Abstract
For the removal of superficial and nodular basal cell carcinomas (BCCs), laser ablation provides certain advantages relative to other treatment modalities. However, efficacy and reliability tend to be variable because tissue is vaporized such that none is available for subsequent histopathological examination for residual BCC (and to confirm complete removal of tumor). Intra-operative reflectance confocal microscopy (RCM) may provide a means to detect residual tumor directly on the patient and guide ablation. However, optimization of ablation parameters will be necessary to control collateral thermal damage and preserve sufficient viability in the underlying layer of tissue, so as to subsequently allow labeling of nuclear morphology with a contrast agent and imaging of residual BCC. We report the results of a preliminary study of two key parameters (fluence, number of passes) vis-à-vis the feasibility of labeling and RCM imaging in human skin ex vivo, following ablation with an erbium:yttrium aluminum garnet laser.
Highlights
About 3.5 million new cases of nonmelanoma skin cancers are diagnosed in the USA every year,[1] and the incidence rate is increasing in other parts of the world, as well.[2]
Histopathologic examination is necessary and usually performed to confirm complete removal of tumor
This process of excision in stages continues until the histopathology indicates complete removal of tumor.) For laser ablation, this limitation may be addressed with highresolution optical imaging that may detect basal cell carcinomas (BCCs) tumor directly on the patient
Summary
About 3.5 million new cases of nonmelanoma skin cancers are diagnosed in the USA every year,[1] and the incidence rate is increasing in other parts of the world, as well.[2]. An optimization of ablation parameters will be necessary to control the damage and preserve sufficient viability in the underlying tissue, so as to subsequently allow labeling of nuclear morphology with a contrast agent and imaging of residual BCC.
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