Facial basal cell carcinoma

Baxter, Julia; Patel, A. N.; Varma, Sandeep

doi:10.1136/bmj.e5342

Cited by 60 publications

(41 citation statements)

References 34 publications

(26 reference statements)

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“…The availability of diagnosis and tumor imaging during surgery is extremely valuable to surgeons as it would enable them to excise and evaluate sequential layers of tissue to ensure the complete removal of tumor cells while sparing as much healthy tissue as possible. This surgical technique, called tissue-conserving surgery, has been used increasingly in the treatment of cancers such as skin (4) and breast (5). However, ensuring the complete excision of the tumor remains one of the key challenges in tissue-conserving surgery.…”

mentioning

confidence: 99%

Diagnosis of tumors during tissue-conserving surgery with integrated autofluorescence and Raman scattering microscopy

Kong

Rowlands

Varma

et al. 2013

Proc. Natl. Acad. Sci. U.S.A.

221

223

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Tissue-conserving surgery is used increasingly in cancer treatment. However, one of the main challenges in this type of surgery is the detection of tumor margins. Histopathology based on tissue sectioning and staining has been the gold standard for cancer diagnosis for more than a century. However, its use during tissue-conserving surgery is limited by time-consuming tissue preparation steps (1-2 h) and the diagnostic variability inherent in subjective image interpretation. Here, we demonstrate an integrated optical technique based on tissue autofluorescence imaging (high sensitivity and high speed but low specificity) and Raman scattering (high sensitivity and high specificity but low speed) that can overcome these limitations. Automated segmentation of autofluorescence images was used to select and prioritize the sampling points for Raman spectroscopy, which then was used to establish the diagnosis based on a spectral classification model (100% sensitivity, 92% specificity per spectrum). This automated sampling strategy allowed objective diagnosis of basal cell carcinoma in skin tissue samples excised during Mohs micrographic surgery faster than frozen section histopathology, and one or two orders of magnitude faster than previous techniques based on infrared or Raman microscopy. We also show that this technique can diagnose the presence or absence of tumors in unsectioned tissue layers, thus eliminating the need for tissue sectioning. This study demonstrates the potential of this technique to provide a rapid and objective intraoperative method to spare healthy tissue and reduce unnecessary surgery by determining whether tumor cells have been removed.

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mentioning

confidence: 99%

Diagnosis of tumors during tissue-conserving surgery with integrated autofluorescence and Raman scattering microscopy

Kong

Rowlands

Varma

et al. 2013

Proc. Natl. Acad. Sci. U.S.A.

221

223

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“…Ultraviolet radiation is the primary factor contributing to the oncogenic transformation of the stratum basale (22). Other risk factors include fair complexion, previous sunburns, family history of skin cancer, and immunosuppression therapy (5,22). Although BCCs lie on the benign spectrum of neoplasia, they can be relentlessly invasive and locally destructive.…”

Section: Basal Cell Carcinomamentioning

confidence: 98%

“…Americans have a 30% lifetime risk for developing a BCC (4), which creates a substantial clinical and economic burden on the health care system. Up to 85% of BCCs arise in the head and neck (5), where the anatomy can be complex, particularly in the periocular and nasolabial regions. Microscopy-coil MR imaging can play a critical role in the evaluation of the subclinical penetrance of these lesions and their suitability for resection.…”

Section: Introductionmentioning

confidence: 99%

High-Resolution Microscopy-Coil MR Imaging of Skin Tumors: Techniques and Novel Clinical Applications

Budak¹,

Weir‐McCall²,

Yeap³

et al. 2015

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High-resolution magnetic resonance (MR) imaging performed with a microscopy coil is a robust radiologic tool for the evaluation of skin lesions. Microscopy-coil MR imaging uses a small surface coil and a 1.5-T or higher MR imaging system. Simple T1- and T2-weighted imaging protocols can be implemented to yield high-quality, high-spatial-resolution images that provide an excellent depiction of dermal anatomy. The primary application of microscopy-coil MR imaging is to delineate the deep margins of skin tumors, thereby providing a preoperative road map for dermatologic surgeons. This information is particularly useful for surgeons who perform Mohs micrographic surgery and in cases of nasofacial neoplasms, where the underlying anatomy is complex. Basal cell carcinoma is the most common nonmelanocytic skin tumor and has a predilection to manifest on the face, where it can be challenging to achieve complete surgical excision while preserving the cosmetic dignity of the patient. Microscopy-coil MR imaging provides dermatologic surgeons with valuable preoperative anatomic information that is not available at conventional clinical examination.

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“…2 Dentists' normal work will produce emissions for the foreseeable future, causing health risks, and who knows which harmful pathogens patients can introduce to the surgery, not to mention the impact of the outdoor air quality or the building structure itself. Each practice has a duty of care for all their employees and patients to reduce the emissions to a safe level.…”

Section: A Global Riskmentioning

confidence: 99%

Skin cancer awareness

Aga¹

2013

Br Dent J

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Facial basal cell carcinoma

Cited by 60 publications

References 34 publications

Diagnosis of tumors during tissue-conserving surgery with integrated autofluorescence and Raman scattering microscopy

Diagnosis of tumors during tissue-conserving surgery with integrated autofluorescence and Raman scattering microscopy

High-Resolution Microscopy-Coil MR Imaging of Skin Tumors: Techniques and Novel Clinical Applications

Skin cancer awareness

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