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Journal of Biomedical Optics

Sensitivity and specificity for detecting basal cell carcinomas in Mohs excisions with confocal fluorescence mosaicing microscopy
Author(s): Daniel S. Gareau; Julie K. Karen; Stephen W. Dusza; Marie Tudisco; Kishwer S. Nehal; Milind Rajadhyaksha
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Paper Abstract

Recent studies have demonstrated the ability of confocal fluorescence mosaicing microscopy to rapidly detect basal cell carcinomas (BCCs) directly in thick and fresh Mohs surgical excisions. Mosaics of confocal images display large areas of tissue with high resolution and magnification equivalent to 2×, which is the standard magnification when examining pathology. Comparison of mosaics to Mohs frozen histopathology was shown to be excellent for all types of BCCs. However, comparisons in the previous studies were visual and qualitative. In this work, we report the results of a semiquantitative preclinical study in which 45 confocal mosaics are blindly evaluated for the presence (or absence) of BCC tumor. The evaluations are made by two clinicians: a senior Mohs surgeon with prior expertise in interpreting confocal images, and a novice Mohs fellow with limited experience. The blinded evaluation is compared to the gold standard of frozen histopathology. BCCs are detected with an overall sensitivity of 96.6%, specificity of 89.2%, positive predictive value of 93.0%, and negative predictive value of 94.7%. The results demonstrate the potential clinical utility of confocal mosaicing microscopy toward rapid surgical pathology at the bedside to expedite and guide surgery.

Paper Details

Date Published: 1 May 2009
PDF: 7 pages
J. Biomed. Opt. 14(3) 034012 doi: 10.1117/1.3130331
Published in: Journal of Biomedical Optics Volume 14, Issue 3
Show Author Affiliations
Daniel S. Gareau, Oregon Health & Science Univ. (United States)
Julie K. Karen, Memorial Sloan-Kettering Cancer Ctr. (United States)
Stephen W. Dusza, Memorial Sloan-Kettering Cancer Ctr. (United States)
Marie Tudisco, Memorial Sloan-Kettering Cancer Ctr. (United States)
Kishwer S. Nehal, Memorial Sloan-Kettering Cancer Ctr. (United States)
Milind Rajadhyaksha, Memorial Sloan-Kettering Cancer Ctr. (United States)

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