RESUMEN
Line-field confocal optical coherence tomography (LC-OCT) is a new technology for skin cancer diagnostics. However, the interobserver agreement (IOA) of known image markers of keratinocyte carcinomas (KC), including basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), as well as precursors, SCC in situ (CIS) and actinic keratosis (AK), remains unexplored. This study determined IOA on the presence or absence of 10 key LC-OCT image markers of KC and precursors, among evaluators new to LC-OCT with different levels of dermatologic imaging experience. Secondly, the frequency and association between reported image markers and lesion types, was determined. Six evaluators blinded to histopathologic diagnoses, assessed 75 LC-OCT images of KC (21 SCC; 21 BCC), CIS (12), and AK (21). For each image, evaluators independently reported the presence or absence of 10 predefined key image markers of KCs and precursors described in an LC-OCT literature review. Evaluators were stratified by experience-level as experienced (3) or novices (3) based on previous OCT and reflectance confocal microscopy usage. IOA was tested for all groups, using Conger's kappa coefficient (κ). The frequency of reported image marker and their association with lesion-types, were calculated as proportions and odds ratios (OR), respectively. Overall IOA was highest for the image markers lobules (κ = 0.68, 95% confidence interval (CI) 0.57;0.78) and clefting (κ = 0.63, CI 0.52;0.74), typically seen in BCC (94%;OR 143.2 and 158.7, respectively, p < 0.001), followed by severe dysplasia (κ = 0.42, CI 0.31;0.53), observed primarily in CIS (79%;OR 7.1, p < 0.001). The remaining seven image-markers had lower IOA (κ = 0.06-0.32) and were more evenly observed across lesion types. The lowest IOA was noted for a well-defined (κ = 0.07, CI 0;0.15) and interrupted dermal-epidermal junction (DEJ) (κ = 0.06, CI -0.002;0.13). IOA was higher for all image markers among experienced evaluators versus novices. This study shows varying IOA for 10 key image markers of KC and precursors in LC-OCT images among evaluators new to the technology. IOA was highest for the assessments of lobules, clefting, and severe dysplasia while lowest for the assessment of the DEJ integrity.
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Carcinoma Basocelular , Carcinoma de Células Escamosas , Queratinocitos , Queratosis Actínica , Variaciones Dependientes del Observador , Neoplasias Cutáneas , Tomografía de Coherencia Óptica , Humanos , Neoplasias Cutáneas/diagnóstico por imagen , Neoplasias Cutáneas/patología , Neoplasias Cutáneas/diagnóstico , Tomografía de Coherencia Óptica/métodos , Carcinoma Basocelular/diagnóstico por imagen , Carcinoma Basocelular/patología , Carcinoma Basocelular/diagnóstico , Carcinoma de Células Escamosas/diagnóstico por imagen , Carcinoma de Células Escamosas/patología , Queratinocitos/patología , Queratosis Actínica/diagnóstico por imagen , Queratosis Actínica/patología , Queratosis Actínica/diagnóstico , Microscopía Confocal/métodos , Lesiones Precancerosas/diagnóstico por imagen , Lesiones Precancerosas/patología , Femenino , Masculino , Anciano , Persona de Mediana EdadAsunto(s)
Carcinoma Basocelular , Recurrencia Local de Neoplasia , Neoplasias Cutáneas , Tomografía de Coherencia Óptica , Humanos , Tomografía de Coherencia Óptica/métodos , Carcinoma Basocelular/cirugía , Carcinoma Basocelular/diagnóstico por imagen , Carcinoma Basocelular/patología , Neoplasias Cutáneas/diagnóstico por imagen , Neoplasias Cutáneas/cirugía , Neoplasias Cutáneas/patología , Recurrencia Local de Neoplasia/diagnóstico por imagen , Cuidados Preoperatorios/métodos , Masculino , AncianoRESUMEN
Correlative imaging of cutaneous tumors provides additional information to the standard histopathologic examination. However, the joint progress in the establishment of analytical techniques, such as Laser-Induced Breakdown Spectroscopy (LIBS) and Laser Ablation Inductively Coupled Plasma Mass Spectrometry (LA-ICP-MS) in clinical practice is still limited. Their combination provides complementary information as it is also shown in our study in terms of major biotic (Ca, Mg, and P) and trace (Cu and Zn) elements. To elucidate changes in the elemental composition in tumors, we have compiled a set of malignant tumors (Squamous Cell Carcinoma, Basal Cell Carcinoma, Malignant Melanoma, and Epithelioid Angiosarcoma), one benign tumor (Pigmented Nevus) and one healthy-skin sample. The data processing was based on a methodological pipeline involving binary image registration and affine transformation. Thus, our paper brings a feasibility study of a practical methodological concept that enables us to compare LIBS and LA-ICP-MS results despite the mutual spatial distortion of original elemental images. Moreover, we also show that LIBS could be a sufficient pre-screening method even for a larger number of samples according to the speed and reproducibility of the analyses. Whereas LA-ICP-MS could serve as a ground truth and reference technique for preselected samples.
