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Ex‐vivo fluorescence confocal microscopy with digital staining for characterizing basal cell carcinoma on frozen sections: A comparison with histology
Author(s) -
Ruini Cristel,
Vladimirova Gabriela,
Kendziora Benjamin,
Salzer Suzanna,
Ergun Ecem,
Sattler Elke,
French Lars E.,
Hartmann Daniela
Publication year - 2021
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.202100094
Subject(s) - frozen section procedure , staining , pathology , acridine orange , histology , basal cell carcinoma , subtyping , confocal , h&e stain , confocal microscopy , ex vivo , microscopy , carcinoma , in vivo , basal cell , biology , medicine , optics , physics , microbiology and biotechnology , computer science , programming language
Ex‐vivo fluorescence confocal microscopy (FCM) has been used on fresh tissue, but there is little experience on frozen sections. We evaluated the applicability of FCM on frozen sections of basal cell carcinomas (BCCs), stained with acridine orange and digitally colored to simulate hematoxylin and eosin (H&E) dyes. We compared our diagnostic accuracy in detecting and subtyping BCCs with FCM to our gold standard (H&E stained frozen sections used in 3D horizontal micrographic surgery). Fourty‐six primary BCCs were analyzed for free margins as well as histological subtype with all FCM modes and conventional H&E staining. Adnexa, artifacts and diagnostic confidence were evaluated. Free margins were identified with a sensitivity and specificity of 92% and 91%. Concordance for tumor subtype was 88%. FCM may be used on both fresh tissue and frozen samples, although with reduced performance and different artifacts. The device is useful for the intraoperative diagnosis, subtyping and margin‐mapping of BCCs.