Comparison of dermoscopy and reflectance confocal microscopy for the diagnosis of malignant skin tumours: a meta-analysis

Xiong, Yiquan; Ma, Shujuan; Mo, Yun; Huo, Shuting; Wen, Yu-Qi; Chen, Qing

doi:10.1007/s00432-017-2391-9

Cited by 27 publications

(23 citation statements)

References 42 publications

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“…Our results are consistent with those of previous studies on the diagnostic accuracy of RCM for skin neoplasms in general; a recent meta‐analysis showed a considerably better diagnostic specificity for malignant skin tumors with RCM than for dermoscopy . The pooled sensitivity of dermoscopy for malignant skin tumors was similar to that of RCM (88.1 % vs 93.5 %), but the specificity of dermoscopy was significantly lower than that of RCM (52.9 % vs 80.3 %).…”

Section: Discussionsupporting

confidence: 91%

Diagnostic impact of reflectance confocal microscopy as a second‐level examination for facial skin lesions

Ahlgrimm‐Siess

Weitzer

Arzberger

et al. 2019

J Deutsche Derma Gesell

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SummaryBackground and objectiveBenign and malignant facial skin lesions may be difficult to differentiate clinically and with dermoscopy. The present study aimed to evaluate the potential utility of in vivo reflectance confocal microscopy (RCM) as a second‐level examination for facial skin neoplasms.Patients and MethodsRetrospective and blinded evaluation of 160 consecutive facial lesions was carried out in two separate steps. Clinical and dermoscopic images were assessed first, followed by combined evaluation of clinical/dermoscopic and RCM images. Our study included 60 % malignant lesions, comprising 43 % melanomas, 9 % basal cell carcinomas, 5 % in situ squamous cell carcinomas and 3 % lymphomas.ResultsAncillary RCM significantly improved diagnostic specificity for the detection of malignancy compared to clinical/dermoscopic evaluation alone (58 % vs 28 %). However, sensitivity was slightly lower for RCM‐based image evaluation (93 % vs 95 %) due to misclassification of one in situ SCC and one lymphoma. In terms of melanoma diagnosis, RCM‐based image evaluation was generally superior; sensitivity was only slightly increased (88 % vs 87 %), but melanoma specificity was significantly higher (84 % vs 58 %).ConclusionRCM is a valuable diagnostic adjunct for facial skin lesions; unnecessary biopsies in this cosmetically sensitive area could be reduced by one third without missing a melanoma.

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Section: Discussionsupporting

confidence: 91%

Diagnostic impact of reflectance confocal microscopy as a second‐level examination for facial skin lesions

Ahlgrimm‐Siess

Weitzer

Arzberger

et al. 2019

J Deutsche Derma Gesell

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“…RCM imaging has been shown to significantly improve diagnostic accuracy and early detection of melanocytic and nonmelanocytic skin cancers compared with clinical and dermoscopic examination alone. 15 , 16 , 17 , 18 , 19 , 20 A recent meta-analysis that evaluated 21 studies with a total of 3602 lesions found that the pooled sensitivity and specificity was 93.6% (92%-95%) and 82.7% (81%-84%), respectively, for all skin cancers. 16 Particularly, RCM had a sensitivity of 92.7% (90%-95%) and specificity of 78.3% (76%-81%) for detecting melanoma and a sensitivity of 91.7% (87%-95%) and specificity of 91.3% (94%-96%) for detecting basal cell carcinoma.…”

Section: Practicality For Using Confocal In a Practicementioning

confidence: 99%

Introduction to reflectance confocal microscopy and its use in clinical practice

Levine¹,

Markowitz²

2018

JAAD Case Reports

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Reflectance confocal microscopy (RCM) is a novel technology that provides noninvasive, in vivo imaging of the skin at nearly histologic resolution. In 2016, the US Centers for Medicare and Medicaid Services (CMS) established reimbursement codes for RCM image acquisition and for the reading and interpretation of images. The combination of RCM imaging with dermoscopy has improved the accuracy of skin cancer diagnosis while reducing the number of biopsies of benign skin lesions. With that, we are starting to see more dermatologists and dermatopathologists using RCM in clinical practice. This editorial is to serve as an introduction on RCM imaging with a focus on its usefulness in both the diagnosis and management of skin cancers. We end by briefly describing the characteristic RCM features of normal skin to serve as a building block for later cases that will explore both the benefits and drawbacks of incorporating RCM imaging for benign and malignant lesions.