Asunto(s)
Neoplasias Cutáneas , Neoplasias Cutáneas/diagnóstico por imagen , Neoplasias Cutáneas/patología , Humanos , Terapia por Láser , Melanoma/diagnóstico por imagen , Melanoma/patología , Espectrometría de Masas/métodos , Carcinoma Basocelular/diagnóstico por imagen , Oligoelementos/análisis , Carcinoma de Células Escamosas/diagnóstico por imagen , Carcinoma de Células Escamosas/patología , Análisis Espectral/métodos , Nevo Pigmentado/diagnóstico por imagen , Rayos LáserRESUMEN
BACKGROUND: Skin neoplasms, particularly basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), are prevalent forms of skin malignancies. To enhance accurate diagnosis, non-invasive techniques including high-frequency ultrasound (HFUS) are crucial. HFUS offers deeper penetration compared to reflectance confocal microscopy (RCM), and optical coherence tomography (OCT), making it valuable for examining skin structures. The aim of this study was to investigate and diagnose localized manifestation of BCC and SCC with HFUS and compare it with pathology results in patients referred to Razi Hospital, Tehran, Iran. METHOD AND MATERIALS: This study included patients diagnosed with BCC and SCC, with clinical and pathological confirmation, attending the oncology clinic of Razi Hospital, Tehran, Iran, from 2022 to 2023. Exclusion criteria comprised metastatic and recurrent cases, patients who underwent treatment or surgery, and tumors located in anatomically challenging areas. HFUS with a 20 MHz probe and Doppler ultrasound were employed to examine the skin. Tumors were subsequently excised, fixed in formalin, and sent for pathological assessment. Ultrasound findings were compared with pathology results. RESULTS: The study assessed 40 patients, with half diagnosed with SCC and the other half with BCC. The majority of SCC patients were male (80%), while BCC patients were relatively evenly divided between males (65%) and females (35%). The mean age was 59.15 ± 11.9 years for SCC and 63.4 ± 8.9 years for BCC. Cheeks (20%) and lips (35%) were the most common sampling sites for BCC and SCC, respectively. The correlation coefficients for tumor size and depth between ultrasound and pathology were 0.981 and 0.912, respectively, indicating a high level of agreement between the two methods. CONCLUSION: In BCC patients, there was complete agreement between sonographic loco-regional extension and pathology findings. However, some discordance (30%) was observed in SCC cases. The study demonstrated a strong correlation between ultrasound and pathology in accurately detecting the depth and extent of the tumor. However, due to the inclusion of only patients with positive pathology, it is not appropriate to evaluate the diagnostic test values and compare them with pathology results. Therefore, it is highly recommended to carry out additional studies with larger sample sizes to further validate these findings.
