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Erschienen in: Lasers in Medical Science 5/2016

07.04.2016 | Original Article

Correlation of histological and ex-vivo confocal tumor thickness in malignant melanoma

verfasst von: Daniela Hartmann, Sebastian Krammer, Cristel Ruini, Thomas Ruzicka, Tanja von Braunmühl

Erschienen in: Lasers in Medical Science | Ausgabe 5/2016

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Abstract

The ex-vivo confocal laser scanning microscopy (ex-vivo CLSM) is a novel diagnostic method for fresh tissue examination, which has already shown promising results in the evaluation of healthy skin and different skin tumors. In malignant melanoma, the histological tumor thickness plays an essential role for further treatment strategies. The immediate perioperative measurement of tumor thickness by means of ex-vivo CLSM might accelerate the decision for further operating procedures in malignant melanoma. Ten histologically confirmed malignant melanomas from various donor sites were blindly examined by two investigators via ex-vivo CLSM and conventional light microscopy. The histopathological tumor thickness (HTT) and confocal tumor thickness (CTT) were measured independently and evaluated using correlation curves, Spearman’s correlation coefficient, and Bland-Altman plots. Bland-Altman plots for HTT and reflectance-mode CTT, as well as for fluorescence-mode CTT, showed high correlations. Spearman’s correlation coefficient of HTT and CTT was 1.00 in FM and RM. The mean difference of RM-CTT and FM-CTT versus HTT was 0.09 ± 0.30 mm and 0.19 ± 0.35 mm. In one case, the HTT was identical to the CTT in both modes. This pilot study shows high conformity of CTT and HTT measured in malignant melanoma underlining the potential of ex-vivo CLSM for perioperative decisions on safety margin excisions of malignant melanoma in the future.
Literatur
1.
Zurück zum Zitat Gartmann N, Brühwiler D (2009) Kontrolle und Visualisierung der Verteilung funktioneller Gruppen auf mesoporösem Siliciumdioxid. Angew Chem 121:6472–6475CrossRef Gartmann N, Brühwiler D (2009) Kontrolle und Visualisierung der Verteilung funktioneller Gruppen auf mesoporösem Siliciumdioxid. Angew Chem 121:6472–6475CrossRef
2.
Zurück zum Zitat Scharnagl N, Schossig M (2005) Charakterisierung von Membranen. Chem Ing Tech 77:517–526CrossRef Scharnagl N, Schossig M (2005) Charakterisierung von Membranen. Chem Ing Tech 77:517–526CrossRef
4.
Zurück zum Zitat Lange-Asschenfeldt S, Bob A, Terhorst D, Ulrich M, Fluhr J, Mendez G, Roewert-Huber H, Stockfleth E, Lange-Asschenfeldt B (2012) Applicability of confocal laser scanning microscopy for evaluation and monitoring of cutaneous wound healing. J Biomed Opt 17:076016. doi:10.1117/1.JBO.17.7.076016 PubMed Lange-Asschenfeldt S, Bob A, Terhorst D, Ulrich M, Fluhr J, Mendez G, Roewert-Huber H, Stockfleth E, Lange-Asschenfeldt B (2012) Applicability of confocal laser scanning microscopy for evaluation and monitoring of cutaneous wound healing. J Biomed Opt 17:076016. doi:10.​1117/​1.​JBO.​17.​7.​076016 PubMed
6.
Zurück zum Zitat Sattler EC, Maier T, Hoffmann VS, Hegyi J, Ruzicka T, Berking C (2012) Noninvasive in vivo detection and quantification of Demodex mites by confocal laser scanning microscopy. Br J Dermatol 167:1042–1047CrossRefPubMed Sattler EC, Maier T, Hoffmann VS, Hegyi J, Ruzicka T, Berking C (2012) Noninvasive in vivo detection and quantification of Demodex mites by confocal laser scanning microscopy. Br J Dermatol 167:1042–1047CrossRefPubMed
7.
Zurück zum Zitat Guitera P, Menzies SW, Longo C, Cesinaro AM, Scolyer RA, Pellacani G (2012) In vivo confocal microscopy for diagnosis of melanoma and basal cell carcinoma using a two-step method: analysis of 710 consecutive clinically equivocal cases. J Investig Dermatol 132:2386–2394CrossRefPubMed Guitera P, Menzies SW, Longo C, Cesinaro AM, Scolyer RA, Pellacani G (2012) In vivo confocal microscopy for diagnosis of melanoma and basal cell carcinoma using a two-step method: analysis of 710 consecutive clinically equivocal cases. J Investig Dermatol 132:2386–2394CrossRefPubMed
8.
