Evidence map›Paper›PMID 41749961›Full record

ReviewCancers2026

Non-Invasive Assessment of Treatment Response in Actinic Keratosis: A Clinically Oriented Multimodal Review.

Gianluca Pistore, Luca Ambrosio, Antonio Di Guardo, Anna Rita Panebianco, Giovanni Di Lella, Claudio Conforti, Giovanni Pellacani, Francesco Moro, Paolo Marchetti, Damiano Abeni and 2 more

Abstract readReview
In one paragraph

Review in Cancers, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Review
  2. Review
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Gianluca PistoreClinical Epidemiology Unit, Istituto Dermopatico dell'Immacolata-IRCCS, 00167 Rome, Italy.ORCID 0009-0004-9423-1607
Luca AmbrosioSkin Cancer Center, Istituto Dermopatico dell'Immacolata-IRCCS, 00167 Rome, Italy.ORCID 0000-0002-6312-7709
Antonio Di GuardoSkin Cancer Center, Istituto Dermopatico dell'Immacolata-IRCCS, 00167 Rome, Italy.ORCID 0000-0002-0117-346X
Anna Rita PanebiancoMedical Direction, Istituto Dermopatico dell'Immacolata-IRCCS, 00167 Rome, Italy.
Giovanni Di LellaSkin Cancer Center, Istituto Dermopatico dell'Immacolata-IRCCS, 00167 Rome, Italy.
Claudio ConfortiSkin Cancer Center, Istituto Dermopatico dell'Immacolata-IRCCS, 00167 Rome, Italy.ORCID 0000-0001-5126-8873
Giovanni PellacaniDermatology Clinic, Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, La Sapienza University, 00185 Rome, Italy.
Francesco MoroDermatology Unit, Istituto Dermopatico dell'Immacolata-IRCCS, 00167 Rome, Italy.ORCID 0000-0003-0031-941X
Paolo MarchettiDepartment of Oncology, Istituto Dermopatico dell'Immacolata-IRCCS, 00167 Rome, Italy.
Damiano AbeniClinical Epidemiology Unit, Istituto Dermopatico dell'Immacolata-IRCCS, 00167 Rome, Italy.ORCID 0000-0002-0167-7617
Luca FaniaSkin Cancer Center, Istituto Dermopatico dell'Immacolata-IRCCS, 00167 Rome, Italy.
Francesco RicciDepartment of Life Science, Health, and Health Professions, Link University of Rome, 00165 Rome, Italy.ORCID 0000-0002-8388-9268

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIn actinic keratosis (AK), clinical clearance after field-directed therapies does not necessarily correspond to histological resolution, resulting in subclinical persistence and risk of recurrence.

objectiveTo provide a practical, up-to-date framework for non-invasive monitoring of treatment response in AK, integrating clinical assessment and dermoscopy with high-resolution imaging techniques, reflectance confocal microscopy (RCM), line-field confocal optical coherence tomography (LC-OCT), and high-frequency ultrasound (HFUS), and to discuss emerging optical biomarkers based on Raman spectroscopy.

resultsFor each modality, we summarize pre- and post-treatment imaging patterns, proposed response criteria, recommended follow-up timing, and correlations with clinical outcomes (including clearance and AKASI) and, when available, histological findings. The available evidence is derived from a limited number of observational studies, predominantly involving RCM and LC-OCT, whereas data on HFUS and Raman spectroscopy remain comparatively scarce. RCM and LC-OCT allow in vivo assessment of epidermal architectural normalization and reduction of intraepidermal keratinocyte atypia. HFUS captures quantitative trajectories of superficial dermal remodeling, including changes in the subepidermal low-echogenic band (SLEB) and dermal echogenicity after photodynamic therapy and other field treatments. Dermoscopy remains the first-line tool for routine follow-up but may fail to detect minimal subclinical persistence. Finally, we discuss the potential role of in vivo Raman spectroscopy for dynamic molecular endpoints and its possible integration with artificial intelligence-based analytical approaches.

conclusionsA standardized multimodal follow-up strategy improves the accuracy of treatment-response assessment compared with clinical evaluation alone. We propose a technique-specific checklist of minimal response criteria and a pragmatic temporal assessment scheme, and outline a research roadmap to support validation and clinical implementation of non-invasive imaging-guided monitoring in actinic keratosis.

Indexed as

actinic keratosisfield cancerizationnon-invasive imagingoptical coherence tomographyreflectance confocal microscopytreatment response

Identifiers

PMID41749961
PMCPMC12939753

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.