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Carcinoma Basocelular , Carcinoma de Células Escamosas , Neoplasias Cutáneas , Humanos , Carcinoma Basocelular/diagnóstico por imagen , Carcinoma Basocelular/patología , Neoplasias Cutáneas/diagnóstico por imagen , Neoplasias Cutáneas/patología , Carcinoma de Células Escamosas/diagnóstico por imagen , Carcinoma de Células Escamosas/patología , Femenino , Masculino , Persona de Mediana Edad , Anciano , Ultrasonografía/métodos , Adulto , Anciano de 80 o más Años , IránRESUMEN
Skin tumors are the most common tumors in humans and the clinical characteristics of three common non-melanoma tumors (IDN, SK, BCC) are similar, resulting in a high misdiagnosis rate. The accurate differential diagnosis of these tumors needs to be judged based on pathological images. However, a shortage of experienced dermatological pathologists leads to bias in the diagnostic accuracy of these skin tumors in China. In this paper, we establish a skin pathological image dataset, SPMLD, for three non-melanoma to achieve automatic and accurate intelligent identification for them. Meanwhile, we propose a lesion-area-based enhanced classification network with the KLS module and an attention module. Specifically, we first collect thousands of H&E-stained tissue sections from patients with clinically and pathologically confirmed IDN, SK, and BCC from a single-center hospital. Then, we scan them to construct a pathological image dataset of these three skin tumors. Furthermore, we mark the complete lesion area of the entire pathology image to better learn the pathologist's diagnosis process. In addition, we applied the proposed network for lesion classification prediction on the SPMLD dataset. Finally, we conduct a series of experiments to demonstrate that this annotation and our network can effectively improve the classification results of various networks. The source dataset and code are available at https://github.com/efss24/SPMLD.git.
Asunto(s)
Neoplasias Cutáneas , Humanos , Neoplasias Cutáneas/patología , Neoplasias Cutáneas/diagnóstico por imagen , Piel/patología , Piel/diagnóstico por imagen , Bases de Datos Factuales , Interpretación de Imagen Asistida por Computador/métodos , Carcinoma Basocelular/patología , Carcinoma Basocelular/diagnóstico por imagenAsunto(s)
Carcinoma Basocelular , Dermoscopía , Microscopía Confocal , Neoplasias Cutáneas , Humanos , Carcinoma Basocelular/diagnóstico por imagen , Carcinoma Basocelular/cirugía , Carcinoma Basocelular/patología , Dermoscopía/métodos , Neoplasias Cutáneas/diagnóstico por imagen , Neoplasias Cutáneas/patología , Neoplasias Cutáneas/cirugía , Microscopía Confocal/métodos , Ultrasonografía/métodos , Masculino , Femenino , Anciano , Persona de Mediana EdadRESUMEN
The clinical diagnosis of pigmented genital lesions is challenging. Reflectance confocal microscopy (RCM) is effective for diagnosis but is limited in its application due to elevated costs. A more affordable dermatoscope with a 400x magnification (D400) has recently been brought to market. The aim of our study was to compare these two imaging techniques for the analysis of pigmented genital tumours. An observational, prospective and mono-centric study was carried out from October 2017 to May 2019, in which clinical, dermatoscopic (20x and 400x) and RCM data from 207 pigmented genital lesions were collected. The images generated via D400 and RCM were analysed by three expert investigators. Similarities between the criteria observed using D400 and RCM were evaluated by each investigator. In total, 207 lesions were included: 183 melanosis, 19 nevi, one basal cell carcinoma (BCC), two condylomas and two melanomas in situ. Our series correlates well with data found in the literature especially for the distribution of different lesions, their topography, and their aspect using x20 dermatoscopy and RCM. Pattern and cell criteria defined using RCM largely paralleled those observed with D400 for all three investigators. Correlation between D400 and RCM was moderate to strong with regards to the identification of the ring pattern and clustered round cells, strong for dendritic and plump cells, and perfect for isolated round cells and spindle cells. D400 is an easy-to-use, cost-effective alternative for the analysis of pigmented genital lesions, particularly for melanosis.
