Confocal mosaicing microscopy in skin excisions: Feasibility of cancer margin screening at the bedside to guide Mohs surgery Book Section


Authors: Gareau, D. S.; Nehal, K.; Rajadhyaksha, M.
Editors: Hofmann-Wellenhof, R.; Pellacani, G.; Malvehy, J.; Soyer, H. P.
Article/Chapter Title: Confocal mosaicing microscopy in skin excisions: Feasibility of cancer margin screening at the bedside to guide Mohs surgery
Abstract: Nonmelanoma skin cancers occur most commonly on cosmetically sensitive areas such as on the face and head-and-neck. For the surgical treatment of these cancers, complete resection of diseased tissue is guided by microscopic pathology, with the objective of preserving perilesional healthy tissue. The current method for screening the margins of staged excisions for the presence of residual tumor is frozen histopathology. Histopathology-guided Mohs surgery for basal cell carcinoma (BCC) is effective [1] with 5-year cure rate of about 99% [2]. However, the preparation of histopathology is laborious and time consuming. Up to 20–45 min may be needed for preparation of frozen sections of an excision [3] and a Mohs procedure requires typically from two to several excisions. Thus, the preparation of Mohs histopathology may require up to hours. As an emerging mode of cellular imaging that is being translated for clinical utility, confocal microscopy potentially offers a means for real-time detection of skin cancers at the bedside, either directly on patients in vivo [4] or directly in surgically excised tissue ex vivo [3–5]. Nuclear and cellular morphology is imaged in noninvasive thin optical sections with high resolution. The optical sectioning of 1–5 μm and resolution of 0.1–1.0 μm is comparable to that for physically microtomed sections in histopathology. Thus, confocal imaging may serve as an adjunct to pathology for guiding Mohs surgery in a more efficient manner, while saving labor, time and cost. © Springer-Verlag Berlin Heidelberg 2012.
Book Title: Reflectance Confocal Microscopy for Skin Diseases
ISBN: 978-3-642-21996-2
Publisher: Springer Berlin Heidelberg  
Publication Place: Berlin, Germany
Date Published: 2012-01-01
Start Page: 449
End Page: 454
Language: English
DOI: 10.1007/978-3-642-21997-9_33
PROVIDER: scopus
DOI/URL:
Notes: Book Chapter: 33 -- Export Date: 3 March 2016 -- Source: Scopus
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MSK Authors
  1. Kishwer S Nehal
    156 Nehal
  2. Daniel S Gareau
    23 Gareau