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Proceedings Paper

Confocal microscopy of excised human skin using acetic acid and crossed polarization: rapid detection of nonmelanoma skin cancers
Author(s): Milind M. Rajadhyaksha; Gregg Menaker; Salvador Gonzalez
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Paper Abstract

Moh's micrographic surgery for basal- and squamous-cell cancers (BCCs, SCCs) involves precise excision of the tumor with minimal damage to the surrounding normal skin. Precise excision is guided by histopathologic examination for tumor margins; typically, 2 - 4 slices of skin are excised, and there is a waiting time of 15 - 45 minutes for the surgeon and patient while each slice is being processed for histopathology. We can avoid the processing by using a confocal reflectance microscope; confocal detection of BCCs and SCCs is possible after staining the nuclei in the excised skin with 5% acetic acid, and imaging in crossed polarization. The cancerous nuclei appear bright against the dark surrounding normal dermis. The contrast is due to increased back-scattering as well as increased depolarization from the intra-nuclear structure relative to that from the surrounding normal dermis. As in conventional histopathology, the tumors are first detected at low resolution (section thickness 20 micrometer) in a wide field (1-2 mm); nuclear morphology is then viewed at high resolution (section thickness 2 micrometer) in a small field (0.25 - 0.50 mm). Mosaics of images are assembled to produce confocal maps of the BCCs or SCCs within large excised tissue. Rapid detection (within minutes) is possible.

Paper Details

Date Published: 17 May 2000
PDF: 5 pages
Proc. SPIE 3907, Lasers in Surgery: Advanced Characterization, Therapeutics, and Systems X, (17 May 2000); doi: 10.1117/12.386240
Show Author Affiliations
Milind M. Rajadhyaksha, Lucid Inc. , Wellman Labs. of Photomedicine/Massachusetts General Hospital (United States)
Gregg Menaker, Wellman Labs. of Photomedicine, Massachusetts General Hospital, and Harvard Medical School (United States)
Salvador Gonzalez, Wellman Labs. of Photomedicine, Massachusetts General Hospital, and Harvard Medical School (United States)


Published in SPIE Proceedings Vol. 3907:
Lasers in Surgery: Advanced Characterization, Therapeutics, and Systems X
R. Rox Anderson; Kenton W. Gregory; Eugene A. Trowers; David S. Robinson; Kenneth Eugene Bartels; Lou Reinisch; Reza S. Malek; C. Gaelyn Garrett; Lloyd P. Tate; Hans-Dieter Reidenbach; Timothy A. Woodward; Kenneth Eugene Bartels; Lawrence S. Bass; George M. Peavy; C. Gaelyn Garrett; Kenton W. Gregory; Nikiforos Kollias; Harvey Lui; Reza S. Malek; George M. Peavy; Hans-Dieter Reidenbach; Lou Reinisch; David S. Robinson; Lloyd P. Tate; Eugene A. Trowers; Timothy A. Woodward, Editor(s)

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