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Dermoscopía , Melanosis , Microscopía Confocal , Neoplasias Cutáneas , Humanos , Microscopía Confocal/métodos , Melanosis/diagnóstico por imagen , Melanosis/patología , Estudios Prospectivos , Neoplasias Cutáneas/patología , Neoplasias Cutáneas/diagnóstico por imagen , Femenino , Masculino , Melanoma/diagnóstico por imagen , Melanoma/patología , Carcinoma Basocelular/diagnóstico por imagen , Carcinoma Basocelular/patología , Persona de Mediana Edad , Adulto , Condiloma Acuminado/diagnóstico por imagen , Condiloma Acuminado/diagnóstico , Condiloma Acuminado/patología , Nevo Pigmentado/diagnóstico por imagen , Nevo Pigmentado/patología , Anciano , Enfermedades de los Genitales Femeninos/diagnóstico por imagen , Enfermedades de los Genitales Femeninos/patología , Nevo/diagnóstico por imagen , Nevo/patologíaRESUMEN
Cutaneous malignancies affecting the ear, exacerbated by extensive ultraviolet (UV) exposure, pose intricate challenges owing to the organ's complex anatomy. This article investigates how the anatomy contributes to late-stage diagnoses and ensuing complexities in surgical interventions. Mohs Micrographic Surgery (MMS), acknowledged as the gold standard for treating most cutaneous malignancies of the ear, ensures superior margin control and cure rates. However, the ear's intricacy necessitates careful consideration of tissue availability and aesthetic outcomes. The manuscript explores new technologies like Reflectance Confocal Microscopy (RCM), Optical Coherence Tomography (OCT), High-Frequency, High-Resolution Ultrasound (HFHRUS), and Raman spectroscopy (RS). These technologies hold the promise of enhancing diagnostic accuracy and providing real-time visualization of excised tissue, thereby improving tumor margin assessments. Dermoscopy continues to be a valuable non-invasive tool for identifying malignant lesions. Staining methods in Mohs surgery are discussed, emphasizing hematoxylin and eosin (H&E) as the gold standard for evaluating tumor margins. Toluidine blue is explored for potential applications in assessing basal cell carcinomas (BCC), and immunohistochemical staining is considered for detecting proteins associated with specific malignancies. As MMS and imaging technologies advance, a thorough evaluation of their practicality, cost-effectiveness, and benefits becomes essential for enhancing surgical outcomes and patient care. The potential synergy of artificial intelligence with these innovations holds promise in revolutionizing tumor detection and improving the efficacy of cutaneous malignancy treatments.
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Carcinoma Basocelular , Neoplasias del Oído , Cirugía de Mohs , Neoplasias Cutáneas , Humanos , Cirugía de Mohs/métodos , Neoplasias Cutáneas/cirugía , Neoplasias Cutáneas/diagnóstico , Neoplasias Cutáneas/patología , Neoplasias del Oído/cirugía , Neoplasias del Oído/patología , Neoplasias del Oído/diagnóstico por imagen , Neoplasias del Oído/diagnóstico , Carcinoma Basocelular/cirugía , Carcinoma Basocelular/patología , Carcinoma Basocelular/diagnóstico , Carcinoma Basocelular/diagnóstico por imagen , Tomografía de Coherencia Óptica/métodos , Microscopía Confocal/métodos , Espectrometría Raman/métodos , Dermoscopía/métodos , Márgenes de EscisiónRESUMEN
Basal cell carcinoma (BCC) is the most frequent malignancy in the general population. To date, dermoscopy is considered a key tool for the diagnosis of BCC; nevertheless, line-field confocal optical coherence tomography (LC-OCT), a new non-invasive optical technique, has become increasingly important in clinical practice, allowing for in vivo imaging at cellular resolution. The present study aimed to investigate the possible correlation between the dermoscopic features of BCC and their LC-OCT counterparts. In total, 100 histopathologically confirmed BCC cases were collected at the Dermatologic Clinic of the University of Siena, Italy. Predefined dermoscopic and LC-OCT criteria were retrospectively evaluated, and their frequencies were calculated. The mean (SD) age of our cohort was 65.46 (13.36) years. Overall, BCC lesions were mainly located on the head (49%), and they were predominantly dermoscopically pigmented (59%). Interestingly, all dermoscopic features considered had a statistically significant agreement with the LC-OCT criteria (all p < 0.05). In conclusion, our results showed that dermoscopic patterns may be associated with LC-OCT findings, potentially increasing accuracy in BCC diagnosis. However, further studies are needed in this field.
