In vivo reflectance confocal microscopy in daily practice: Image features correlated to histopathology

Pan, Zhiyong; Dong, Dake; Chen, S.-J.; Lu, Liping; Hu, Tu; Qiang, Jun

doi:10.1111/srt.12417

Cited by 4 publications

(3 citation statements)

References 13 publications

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“…Several non‐invasive diagnostic methods have been proposed as useful tools for skin investigation, 5–12 and in this setting of constantly emerging technologies to assist with medical diagnosis, dermatology distinguishes itself with the promise of high‐definition imaging devices capable of in vivo resolutions approaching those of histopathology. Reflectance confocal microscopy (RCM) and optical coherence tomography (OCT) are among the most used techniques for in vivo evaluation of the skin 13–17 . These techniques have been already proven to be helpful in the diagnosis of skin cancers and inflammatory skin diseases due to their excellent correlation with histopathology 16–25 …”

Section: Introductionmentioning

confidence: 99%

A plea for standardization of confocal microscopy and optical coherence tomography parameters to evaluate physiological and para‐physiological skin conditions in cosmetic science

Ciardo

Pezzini

Guida

et al. 2021

Experimental Dermatology

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Non‐invasive reflectance confocal microscopy (RCM) and optical coherence tomography (OCT) have been extended to the dermo‐cosmetic field, for skin pathophysiology understanding and therapeutics monitoring. However, standardized methodology and parameters to interpret structures and changes in these settings are still lacking. Present study aimed to propose a validated standard methodology and a list of defined parameters for objective non‐pathological skin assessments in the cosmetically sensitive cheekbone area of the face. OCT and RCM quantitative, semi‐quantitative and qualitative features were considered for assessments. Validation process included 50 sets of images divided into two age groups. Inter‐rater reliability was explored to assess the influence of the proposed methodology. Quantitative OCT parameters of “epidermal thickness,” “density and attenuation coefficients” and “vascular density” were considered and calculated. Severity scales were developed for semi‐quantitative OCT features of “disruption of collagen” and “vascular asset,” while extent scales were produced for semi‐quantitative RCM “irregular honeycomb,” “mottled pigmentation” and “polycyclic papillary contours.” Qualitative assessment was obtained for RCM type of collagen, and comparison between age groups was performed for all features considered. Severity visual scales assistance proved excellent inter‐rater agreement across all semi‐quantitative and qualitative domains. The assistance of shareable software systems allows for objective OCT quantitative parameters measurement. The use of standard reference scales, within a defined assessment methodology, offers high inter‐rater reliability and thus reproducibility for semi‐quantitative and qualitative OCT and RCM parameters. Taken together, our results may represent a starting point for a standardized application of RCM and OCT in dermo‐cosmetic research and practice.

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Section: Introductionmentioning

confidence: 99%

A plea for standardization of confocal microscopy and optical coherence tomography parameters to evaluate physiological and para‐physiological skin conditions in cosmetic science

Ciardo

Pezzini

Guida

et al. 2021

Experimental Dermatology

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“…Previous studies also have applied a variety of technologies to image abnormal dilated vessels in PWS and compare the changes in images obtained before and after treatment to evaluate the efficacy of treatment. These instruments include structural imaging technologies, such as optical coherence tomography, photoacoustic imaging, reflectance and confocal microscope, as well as functional imaging technologies, such as laser doppler blood flow imaging, laser speckle imaging and space frequency domain imaging 26–31 . However, the accuracy of these technologies for imaging abnormal blood vessels in PWS has not been verified, and they are usually expensive and generally too time‐consuming to be commonly used during outpatient visits.…”

Section: Discussionmentioning

confidence: 99%

A proposed scoring system for facial port‐wine stain evaluation: Facial port‐wine stain area and severity index

