ArticleJournal of the European Academy of Dermatology and Venereology : JEADV2019
Peri-operative delineation of non-melanoma skin cancer margins in vivo with handheld reflectance confocal microscopy and video-mosaicking.
Article in Journal of the European Academy of Dermatology and Venereology : JEADV, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed.
- Surgical Outcomes of Nonmelanoma Skin Cancer Managed with Systematic Preoperative Reflectance Confocal Microscopy-Guided Margin Assessment: A Retrospective Cohort Study Comparing Wide Local Excision and Mohs Micrographic Surgery.Diagnostics (Basel, Switzerland) · 2026Article
- Mohs Micrographic Surgery: A Narrative Review of Current Practices, Emerging Trends, and Case-Based Insights.Advances in therapy · 2025Review
- In Vivo Confocal Microscopy in the Surgical Treatment of Keratinocyte Carcinomas: A Systematic Review.Journal of clinical medicine · 2025Review
- Challenges for New Adopters in Pre-Surgical Margin Assessment by Handheld Reflectance Confocal Microscope of Basal Cell Carcinoma; A Prospective Single-center Study.Dermatology practical & conceptual · 2022Review
- Article
- Fluorescence-guided surgery for non-melanoma and melanoma skin cancer: Case series and a brief review of the literature.Photodermatology, photoimmunology & photomedicine · 2021Review
- Intensity-Mosaic: automatic panorama mosaicking of disordered images with insufficient features.Journal of medical imaging (Bellingham, Wash.) · 2021Article
- Segmentation of cellular patterns in confocal images of melanocytic lesions in vivo via a multiscale encoder-decoder network (MED-Net).Medical image analysis · 2021Article
- Real-time video mosaicking to guide handheld in vivo microscopy.Journal of biophotonics · 2020Article
- Skin cancer detection using non-invasive techniques.RSC advances · 2018Review
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Authors and funding
9 authors.
Funding
Abstract
backgroundThe surgical removal of non-melanoma skin cancers (NMSCs) is guided by the pathologic examination of margins. However, the preparation of histopathology is time consuming, labour-intensive and requires separate laboratory infrastructure. Furthermore, when histopathology indicates positive margins, patients must return for re-excisions. Reflectance confocal microscopy (RCM) with a new video-mosaicking approach can noninvasively delineate margins directly on patients and potentially guide surgery in real-time, augmenting the traditional approaches of histopathology.
objectiveTo assess a new peri-operative RCM video-mosaicking approach for comprehensive delineation of NMSC margins on patients in vivo.
methodsThirty-five patients undergoing Mohs micrographic surgery (MMS) in the Mohs surgery unit at Memorial Sloan Kettering Cancer Center, New York, NY were included in the study. RCM imaging was performed before and after the first staged excision by acquiring videos along the surgical margins (epidermal, peripheral and deep dermal) of each wound, which were subsequently processed into video-mosaics. Two RCM evaluators read and assessed video-mosaics, and subsequently compared to the corresponding Mohs frozen histopathology.
resultsReflectance confocal microscopy videos and video-mosaics displayed acceptable imaging quality (resolution and contrast), pre-operatively in 32/35 (91%) NMSC lesions and intra-operatively in 29/35 lesions (83%). Pre-operative delineation of margins correlated with the histopathology in 32/35 (91%) lesions. Intra-operative delineation correlated in 10/14 (71%) lesions for the presence of residual tumour and in 18/21 (86%) lesions for absence. Sensitivity/specificity were 71%/86% and 86%/81% for two RCM video-mosaic evaluators, and overall agreement was 80% and 83% with histopathology, with moderate inter-evaluator agreement (k = 0.59, P ≤ 0.0002).
conclusionsPeri-operative RCM video-mosaicking of NMSC margins directly on patients may potentially guide surgery in real-time, serve as an adjunct to histopathology, reduce time spent in clinic and reduce the need for re-excisions. Further testing in larger studies is needed.
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