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Carcinoma Basocelular , Dermoscopía , Neoplasias Cutáneas , Tomografía de Coherencia Óptica , Humanos , Carcinoma Basocelular/diagnóstico por imagen , Carcinoma Basocelular/patología , Dermoscopía/métodos , Neoplasias Cutáneas/diagnóstico por imagen , Neoplasias Cutáneas/patología , Anciano , Masculino , Femenino , Estudios Retrospectivos , Tomografía de Coherencia Óptica/métodos , Persona de Mediana Edad , Anciano de 80 o más Años , Italia , AdultoRESUMEN
Surgical management of basal cell carcinoma (BCC) typically involves surgical excision with post-operative margin assessment using the bread-loafing technique; or gold-standard Mohs micrographic surgery (MMS), where margins are iteratively examined for residual cancer after tumour removal, with additional excisions performed upon detecting residual tumour at margins. There is limited sampling of resection margins with bread loafing, with detection of positive margins 44% of the time using 2 mm intervals. To resolve this, we have developed three-dimensional (3D) Tissue Imaging for: (1) complete examination of cancer margins and (2) detection of tumour proximity to nerves and blood vessels. 3D Tissue optical clearing with a light sheet imaging protocol was developed for margin assessment in two datasets assessed by two independent evaluators: (1) 48 samples from 29 patients with varied BCC subtypes, sizes and pigmentation levels; (2) 32 samples with matching Mohs' surgeon reading of tumour margins using two-dimensional haematoxylin & eosin-stained sections. The 3D Tissue Imaging protocol permits a complete examination of deeper and peripheral margins. Two independent evaluators achieved negative predictive values of 92.3% and 88.24% with 3D Tissue Imaging. Images obtained from 3D Tissue Imaging recapitulates histological features of BCC, such as nuclear crowding, palisading and retraction clefting and provides a 3D context for recognising normal skin adnexal structures. Concurrent immunofluorescence labelling of nerves and blood vessels allows visualisation of structures closer to tumour-positive regions, which may have a higher risk for neural and vascular infiltration. Together, this method provides more information in a 3D spatial context, enabling better cancer management by clinicians.
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Carcinoma Basocelular , Imagenología Tridimensional , Márgenes de Escisión , Cirugía de Mohs , Neoplasias Cutáneas , Humanos , Carcinoma Basocelular/diagnóstico por imagen , Carcinoma Basocelular/cirugía , Carcinoma Basocelular/patología , Neoplasias Cutáneas/diagnóstico por imagen , Neoplasias Cutáneas/cirugía , Neoplasias Cutáneas/patologíaRESUMEN
Dermoscopy can be an important help for the diagnosis of skin cancers and inflammatory cutaneous diseases. The list of the dermoscopic features reported in granuloma faciale is wide and includes vascular and non-vascular features. We report here three cases of diffuse flat facial and extrafacial granuloma faciale that exhibited elongated linear vessels simulating branching vessels and diffuse structureless orange areas. The differential diagnosis between flat-type granuloma faciale, basal cell carcinoma and cutaneous sarcoidosis can be extremely difficult, making histology mandatory before any treatment.
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Dermoscopía , Granuloma , Humanos , Masculino , Femenino , Diagnóstico Diferencial , Persona de Mediana Edad , Granuloma/patología , Granuloma/diagnóstico por imagen , Dermatosis Facial/patología , Dermatosis Facial/diagnóstico por imagen , Sarcoidosis/patología , Sarcoidosis/diagnóstico por imagen , Carcinoma Basocelular/patología , Carcinoma Basocelular/diagnóstico por imagen , Neoplasias Cutáneas/patología , Neoplasias Cutáneas/diagnóstico por imagen , Anciano , AdultoRESUMEN
Basal Cell Carcinoma (BCC) is the most prevalent skin cancer and continues to witness a surge in incidence rates. The categorization of BCC subtypes into low or high risk, guided by recurrence and invasiveness metrics, underscores the need for precise differentiation. While the punch biopsy remains the gold standard for diagnosis, its invasiveness prompts a need for non-invasive alternatives. Ultrasound (US) has emerged as a noteworthy candidate, gaining momentum in its potential to offer a less intrusive diagnostic approach. We conducted a systematic review regarding features of the high-risk subtypes of BCC on US. A thorough literature search of PubMed Medline, Embase, and CINAHL databases was conducted according to PRISMA guidelines and a total of nine studies meeting our inclusion criteria were included in this review. Evidence is still nascent but US features such as lesional shape, depth, hyperechoic spots, and color doppler may be helpful in differentiating high-risk BCC subtypes. However, further prospective studies with standardized interventions and outcome measures are required.
