Improving lesion localization when imaging with handheld reflectance confocal microscope

Abstract

What's known/what're new statements• The handheld reflectance confocal microscope facilitates the rapid imaging of skin lesions and is well suited for imaging on curved anatomical sites. However, maintaining the position of the 1 mm probe can be difficult. To address this, we began using adhesive paper rings with different diameters centered over the areas of interest. The ring fibers are readily distinguished from skin, thus serving as a reference frame and ensuring the correct positioning of the device.

Correlation of Handheld Reflectance Confocal Microscopy With Radial Video Mosaicing for Margin Mapping of Lentigo Maligna and Lentigo Maligna Melanoma

“…Recently, adhesive rings have been utilized to define the area of interest when imaging with HRCM. 19,21,30 Adhesive rings are inexpensive, can be adapted to the shape of the lesion by slightly bending them or placing multiple rings outside the lesion margins, and, because the fibers can be identified on HRCM, can easily facilitate orientation thus allowing a single operator to perform the image acquisition, as opposed to the 2 operators needed with other LM mapping techniques using HRCM. 15 We used commercially-available paper rings with a 2.5-mm-wide rim to calculate the surgical margins by combining them with videomosaicking; however, it is also possible to customize the diameter and rim width by cutting adhesive plastic, 30 thus permitting tailored HRCM navigation and margin estimation.…”

“…To facilitate RCM navigation and margin calculation, we placed adhesive paper rings (product number 1529; 3M, Flemington, NJ) surrounding this margin 21 (Figure 1). In irregularly-shaped lesions, multiple paper rings were placed and eventually overlapped to allocate the entire lesion inside the paper rings and image its entire borders.…”

The value of reflectance confocal microscopy in diagnosis of flat pigmented facial lesions: a prospective study

“…The need of full contact between the RCM device and the skin is challenging on the face due to the convex and concave areas and led to exclusion of some lesions for this study which has been performed with a conventional confocal microscope rather than with a smaller handheld device that is commercially available (Vivascope 3000). This handheld device has been shown to be useful on curvy anatomical sites, (especially as these sites are often the ones where operation might render more difficulty) . The possibility of obtaining a larger area of view with the handheld confocal microscope may facilitate its usability …”

“…This handheld device has been shown to be useful on curvy anatomical sites, (especially as these sites are often the ones where operation might render more difficulty). [26][27][28][29] The possibility of obtaining a larger area of view with the handheld confocal microscope may facilitate its usability. 30 Like any clinical tool, training is required for effective use and diagnostic accuracy of both methods is dependent on evaluator experience.…”

Evaluation of a Combined Reflectance Confocal Microscopy–Optical Coherence Tomography Device for Detection and Depth Assessment of Basal Cell Carcinoma

“…We placed adhesive paper rings (3M, Flemington, NJ) at the clinical margins for image navigation; this is a previously proven method. 25,26 Dermoscopic examination was subsequently carried out with a handheld dermatoscope within the paper ring. The ring divided the lesion in four hypothetical quadrants; the imaging in dermoscopically-suspicious areas was guided through these quadrants and clock positions.…”