Sensitivity and specificity of reflectance-mode confocal microscopy for in vivo diagnosis of basal cell carcinoma: A multicenter study

Nori, Sarita; Rius-Díaz, Francisca; Cuevas, J; Goldgeier, Mark H.; Jaén, Pedro; Torres, Abel; González, Salvador

doi:10.1016/j.jaad.2004.06.028

Cited by 336 publications

(364 citation statements)

References 19 publications

(23 reference statements)

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“…not done on new set of patients were excluded. Finally eight studies [21,[26][27][28][29][30][31][32] met the criteria to be included for meta analysis. The evidence level of the studies was determined as per the NICE guidelines on development methods [33].…”

Section: Methodological Qualitymentioning

confidence: 99%

“…In a study by Nori S et al sensitivity and specificity were calculated by using 1-5 criteria's of CLSM [21]. We used sensitivity and specificity values for 4 or more criteria's from this study as they give optimum sensitivity and specificity.…”

Section: Methodological Qualitymentioning

confidence: 99%

“…Average sensitivity, specificity, positive and negative predictive values from these studies is shown in Table 2. All selected studies had CLSM done on either a single or more than one type of skin cancer and normal peri-lesional skin [26] and/or benign lesions [21,[27][28][29][30][31][32]. The skin cancers included melanoma, BCC and SCC and the benign lesions included seborrheic keratosis [21,30], benign melanocytic lesions [21,[27][28][29][30][31][32], actinic keratosis [21,29,31,32], sebaceous hyperplasia [21], acne [21], rosacea [21], wart [21], molluscum contagiosum [21], cutaneous T cell lymphoma [21], eczema [21, dermatofibroma[21,30,31], tinea [21], vascular lesions [30] and Bowen's disease [31] etc.…”

Section: Included Studiesmentioning

confidence: 99%

“…The skin cancers included melanoma, BCC and SCC and the benign lesions included seborrheic keratosis [21,30], benign melanocytic lesions [21,[27][28][29][30][31][32], actinic keratosis [21,29,31,32], sebaceous hyperplasia [21], acne [21], rosacea [21], wart [21], molluscum contagiosum [21], cutaneous T cell lymphoma [21], eczema [21, dermatofibroma[21,30,31], tinea [21], vascular lesions [30] and Bowen's disease [31] etc. Five studies [21,[26][27][28][29] were done on one type of skin cancer. In 3 studies more than one skin cancer was included in the study population [30][31][32].…”

Section: Included Studiesmentioning

confidence: 99%

“…Typical CLSM has a lateral resolution of 0.5-1µm and axial resolution of 3-5 µm providing horizontal sections similar to thickness of histology sections. Maximum penetration of the skin is 350µm [21,22]. Different skin cancers have different morphological features which can be distinguished by using CLSM in vivo and ex vivo, enabling it to be potentially used to give a real time diagnosis to the patients negating the need to wait for histopathology results [22,23].…”

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confidence: 99%

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2015

Journal of Cancer Research and Therapeutic Oncology

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Background: Nonmelanoma skin cancer (Basal Cell Cancer (BCC) and Squamous Cell Cancer (SCC)) are the most prevalent cancer in the light-skinned population. The incidence of melanoma has been increasing steadily throughout the world. Early recognition of skin cancer without doing biopsy remains challenging. The development of noninvasive diagnostic technologies is highly relevant and desired. Confocal Laser Scanning Microscopy (CLSM) enables in vivo and ex vivo imaging of human skin at a quasi-histologic resolution. Methods and Materials: Several databases like Medline, Embase, all EBM reviews (ACP Journal Club, Cochrane Controlled Trials Register, Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects) and Journals@Ovid were used to perform a literature search on CLSM in the diagnosis of melanoma and non melanoma skin cancers. Standards for Reporting of Diagnosis Accuracy (STARD) initiative checklist and National Institute for Health and Clinical Excellence (NICE) guidelines on methodology were used to assess the quality of the studies found. Eight studies fulfilling relevant criteria inclusive of assessment of diagnostic accuracy of CSLM and histopathology were selected. Heterogeneity among the studies was assessed and the data was pooled for meta-analysis. Results:The eight included studies did not have considerable heterogeneity between them. The pooled sensitivity for melanoma diagnosis was 91.4% and for BCC diagnosis was 90.1%. Pooled specificities were 79.9% and 92.6% for malignant melanoma and BCC respectively. Diagnostic odds ratios for melanoma and BCC were 80.1 and 358.1 respectively. Conclusions: From the limited good quality available literature we found that CLSM has the potential to be an additional noninvasive diagnostic test to dermoscopy for the diagnosis of BCC and melanoma.

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Section: Methodological Qualitymentioning

confidence: 99%

Section: Methodological Qualitymentioning

confidence: 99%

Section: Included Studiesmentioning

confidence: 99%

Section: Included Studiesmentioning

confidence: 99%

mentioning

confidence: 99%

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Untitled

2015

Journal of Cancer Research and Therapeutic Oncology

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In Vivo Confocal Scanning Laser Microscopy of a Series of Congenital Melanocytic Nevi Suggestive of Having Developed Malignant Melanoma

Marghoob¹,

Charles²,

Busam³

et al. 2005

Arch Dermatol

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To determine the utility of confocal scanning laser microscopy (CSLM) in the in vivo evaluation of congenital melanocytic nevi (CMNs) that are suggestive of having developed melanoma. Design:The CMNs suggestive of melanoma by clinical and dermoscopic examination were imaged by CSLM, and the findings correlated with the features seen on dermoscopic and histologic examination.Setting: Dermatology clinic specializing in pigmented lesions.Patients: Seven patients with clinically irregular small to medium CMNs. Interventions:The areas imaged by CSLM were sampled with 3-mm punch biopsy specimens. The entire lesion was subsequently excised. The punch biopsy specimens were step sectioned horizontally to correlate with the CSLM images. Excised samples were step sectioned and processed routinely. Histologic features observed on CSLM were correlated with the features seen on dermoscopic and light microscopic examination.Main Outcome Measure: Correlation of the structures seen using CSLM with the dermoscopic and histologic features of CMNs and melanoma. Results:The CSLM illustrated histologic characteristics of CMNs, including the presence of hyperpigmented keratinocytes, nevus cells, melanophages, and a normal "honeycomb" epidermal architecture. Features suggestive of melanoma were not evident by CSLM in 6 histologically proven benign CMNs. Histologic features associated with melanoma, such as an increased number of intraepidermal atypical melanocytes (pagetoid) and loss of normal epidermal cellular architecture, were identified by CSLM in 1 lesion, which on histologic analysis revealed melanoma in association with a CMN. Conclusion:Our results illustrate that CSLM may be useful for clinicopathologic correlations and for the preliminary noninvasive diagnosis of pigmented neoplasms in vivo.

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Confocal Scanning Laser Reflectance Microscopy

Marghoob¹,

Halpern²

2005

Arch Dermatol

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Sensitivity and specificity of reflectance-mode confocal microscopy for in vivo diagnosis of basal cell carcinoma: A multicenter study

Cited by 336 publications

References 19 publications

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Untitled

In Vivo Confocal Scanning Laser Microscopy of a Series of Congenital Melanocytic Nevi Suggestive of Having Developed Malignant Melanoma

Confocal Scanning Laser Reflectance Microscopy

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