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Ex vivo confocal microscopy for surgical margin assessment: A histology‐compared study on 109 specimens

BACKGROUND: The assessment of surgical margins is mandatory to prevent local recurrence or distant dissemination of skin cancers. Histological examination of haematoxylin and eosin (H&E)‐stained slides from paraffin‐embedded or frozen samples is the gold standard for margin assessment, but is a...

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Autores principales: Grizzetti, L., Kuonen, F.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9168011/
https://www.ncbi.nlm.nih.gov/pubmed/35677928
http://dx.doi.org/10.1002/ski2.91
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author Grizzetti, L.
Kuonen, F.
author_facet Grizzetti, L.
Kuonen, F.
author_sort Grizzetti, L.
collection PubMed
description BACKGROUND: The assessment of surgical margins is mandatory to prevent local recurrence or distant dissemination of skin cancers. Histological examination of haematoxylin and eosin (H&E)‐stained slides from paraffin‐embedded or frozen samples is the gold standard for margin assessment, but is a time‐consuming procedure. Ex vivo confocal laser scanning microscopy (CLSM) is an upcoming technique that scans unfixed fresh tissue rapidly, allowing fast per‐operative margin assessment. OBJECTIVE: Here, we propose to assess the efficiency of a new ex vivo confocal microscope for the per‐operative assessment of surgical margins. METHODS: We analyzed 16 biopsies and 93 surgical specimens of basal cell and squamous cell carcinomas by ex vivo CLSM using Histolog® Scanner V2. Surgical specimens included fusiform excisions, slow‐Mohs peripheral and deep compartments, and Mohs excisions. The time required from surgical excision to image analysis was recorded and the quality of the images obtained for each specimen assessed. The presence or absence of tumour was estimated based on ex vivo CLSM images and compared with conventional H&E‐stained sections from paraffin‐embedded or frozen (Mohs) specimens. RESULTS: Mean time for specimen processing using Histolog Scanner was 5.1 ± 3.4 min. We obtained 89% of high quality images. Mean time for confocal image analysis was 1 ± 0.76 min. The diagnostic sensitivity and specificity for ex vivo CLSM compared to classical H&E procedures were respectively 93% and 100% when performed on tumour biopsies. The overall sensitivity and specificity for ex vivo CLSM for margin assessment compared to classical H&E procedures were respectively 61.5% and 95%, with variations depending on the type of tumour or surgical specimen analyzed. In particular, we obtained 80% sensitivity and 100% specificity for the assessment of BCC surgical margins. CONCLUSION: Our data suggest that ex vivo CLSM using Histolog® Scanner V2 could be a valid help for surgeons for a fast and accurate per‐operative margin analysis.
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spelling pubmed-91680112022-06-07 Ex vivo confocal microscopy for surgical margin assessment: A histology‐compared study on 109 specimens Grizzetti, L. Kuonen, F. Skin Health Dis Original Articles BACKGROUND: The assessment of surgical margins is mandatory to prevent local recurrence or distant dissemination of skin cancers. Histological examination of haematoxylin and eosin (H&E)‐stained slides from paraffin‐embedded or frozen samples is the gold standard for margin assessment, but is a time‐consuming procedure. Ex vivo confocal laser scanning microscopy (CLSM) is an upcoming technique that scans unfixed fresh tissue rapidly, allowing fast per‐operative margin assessment. OBJECTIVE: Here, we propose to assess the efficiency of a new ex vivo confocal microscope for the per‐operative assessment of surgical margins. METHODS: We analyzed 16 biopsies and 93 surgical specimens of basal cell and squamous cell carcinomas by ex vivo CLSM using Histolog® Scanner V2. Surgical specimens included fusiform excisions, slow‐Mohs peripheral and deep compartments, and Mohs excisions. The time required from surgical excision to image analysis was recorded and the quality of the images obtained for each specimen assessed. The presence or absence of tumour was estimated based on ex vivo CLSM images and compared with conventional H&E‐stained sections from paraffin‐embedded or frozen (Mohs) specimens. RESULTS: Mean time for specimen processing using Histolog Scanner was 5.1 ± 3.4 min. We obtained 89% of high quality images. Mean time for confocal image analysis was 1 ± 0.76 min. The diagnostic sensitivity and specificity for ex vivo CLSM compared to classical H&E procedures were respectively 93% and 100% when performed on tumour biopsies. The overall sensitivity and specificity for ex vivo CLSM for margin assessment compared to classical H&E procedures were respectively 61.5% and 95%, with variations depending on the type of tumour or surgical specimen analyzed. In particular, we obtained 80% sensitivity and 100% specificity for the assessment of BCC surgical margins. CONCLUSION: Our data suggest that ex vivo CLSM using Histolog® Scanner V2 could be a valid help for surgeons for a fast and accurate per‐operative margin analysis. John Wiley and Sons Inc. 2022-01-10 /pmc/articles/PMC9168011/ /pubmed/35677928 http://dx.doi.org/10.1002/ski2.91 Text en © 2022 The Authors. Skin Health and Disease published by John Wiley & Sons Ltd on behalf of British Association of Dermatologists. https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Articles
Grizzetti, L.
Kuonen, F.
Ex vivo confocal microscopy for surgical margin assessment: A histology‐compared study on 109 specimens
title Ex vivo confocal microscopy for surgical margin assessment: A histology‐compared study on 109 specimens
title_full Ex vivo confocal microscopy for surgical margin assessment: A histology‐compared study on 109 specimens
title_fullStr Ex vivo confocal microscopy for surgical margin assessment: A histology‐compared study on 109 specimens
title_full_unstemmed Ex vivo confocal microscopy for surgical margin assessment: A histology‐compared study on 109 specimens
title_short Ex vivo confocal microscopy for surgical margin assessment: A histology‐compared study on 109 specimens
title_sort ex vivo confocal microscopy for surgical margin assessment: a histology‐compared study on 109 specimens
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9168011/
https://www.ncbi.nlm.nih.gov/pubmed/35677928
http://dx.doi.org/10.1002/ski2.91
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