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“…Unsere Ergebnisse stehen im Einklang mit Ergebnissen vorangegangener Studien über die allgemeine diagnostische Genauigkeit der RCM bei Hautneoplasien; eine rezente Metaanalyse zeigte im Vergleich zur Dermatoskopie eine beträchtliche Verbesserung der diagnostischen Spezifität bei malignen Hauttumoren durch die RCM . Die gepoolte Sensitivität der Dermatoskopie für maligne Hauttumoren war ähnlich der der RCM (88,1 % vs. 93,5 %), die Spezifität der Dermatoskopie war aber deutlich niedriger (52,9 % vs. 80,3 %).…”

Section: Diskussionunclassified

Diagnostischer Nutzen der Konfokalmikroskopie als weiterführende Untersuchungsmethode von Gesichtsläsionen

Ahlgrimm‐Siess¹,

Weitzer

Arzberger

et al. 2019

J Deutsche Derma Gesell

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Zusammenfassung Hintergrund und Zielsetzung Benigne und maligne Läsionen der Gesichtshaut können klinisch und dermatoskopisch schwierig zu differenzieren sein. Die vorliegende Studie zielte darauf ab, den diagnostischen Nutzen der In‐vivo‐Konfokalmikroskopie (RCM) als weiterführende Untersuchungsmethode für Neubildungen der Gesichtshaut zu untersuchen. Patienten und Methodik Retrospektive und verblindete Untersuchung von 160 konsekutiven Gesichtsläsionen in zwei getrennten Schritten: zuerst Auswertung der klinischen und dermatoskopischen Bilder, gefolgt von einer kombinierten Beurteilung der klinischen, dermatoskopischen und RCM‐Bilder. Unsere Studie schloss 60 % maligne Läsionen ein, bestehend aus 43 % Melanomen, 9 % Basalzellkarzinomen, 5 % In‐situ‐Plattenepithelkarzinomen und 3 % Lymphomen. Ergebnisse Die zusätzliche RCM verbesserte die diagnostische Spezifität für die Erkennung von Malignomen im Vergleich zur klinisch‐dermatoskopischen Auswertung allein deutlich (58 % vs. 28 %). Die Sensitivität war für die RCM‐basierte Auswertung jedoch wegen der Fehlbeurteilung eines In‐situ‐Plattenepithelkarzinoms und eines Lymphoms etwas erniedrigt (93 % vs. 95 %). Im Bezug auf die Melanomdiagnose schnitt die RCM‐basierte Bildauswertung generell besser ab; die Sensitivität war nur gering erhöht (88 % vs. 87 %), die Spezifität jedoch deutlich (84 % vs. 58 %). Schlussfolgerungen Die RCM stellt ein wertvolles diagnostisches Hilfsmittel im Gesichtsbereich dar; die Anzahl unnötiger Biopsien in diesem kosmetisch sensiblen Areal könnte, ohne ein Melanom zu übersehen, um ein Drittel reduziert werden.

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Comparison of dermoscopy and reflectance confocal microscopy for the diagnosis of malignant skin tumours: a meta-analysis

Abstract: When compared with dermoscopy, RCM has a significantly greater diagnostic specificity for malignant skin tumours and so could improve their detection rate.

Cited by 27 publications

References 42 publications

Diagnostic impact of reflectance confocal microscopy as a second‐level examination for facial skin lesions

Diagnostic impact of reflectance confocal microscopy as a second‐level examination for facial skin lesions

Introduction to reflectance confocal microscopy and its use in clinical practice

Diagnostischer Nutzen der Konfokalmikroskopie als weiterführende Untersuchungsmethode von Gesichtsläsionen

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