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Carcinoma Basocelular , Neoplasias Cutáneas , Carcinoma Basocelular/diagnóstico por imagen , Carcinoma Basocelular/patología , Carcinoma Basocelular/diagnóstico , Carcinoma Basocelular/epidemiología , Humanos , Neoplasias Cutáneas/diagnóstico por imagen , Neoplasias Cutáneas/patología , Neoplasias Cutáneas/diagnóstico , Piel/diagnóstico por imagen , Piel/patología , Ultrasonografía Doppler en Color/métodos , Ultrasonografía/métodos , BiopsiaAsunto(s)
Carcinoma Basocelular , Dermoscopía , Neoplasias Cutáneas , Humanos , Estudios Retrospectivos , Femenino , Neoplasias Cutáneas/patología , Neoplasias Cutáneas/diagnóstico , Neoplasias Cutáneas/diagnóstico por imagen , Masculino , Persona de Mediana Edad , Carcinoma Basocelular/patología , Carcinoma Basocelular/diagnóstico por imagen , Carcinoma Basocelular/diagnóstico , Anciano , Adulto , Anciano de 80 o más AñosAsunto(s)
Neoplasias Cutáneas , Humanos , Neoplasias Cutáneas/cirugía , Neoplasias Cutáneas/patología , Neoplasias Cutáneas/diagnóstico por imagen , Ultrasonografía , Cartílago Auricular/diagnóstico por imagen , Pabellón Auricular/cirugía , Pabellón Auricular/patología , Invasividad Neoplásica , Carcinoma Basocelular/cirugía , Carcinoma Basocelular/diagnóstico por imagen , Carcinoma Basocelular/patología , Neoplasias del Oído/cirugía , Neoplasias del Oído/diagnóstico por imagen , Neoplasias del Oído/patología , Masculino , Cirugía de Mohs , Femenino , AncianoRESUMEN
MySkinSelfie is a mobile phone application for skin self-monitoring, enabling secure sharing of patient-captured images with healthcare providers. This retrospective study assessed MySkinSelfie's role in remote skin cancer assessment at two centres for urgent (melanoma and squamous cell carcinoma) and nonurgent skin cancer referrals, investigating the feasibility of using patient-captured images without dermoscopy for remote diagnosis. The total number of lesions using MySkinSelfie was 814, with a mean patient age of 63â years. Remote consultations reduced face-to-face appointments by 90% for basal cell carcinoma and by 63% for referrals on a 2-week waiting list. Diagnostic concordance (consultant vs. histological diagnosis) rates of 72% and 83% were observed for basal cell carcinoma (n = 107) and urgent skin cancers (n = 704), respectively. Challenges included image quality, workflow integration and lack of dermoscopy. Higher sensitivities were observed in recent artificial intelligence algorithms employing dermoscopy. While patient-captured images proved useful during the COVID-19 pandemic, further research is needed to explore the feasibility of widespread patient-led dermoscopy to enable direct patient-to-artificial intelligence diagnostic assessment.
