology Unit Department of Medical Surgical and Neurological Sciences University of Siena Siena Italy
| | - S Puig
- Melanoma Unit Hospital Clinic Barcelona University of Barcelona Barcelona Spain
- CIBER de enfermedades raras Instituto de Salud Carlos III Barcelona Spain
| | - J Malvehy
- Melanoma Unit Hospital Clinic Barcelona University of Barcelona Barcelona Spain
- CIBER de enfermedades raras Instituto de Salud Carlos III Barcelona Spain
| | - JL Perrot
- Department of Dermatology University Hospital of Saint‐Etienne Saint‐Etienne France
| | - V del Marmol
- Department of Dermatology Hôpital Erasme Université Libre de Bruxelles Brussels Belgium
| | - K Peris
- Università Cattolica del Sacro Cuore, Dermatologia Rome Italy
- Fondazione Policlinico Universitario A. Gemelli IRCCS Rome Italy
| | - M Suppa
- Department of Dermatology Hôpital Erasme 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 Université Libre de Bruxelles Brussels Belgium
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24
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Schuh S, Ruini C, Perwein MKE, Daxenberger F, Gust C, Sattler EC, Welzel J. Line-Field Confocal Optical Coherence Tomography: A New Tool for the Differentiation between Nevi and Melanomas? Cancers (Basel) 2022; 14:1140. [PMID: 35267448 DOI: 10.3390/cancers14051140] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Revised: 02/20/2022] [Accepted: 02/22/2022] [Indexed: 02/04/2023] Open
Abstract
Until now, the clinical differentiation between a nevus and a melanoma is still challenging in some cases. Line-field confocal optical coherence tomography (LC-OCT) is a new tool with the aim to change that. The aim of the study was to evaluate LC-OCT for the discrimination between nevi and melanomas. A total of 84 melanocytic lesions were examined with LC-OCT and 36 were also imaged with RCM. The observers recorded the diagnoses, and the presence or absence of the 18 most common imaging parameters for melanocytic lesions, nevi, and melanomas in the LC-OCT images. Their confidence in diagnosis and the image quality of LC-OCT and RCM were evaluated. The most useful criteria, the sensitivity and specificity of LC-OCT vs. RCM vs. histology, to differentiate a (dysplastic) nevus from a melanoma were analyzed. Good image quality correlated with better diagnostic performance (Spearman correlation: 0.4). LC-OCT had a 93% sensitivity and 100% specificity compared to RCM (93% sensitivity, 95% specificity) for diagnosing a melanoma (vs. all types of nevi). No difference in performance between RCM and LC-OCT was observed (McNemar's p value = 1). Both devices falsely diagnosed dysplastic nevi as non-dysplastic (43% sensitivity for dysplastic nevus diagnosis). The most significant criteria for diagnosing a melanoma with LC-OCT were irregular honeycombed patterns (92% occurrence rate; 31.7 odds ratio (OR)), the presence of pagetoid spread (89% occurrence rate; 23.6 OR) and the absence of dermal nests (23% occurrence rate, 0.02 OR). In conclusion LC-OCT is useful for the discrimination between melanomas and nevi.
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Abstract
Optical coherence tomography (OCT) and confocal laser microscopy (CLSM) are established non-invasive methods in clinical dermatological routine diagnosis. Whereas CLSM is especially useful to distinguish between nevi and melanoma, OCT is suitable for the diagnosis and differentiation of non-melanoma skin cancer. Line-field confocal optical coherence tomography (LC-OCT) is a new innovative device, which has better cellular resolution than OCT and a higher penetration depth than CLSM. Similar to CLSM, LC-OCT also allows 3D images in real time to be taken. Therefore LC-OCT is very useful for the examination of skin lesions of all kinds, since it unites the features of CLSM and OCT.
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26
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Verzì AE, Micali G, Lacarrubba F. Line-Field Confocal Optical Coherence Tomography May Enhance Monitoring of Superficial Basal Cell Carcinoma Treated with Imiquimod 5% Cream: A Pilot Study. Cancers (Basel) 2021; 13:4913. [PMID: 34638396 DOI: 10.3390/cancers13194913] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 09/26/2021] [Accepted: 09/26/2021] [Indexed: 12/12/2022] Open
Abstract
Line-field confocal optical coherence tomography (LC-OCT) is a novel, non-invasive technique for real-time skin imaging. Imiquimod (IQ) 5% cream is an immune response modifier currently approved for the treatment of small, superficial basal cell carcinoma (BCC). The aim of this study was to investigate if LC-OCT may be useful to enhance the treatment monitoring of BCC. Twenty superficial BCCs from 12 patients were treated with IQ 5% cream once daily, five days a week, for six weeks. Clinical and LC-OCT evaluations were performed at baseline and 4 weeks after the end of treatment. At the end of the study, 13 lesions showed a complete clinical and LC-OCT response, 4 lesions a partial clinical and LC-OCT response, and 3 lesions a complete clinical response but residual tumoral signs at LC-OCT. Our pilot study suggests that LC-OCT may represent a promising tool able to enhance the evaluation of the treatment response of BCCs to non-invasive treatments. In our case series, its use highlighted, through a detailed, fast, and complete examination of the treated area, three cases of residual BCC that otherwise would have gone undetected at clinical examination. Future studies on larger series of patients treated with different modalities and with a longer follow-up are advisable.
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