Ren

Tuan

Huang

et al. 2021

J of Cosmetic Dermatology

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Background: Port-wine stain (PWS) is a congenital capillary malformation that often occurs on the face. Feasible and quantitative evaluation of facial port-wine stain (FPWS) can significantly impact its clinical management and aid in future research. Aim:To develop and validate an easy-to-use scoring system for FPWS evaluation.Methods: A facial port-wine stain area and severity index (FSASI) scoring system was proposed. To determine the FSASI score, the face was divided into four regions: forehead, right malar, left malar, and perioral. The severity of FPWS in each region was evaluated by three factors: percentage of the area affected, lesion color, and thickness. To evaluate the intra-and inter-rater reliability of FSASI, two separate FSASI assessments on 111 clinical pictures were conducted by each rater in a one-week interval, and the results from 6 independent raters at different time points were compared. Validity of the FSASI scores was assessed by comparing it with physician global assessment (PGA) and traditional classification data. Validity of the area and color elements of FSASI was also determined. The changes in FSASI scores after vasculartargeted photodynamic therapy (V-PDT) were analyzed to evaluate the treatment effect.Results: The FSASI scoring system showed good intra-and inter-rater reliability (ICC >0.75, p < 0.001) and was found to be comparable to PGA scores (Spearman's r = 0.752-0.907, p < 0.001) and traditional classification data (Spearman's r = 0.426-0.662, p < 0.001). Efficacy analysis indicated that FSASI scores decreased after V-PDT treatment. Conclusion:The results of this study demonstrated the reliability and validity of FSASI, which may be applied to assess the severity of FPWS and to evaluate treatment effects in clinical practice and research.

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“…Many studies have reported the usefulness of in vivo confocal microscopy, which correlates well with standard histology, which was first adopted by ophthalmologists, then widespread in dermatology and, recently, has started to be applied in stomatology . In vivo reflectance confocal microscopy (RCM) can real–time image vital tissues scanned from the surface to the submucosa/superficial dermis, on horizontal planes at microscopic resolution, based on the mechanisms of backscattering of light by vital structures with different refractive indexes …”

Section: Introductionmentioning

confidence: 99%

In vivo reflectance confocal microscopy of oral lichen planus

et al. 2019

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Background In vivo reflectance confocal microscopy (RCM) is an imaging technique that can virtually biopsy vital tissues, noninvasively and in real time. It results in horizontal virtual slices at a microscopic resolution that correlates well with conventional histopathology. Despite the widespread use of RCM in dermatology, it is still rarely applied to the study of oral pathologies. The aim of the present work is to describe RCM cellular and architectural findings in oral mucosae affected by oral lichen planus (OLP). Materials and Methods A series of conventionally diagnosed OLP lesions underwentRCM imaging with a portable reflectance confocal microscope that could scan from the surface to the submucosa. The confocal findings were collected, described, and compared with the literature.Results A total of 31 oral sites affected by OLP in 12 patients were considered. According to their clinical appearance, 22 lesions showed a reticular-plaque pattern, six lesions were mainly atrophic-erosive, and the remaining three presented a mixed pattern. RCM examination showed hypergranulosis, epithelial disarray, spongiosis, necrotic keratinocytes, epithelial and subepithelial inflammatory cell infiltration, and dilated vessels; all findings were in lichen planus, with differences noted between the "white" and "red" manifestations of this pathology. Conclusions The use of RCM in routine clinical oral pathology tests is recommended to avoid recurrence of OLP and changes in its responsiveness to therapy, thus limiting the need for biopsy of lesions suspected of tumoral changes.

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In vivo reflectance confocal microscopy in daily practice: Image features correlated to histopathology

Abstract: Features correlating well to histopathology are observed on RCM. RCM can be used as an auxiliary diagnosis tool for the clinical diagnosis.

Cited by 4 publications

References 13 publications

A plea for standardization of confocal microscopy and optical coherence tomography parameters to evaluate physiological and para‐physiological skin conditions in cosmetic science

A plea for standardization of confocal microscopy and optical coherence tomography parameters to evaluate physiological and para‐physiological skin conditions in cosmetic science

A proposed scoring system for facial port‐wine stain evaluation: Facial port‐wine stain area and severity index

In vivo reflectance confocal microscopy of oral lichen planus

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