Confocal imaging of carbon dioxide laser-ablated basal cell carcinomas: An ex-vivo study on the uptake of contrast agent and ablation parameters.
Confocal imaging of carbon dioxide laser-ablated basal cell carcinomas: An ex-vivo study on the uptake of contrast agent and ablation parameters.
复制标题
二氧化碳激光消融基底细胞癌的共焦成像：关于造影剂摄取和消融参数的离体研究。
DOI：
10.1002/lsm.22415
复制
发表时间：
2016
影响因子：
2.4
通讯作者：
Rajadhyaksha,Milind
中科院分区：
文献类型：
--
作者：
Sierra,Heidy;Damanpour,Shadi;Hibler,Brian;Nehal,Kishwer;Rossi,Anthony;Rajadhyaksha,Milind
背景与目的激光消融治疗浅表性及早期结节性基底细胞癌是一种有效的微创治疗方法。然而，消融后缺乏组织学证实导致复发率的高变异性，这一直是一个限制。反射共聚焦显微镜(RCM)成像结合造影剂，可以直接检测患者身上是否有残留的基底细胞癌肿瘤，从而提供非侵入性的组织学样反馈来指导消融。本研究的目的是确定有效的CO2激光消融参数(消融剂量、消融次数)，使消融后组织既能去除基底细胞癌，又能控制热凝区，从而能够摄取造影剂和RCM成像。材料与方法我们使用72例废弃的新鲜正常皮肤标本和冰冻的基底细胞癌标本来表征消融深度，评估对比剂的摄取和图像质量。在消融前和消融后的成像过程中，使用醋酸来增强核的亮度(“乙酰白化”)。结果1-3次5.5 J/cm2、6.5和7.5 J/cm2，1-2次8.5 J/cm2显示消融后组织摄取醋酸对比剂，RCM成像显示消融后组织中有无残留的基底细胞癌。结论使用有效的消融参数可以使RCM成像能够指导消融。激光外科医生。2016年48：133-139。©2015 Wiley期刊，Inc.
Background and ObjectivesLaser ablation can be an effective treatment for the minimally invasive removal of superficial and early nodular basal cell carcinomas (BCCs). However, the lack of histological confirmation after ablation results in high variability of recurrence rates and has been a limitation. Reflectance confocal microscopy (RCM) imaging, combined with a contrast agent, may detect the presence (or absence) of residual BCC tumors directly on the patient and thus provide noninvasive histology‐like feedback to guide ablation. The goal of thisex vivobench‐top study was to determine affective ablation parameters (fluence, number of passes) for a CO2 laser that will allow both removal of BCCs and control of the underlying thermal coagulation zone in post‐ablated tissue to enable uptake of contrast agent and RCM imaging.Materials and MethodsWe used 72 discarded fresh normal skin specimens and frozen BCC tumor specimens to characterize the depth of ablation and to evaluate uptake of contrast agent and image quality. Acetic acid was used to enhance nuclear brightness (“acetowhitening”) during imaging pre‐ and post‐ablation. Histology sections of the post‐ablated imaged surface were visually examined for the appearance of nuclear and dermal morphology and compared to the RCM images.ResultsResults for 1–3 passes of 5.5 J/cm2, 6.5 and 7.5 J/cm2, and 1–2 passes of 8.5 J/cm2showed the uptake of acetic acid for contrast and RCM imaging of the presence and absence of residual BCC tumors in post‐ablated tissue. Morphologic details in the images were validated by the histology.ConclusionThe use of effective ablation parameters may enable RCM imaging to guide ablation. Lasers Surg. Med. 48:133–139, 2016. © 2015 Wiley Periodicals, Inc.