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Proceedings Paper

Reflectance confocal microscopy-guided laser ablation of basal cell carcinomas: initial in vivo results
Author(s): Heidy Sierra; Miguel Cordova; Oriol Yelamos; Chih-Shan Jason Chen; Milind Rajadhyaksha
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Paper Abstract

Laser ablation offers a procedure for precise, fast and minimally invasive removal of superficial and early nodular basal cell carcinomas (BCCs). However, the lack of histopathological confirmation has been a limitation toward widespread use in the clinic. A reflectance confocal microscopy (RCM) imaging-guided laser ablation approach offers cellular-level histopathology-like feedback directly on the patient, which may guide and help improve the efficacy of this procedure. We performed an initial study on 44 BCCs on 21 patients in vivo (based in an ex vivo bench-top study reported in our earlier papers), using a pulsed erbium: ytterbium aluminum garnet laser and a contrast agent (aluminum chloride). Initial 10 lesions, the RCM imaging-guided detection of either presence of residual tumor or complete clearance was immediately confirmed with histopathology. Additionally, 34 BCCs on 15 patients were treated with RCM imaging-guided laser ablation, and the clearance of tumor is currently being monitored with follow-up imaging (i. e., no histopathology) at 3, 6 and 18 months. Thus far, the imaging resolution appears to be sufficient and consistent for monitoring efficacy in the wound, both immediately post-ablation and subsequently during recovery. The efficacy appears to be promising. However, further investigation and optimization to image over the entire wound (without missing any areas) need to be investigated.

Paper Details

Date Published: 24 March 2017
PDF: 13 pages
Proc. SPIE 10060, Optical Biopsy XV: Toward Real-Time Spectroscopic Imaging and Diagnosis, 1006004 (24 March 2017); doi: 10.1117/12.2254741
Show Author Affiliations
Heidy Sierra, Univ. de Puerto Rico (United States)
Miguel Cordova, Memorial Sloan-Kettering Cancer Ctr. (United States)
Oriol Yelamos, Memorial Sloan-Kettering Cancer Ctr. (United States)
Chih-Shan Jason Chen, Memorial Sloan-Kettering Cancer Ctr. (United States)
Milind Rajadhyaksha, Memorial Sloan-Kettering Cancer Ctr. (United States)

Published in SPIE Proceedings Vol. 10060:
Optical Biopsy XV: Toward Real-Time Spectroscopic Imaging and Diagnosis
Robert R. Alfano; Stavros G. Demos, Editor(s)

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