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Inteligencia Artificial , COVID-19 , Dermatología , Dermoscopía , Neoplasias Cutáneas , Telemedicina , Humanos , COVID-19/epidemiología , Neoplasias Cutáneas/diagnóstico , Neoplasias Cutáneas/diagnóstico por imagen , Neoplasias Cutáneas/patología , Persona de Mediana Edad , Estudios Retrospectivos , Dermatología/métodos , Dermoscopía/métodos , Masculino , Femenino , Anciano , Carcinoma de Células Escamosas/diagnóstico por imagen , Carcinoma de Células Escamosas/patología , Carcinoma de Células Escamosas/diagnóstico , Melanoma/diagnóstico por imagen , Melanoma/diagnóstico , Melanoma/patología , Carcinoma Basocelular/diagnóstico por imagen , Carcinoma Basocelular/diagnóstico , Carcinoma Basocelular/patología , Aplicaciones Móviles , SARS-CoV-2 , Consulta Remota , Adulto , Derivación y ConsultaRESUMEN
PURPOSE: Real-time assessment of surgical margins is critical for favorable outcomes in cancer patients. The iKnife is a mass spectrometry device that has demonstrated potential for margin detection in cancer surgery. Previous studies have shown that using deep learning on iKnife data can facilitate real-time tissue characterization. However, none of the existing literature on the iKnife facilitate the use of publicly available, state-of-the-art pretrained networks or datasets that have been used in computer vision and other domains. METHODS: In a new framework we call ImSpect, we convert 1D iKnife data, captured during basal cell carcinoma (BCC) surgery, into 2D images in order to capitalize on state-of-the-art image classification networks. We also use self-supervision to leverage large amounts of unlabeled, intraoperative data to accommodate the data requirements of these networks. RESULTS: Through extensive ablation studies, we show that we can surpass previous benchmarks of margin evaluation in BCC surgery using iKnife data, achieving an area under the receiver operating characteristic curve (AUC) of 81%. We also depict the attention maps of the developed DL models to evaluate the biological relevance of the embedding space CONCLUSIONS: We propose a new method for characterizing tissue at the surgical margins, using mass spectrometry data from cancer surgery.
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Carcinoma Basocelular , Márgenes de Escisión , Espectrometría de Masas , Neoplasias Cutáneas , Humanos , Espectrometría de Masas/métodos , Carcinoma Basocelular/cirugía , Carcinoma Basocelular/diagnóstico por imagen , Carcinoma Basocelular/patología , Neoplasias Cutáneas/cirugía , Neoplasias Cutáneas/diagnóstico por imagen , Aprendizaje Automático Supervisado , Aprendizaje ProfundoAsunto(s)
Enfermedad de Bowen , Carcinoma Basocelular , Enfermedades de la Piel , Neoplasias Cutáneas , Humanos , Enfermedad de Bowen/diagnóstico por imagen , Enfermedad de Bowen/patología , Imágenes Hiperespectrales , Carcinoma Basocelular/diagnóstico por imagen , Neoplasias Cutáneas/diagnóstico por imagen , Neoplasias Cutáneas/patologíaRESUMEN
Non-invasive diagnostics like line-field confocal optical coherence tomography (LC-OCT) are being implemented in dermato-oncology. However, unification of terminology in LC-OCT is lacking. By reviewing the LC-OCT literature in the field of dermato-oncology, this study aimed to develop a unified terminological glossary integrated with traditional histopathology. A PRISMA-guided literature-search was conducted for English-language publications on LC-OCT of actinic keratosis (AK), keratinocyte carcinoma (KC), and malignant melanoma (MM). Study characteristics and terminology were compiled. To harmonize LC-OCT terminology and integrate with histopathology, synonymous terms for image features of AK, KC, and MM were merged by two authors, organized by skin layer and lesion-type. A subset of key LC-OCT image-markers with histopathological correlates that in combination were typical of AK, squamous cell carcinoma in situ (SCCis), invasive squamous cell carcinoma (SCC), basal cell carcinoma (BCC), and MM in traditional histopathology, were selected from the glossary by an experienced dermatopathologist. Seventeen observational studies of AK (7 studies), KC (13 studies), MM (7 studies) utilizing LC-OCT were included, with 117 terms describing either AK, KC, or MM. These were merged to produce 45 merged-terms (61.5% reduction); 5 assigned to the stratum corneum (SC), 23 to the viable epidermis, 2 to dermo-epidermal junction (DEJ) and 15 to the dermis. For each lesion, mandatory key image-markers were a well-defined DEJ and presence of mild/moderate but not severe epidermal dysplasia for AK, severe epidermal dysplasia and well-defined DEJ for SCCis, interrupted DEJ and/or dermal broad infiltrative strands for invasive SCC, dermal lobules connected and/or unconnected to the epidermis for BCC, as well as single atypical melanocytes and/or nest of atypical melanocytes in the epidermis or dermis for MM. This review compiles evidence on LC-OCT in dermato-oncology, providing a harmonized histopathology-integrated terminology and key image-markers for each lesion. Further evaluation is required to determine the clinical value of these findings.
