TY - JOUR
T1 - Confocal imaging of carbon dioxide laser-ablated basal cell carcinomas
T2 - An ex-vivo study on the uptake of contrast agent and ablation parameters
AU - Sierra, Heidy
AU - Damanpour, Shadi
AU - Hibler, Brian
AU - Nehal, Kishwer
AU - Rossi, Anthony
AU - Rajadhyaksha, Milind
N1 - Funding Information:
We thank the NIH for funding support (grant R01EB012466 from NIBIB’s Image-guided Interventions program) as well William Phillips and Marie Tudisco for their help with preparation of histology sections
Funding Information:
We thank the NIH for funding support (grant R01EB012466 from NIBIB’s Image-guided Interventions program) as well William Phillips and Marie Tudisco for their help with preparation of histology sections
Publisher Copyright:
© 2015 Wiley Periodicals, Inc.
PY - 2016/2/1
Y1 - 2016/2/1
N2 - Background and Objectives Laser ablation can be an effective treatment for the minimally invasive removal of superficial and early nodular basal cell carcinomas (BCCs). However, the lack of histological confirmation after ablation results in high variability of recurrence rates and has been a limitation. Reflectance confocal microscopy (RCM) imaging, combined with a contrast agent, may detect the presence (or absence) of residual BCC tumors directly on the patient and thus provide noninvasive histology-like feedback to guide ablation. The goal of this ex vivo bench-top study was to determine affective ablation parameters (fluence, number of passes) for a CO2 laser that will allow both removal of BCCs and control of the underlying thermal coagulation zone in post-ablated tissue to enable uptake of contrast agent and RCM imaging. Materials and Methods We used 72 discarded fresh normal skin specimens and frozen BCC tumor specimens to characterize the depth of ablation and to evaluate uptake of contrast agent and image quality. Acetic acid was used to enhance nuclear brightness ("acetowhitening") during imaging pre- and post-ablation. Histology sections of the post-ablated imaged surface were visually examined for the appearance of nuclear and dermal morphology and compared to the RCM images. Results Results for 1-3 passes of 5.5 J/cm2, 6.5 and 7.5 J/cm2, and 1-2 passes of 8.5 J/cm2 showed the uptake of acetic acid for contrast and RCM imaging of the presence and absence of residual BCC tumors in post-ablated tissue. Morphologic details in the images were validated by the histology. Conclusion The use of effective ablation parameters may enable RCM imaging to guide ablation.
AB - Background and Objectives Laser ablation can be an effective treatment for the minimally invasive removal of superficial and early nodular basal cell carcinomas (BCCs). However, the lack of histological confirmation after ablation results in high variability of recurrence rates and has been a limitation. Reflectance confocal microscopy (RCM) imaging, combined with a contrast agent, may detect the presence (or absence) of residual BCC tumors directly on the patient and thus provide noninvasive histology-like feedback to guide ablation. The goal of this ex vivo bench-top study was to determine affective ablation parameters (fluence, number of passes) for a CO2 laser that will allow both removal of BCCs and control of the underlying thermal coagulation zone in post-ablated tissue to enable uptake of contrast agent and RCM imaging. Materials and Methods We used 72 discarded fresh normal skin specimens and frozen BCC tumor specimens to characterize the depth of ablation and to evaluate uptake of contrast agent and image quality. Acetic acid was used to enhance nuclear brightness ("acetowhitening") during imaging pre- and post-ablation. Histology sections of the post-ablated imaged surface were visually examined for the appearance of nuclear and dermal morphology and compared to the RCM images. Results Results for 1-3 passes of 5.5 J/cm2, 6.5 and 7.5 J/cm2, and 1-2 passes of 8.5 J/cm2 showed the uptake of acetic acid for contrast and RCM imaging of the presence and absence of residual BCC tumors in post-ablated tissue. Morphologic details in the images were validated by the histology. Conclusion The use of effective ablation parameters may enable RCM imaging to guide ablation.
KW - image-guided laser ablation
KW - less invasive skin cancer treatment
KW - nonmelanoma skinc cancer
KW - reflectance confocal microscopy
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U2 - 10.1002/lsm.22415
DO - 10.1002/lsm.22415
M3 - Article
C2 - 26392001
AN - SCOPUS:84959325527
VL - 48
SP - 133
EP - 139
JO - Lasers in Surgery and Medicine
JF - Lasers in Surgery and Medicine
SN - 0196-8092
IS - 2
ER -