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Simple 3‐criteria‐based ex vivo confocal diagnosis of basal cell carcinoma
Author(s) -
Hartmann Daniela,
Krammer Sebastian,
Bachmann Mario R.,
Mathemeier Leonie,
Ruzicka Thomas,
von Braunmühl Tanja
Publication year - 2018
Publication title -
journal of biophotonics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.877
H-Index - 66
eISSN - 1864-0648
pISSN - 1864-063X
DOI - 10.1002/jbio.201800062
Subject(s) - basal cell carcinoma , ex vivo , mohs surgery , medicine , confocal , diagnostic accuracy , basal (medicine) , in vivo , pathology , nuclear medicine , basal cell , dermatology , radiology , biology , geometry , microbiology and biotechnology , mathematics , insulin
Background Fast and simple microscopic evaluation of basal cell carcinoma (BCC) together with its subtype determination would accelerate diagnostic and therapeutic procedures in dermatology including Mohs surgery. Objectives Assessing whether simplified 3‐criteria‐based ex vivo confocal microscopic (CM) examination can reliably predict BCC diagnosis and subtype. Analyzing interobserver agreement between expert and novice examiner. Methods CM images of 235 skin samples from 150 patients were prospectively evaluated by 2 blinded examiners for the presence of 3 predefined BCC criteria namely presence of tumor mass, peripheral palisading and clefting. Results Out of 235 skin samples 116 showed histological presence of BCC, confocally expert diagnosed a BCC in 110 and novice examiner in 107 samples. The overall sensitivity and specificity of detecting residual BCC was 96.6% and 98.7%, respectively. Confocally, examiners diagnosed correctly nodular BCC in 96.6%, respectively, 98.3%, superficial BCC in 96.8%, respectively, 93.5%, infiltrating BCC in 88.9%, respectively, 83.3% and other BCC subtype in 22.2%, respectively, 0% (expert and novice examiner, respectively). Conclusion Ex vivo CM allowed intraoperative examination of BCC based on only 3‐criteria with high sensitivity and specificity, provided useful information on tumor subtype and showed that both experienced and non‐experienced examiners may use this diagnostic approach with excellent results.