Detection and Discrimination of Non-Melanoma Skin Cancer by Multimodal Imaging

Abstract

Non-melanoma skin cancer (NMSC) belongs to the most frequent human neoplasms. Its exposed location facilitates a fast ambulant treatment. However, in the clinical practice far more lesions are removed than necessary, due to the lack of an efficient pre-operational examination procedure: Standard imaging methods often do not provide a sufficient spatial resolution. The demand for an efficient in vivo imaging technique might be met in the near future by non-linear microscopy. As a first step towards this goal, the appearance of NMSC in various microspectroscopic modalities has to be defined and approaches have to be derived to distinguish healthy skin from NMSC using non-linear optical microscopy. Therefore, in this contribution the appearance of ex vivo NMSC in a combination of coherent anti-Stokes Raman scattering (CARS), second harmonic generation (SHG) and two photon excited fluorescence (TPEF) imaging—referred as multimodal imaging—is described. Analogous to H&E staining, an overview of the distinct appearances and features of basal cell and squamous cell carcinoma in the complementary modalities is derived, and is expected to boost in vivo studies of this promising technological approach.

Diagnostic accuracy of ex vivo fluorescence confocal microscopy in Mohs surgery of basal cell carcinomas: a prospective study on 753 margins

“…2 In the last few years, new tools have been developed in an attempt to speed up and obtain a more efficient skin cancer diagnosis pre-and intraoperatively. [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] Reflectance confocal microscopy has been successfully applied to skin cancer diagnosis in the clinical setting, with an emphasis on BCC. 10,11,13,15 However, reflectance confocal microscopy is mainly used for preoperative in vivo skin cancer diagnosis.…”

Multimodal image analysis in tissue diagnostics for skin melanoma

“…Thereafter, the value of FDR was calculated for each feature according to Equation , where index i = 1 , 2 , … , m represent the selected feature. The μ 1 , i , and μ 2 , i , are, respectively, the mean and variance values of the 2 classes under investigation . As we will describe in the next section, the calculation of FDR is done for each different classification task separately.…”

Accumulating advantages, reducing limitations: Multimodal nonlinear imaging in biomedical sciences – The synergy of multiple contrast mechanisms

“…Here in vivo detection of the composition of healthy skin is of interest [115], as is the comparison of normal skin structure to engineered skin tissue [110]. Other studies analyze disease induced alterations in the structure, e.g., for malignancies [116] like melanoma [104], basal and squamous cell carcinoma [106], and the process of scar progression [39,40]. In another study the effect of radiotherapy on skin aging was investigated [117].…”

“…There is manifold prove that the structure of collagen fibers is related to the mechanism of disease progression, starting from scar and keloid formation to remodeling of the connective tissue during carcinogenesis [102] and the progression of cardiovascular diseases [103]. Invasive tumor growth for example results in rejection of the connective tissue, which results in the formation of void-like structures composed of collagen fibers that are regularly found surrounding tumor nests, e.g., in case of melanoma [104], or squamous and basal cell carcinoma in human skin [105,106].…”