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Carcinoma Basocelular , Carcinoma de Células Escamosas , Queratosis Actínica , Melanoma , Neoplasias Cutáneas , Humanos , Tomografía de Coherencia Óptica/métodos , Neoplasias Cutáneas/diagnóstico por imagen , Neoplasias Cutáneas/patología , Queratosis Actínica/diagnóstico por imagen , Queratosis Actínica/patología , Melanoma/diagnóstico por imagen , Melanoma/patología , Carcinoma de Células Escamosas/diagnóstico por imagen , Carcinoma de Células Escamosas/patología , Carcinoma Basocelular/diagnóstico por imagenRESUMEN
La terminología usada para describir los diferentes hallazgos en la microscopía confocal de reflectancia (MCR), tanto en lesiones melanocíticas, como en no melanocíticas se ha consensuado en inglés. En el presente trabajo, se proponen los términos en español que mejor interpretan estos conceptos ya descritos para la MCR, mediante el consenso de expertos de distintas nacionalidades de habla hispana y utilizando el método DELPHI para el acuerdo final. Se obtuvieron 52 términos en total, de los cuales 28 fueron para lesiones melanocíticas y 24 para lesiones no melanocíticas. El uso de la nomenclatura propuesta permitirá una homogeneización y mejor entendimiento de las estructuras; una descripción más estandarizada en los registros clínicos y una mejor interpretación de estos informes por otros dermatólogos.(AU)
The terminology used to describe reflectance confocal microscopy (RCM) findings in both melanocytic and nonmelanocytic lesions has been standardized in English. We convened a panel of Spanish-speaking RCM experts and used the Delphi method to seek consensus on which Spanish terms best describe RCM findings in this setting. The experts agreed on 52 terms: 28 for melanocytic lesions and 24 for nonmelanocytic lesions. The resulting terminology will facilitate homogenization, leading to a better understanding of structures, more standardized descriptions in clinical registries, and easier interpretation of clinical reports exchanged between dermatologists.(AU)
Asunto(s)
Humanos , Masculino , Femenino , Terminología como Asunto , Microscopía Confocal , Hallazgos Morfológicos y Microscópicos , Carcinoma Basocelular/diagnóstico por imagen , Melanoma/microbiología , TraducciónRESUMEN
La terminología usada para describir los diferentes hallazgos en la microscopía confocal de reflectancia (MCR), tanto en lesiones melanocíticas, como en no melanocíticas se ha consensuado en inglés. En el presente trabajo, se proponen los términos en español que mejor interpretan estos conceptos ya descritos para la MCR, mediante el consenso de expertos de distintas nacionalidades de habla hispana y utilizando el método DELPHI para el acuerdo final. Se obtuvieron 52 términos en total, de los cuales 28 fueron para lesiones melanocíticas y 24 para lesiones no melanocíticas. El uso de la nomenclatura propuesta permitirá una homogeneización y mejor entendimiento de las estructuras; una descripción más estandarizada en los registros clínicos y una mejor interpretación de estos informes por otros dermatólogos.(AU)
The terminology used to describe reflectance confocal microscopy (RCM) findings in both melanocytic and nonmelanocytic lesions has been standardized in English. We convened a panel of Spanish-speaking RCM experts and used the Delphi method to seek consensus on which Spanish terms best describe RCM findings in this setting. The experts agreed on 52 terms: 28 for melanocytic lesions and 24 for nonmelanocytic lesions. The resulting terminology will facilitate homogenization, leading to a better understanding of structures, more standardized descriptions in clinical registries, and easier interpretation of clinical reports exchanged between dermatologists.(AU)