Zurück zum Zitat Maier T, Sattler EC, Braun-Falco M, Korting HC, Ruzicka T, Berking C (2013) Reflectance confocal microscopy in the diagnosis of partially and completely amelanotic melanoma: report on seven cases. J Eur Acad Dermatol Venereol 27:e42–52CrossRefPubMed Maier T, Sattler EC, Braun-Falco M, Korting HC, Ruzicka T, Berking C (2013) Reflectance confocal microscopy in the diagnosis of partially and completely amelanotic melanoma: report on seven cases. J Eur Acad Dermatol Venereol 27:e42–52CrossRefPubMed
9.
Zurück zum Zitat Hartmann D, Ruini C, Mathemeier L, Dietrich A, Ruzicka T, von Braunmühl T (2015) Identification of ex-vivo confocal scanning microscopic features and their histological correlates in human skin. J Biophotonics. doi:10.1002/jbio.201500124 PubMed Hartmann D, Ruini C, Mathemeier L, Dietrich A, Ruzicka T, von Braunmühl T (2015) Identification of ex-vivo confocal scanning microscopic features and their histological correlates in human skin. J Biophotonics. doi:10.​1002/​jbio.​201500124 PubMed
10.
Zurück zum Zitat Longo C, Rajadhyaksha M, Ragazzi M, Nehal K, Gardini S, Moscarella E, Lallas A, Zalaudek I, Piana S, Argenziano G, Pellacani G (2014) Evaluating ex vivo fluorescence confocal microscopy images of basal cell carcinomas in Mohs excised tissue. Br J Dermatol 171:561–570CrossRefPubMed Longo C, Rajadhyaksha M, Ragazzi M, Nehal K, Gardini S, Moscarella E, Lallas A, Zalaudek I, Piana S, Argenziano G, Pellacani G (2014) Evaluating ex vivo fluorescence confocal microscopy images of basal cell carcinomas in Mohs excised tissue. Br J Dermatol 171:561–570CrossRefPubMed
11.
Zurück zum Zitat Karen JK, Gareau DS, Dusza SW, Tudisco M, Rajadhyaksha M, Nehal KS (2009) Detection of basal cell carcinomas in Mohs excisions with fluorescence confocal mosaicing microscopy. Br J Dermatol 160:1242–1250CrossRefPubMedPubMedCentral Karen JK, Gareau DS, Dusza SW, Tudisco M, Rajadhyaksha M, Nehal KS (2009) Detection of basal cell carcinomas in Mohs excisions with fluorescence confocal mosaicing microscopy. Br J Dermatol 160:1242–1250CrossRefPubMedPubMedCentral
12.
Zurück zum Zitat Gareau DS, Karen JK, Dusza SW, Tudisco M, Nehal KS, Rajadhyaksha M (2009) Sensitivity and specificity for detecting basal cell carcinomas in Mohs excisions with confocal fluorescence mosaicing microscopy. J Biomed Opt 14:34012CrossRef Gareau DS, Karen JK, Dusza SW, Tudisco M, Nehal KS, Rajadhyaksha M (2009) Sensitivity and specificity for detecting basal cell carcinomas in Mohs excisions with confocal fluorescence mosaicing microscopy. J Biomed Opt 14:34012CrossRef
13.
Zurück zum Zitat Longo C, Ragazzi M, Gardini S, Piana S, Moscarella E, Lallas A, Raucci M, Argenziano G, Pellacani G (2015) Ex vivo fluorescence confocal microscopy in conjunction with Mohs micrographic surgery for cutaneous squamous cell carcinoma. J Am Acad Dermatol 73:321–322CrossRefPubMed Longo C, Ragazzi M, Gardini S, Piana S, Moscarella E, Lallas A, Raucci M, Argenziano G, Pellacani G (2015) Ex vivo fluorescence confocal microscopy in conjunction with Mohs micrographic surgery for cutaneous squamous cell carcinoma. J Am Acad Dermatol 73:321–322CrossRefPubMed
14.
Zurück zum Zitat Bennàssar A, Vilata A, Puig S, Malvehy J (2014) Ex vivo fluorescence confocal microscopy for fast evaluation of tumour margins during Mohs surgery. J Br Dermatol 170:360–365CrossRef Bennàssar A, Vilata A, Puig S, Malvehy J (2014) Ex vivo fluorescence confocal microscopy for fast evaluation of tumour margins during Mohs surgery. J Br Dermatol 170:360–365CrossRef
15.
Zurück zum Zitat Longo C, Ragazzi M, Castagnetti F, Gardini S, Palmieri T, Lallas A, Moscarella E, Piana S, Pellacani G, Zalaudek I, Argenziano G (2013) Inserting ex vivo fluorescence confocal microscopy perioperatively in Mohs micrographic surgery expedites bedside assessment of excision margins in recurrent basal cell carcinoma. Dermatology 227:89–92CrossRefPubMed Longo C, Ragazzi M, Castagnetti F, Gardini S, Palmieri T, Lallas A, Moscarella E, Piana S, Pellacani G, Zalaudek I, Argenziano G (2013) Inserting ex vivo fluorescence confocal microscopy perioperatively in Mohs micrographic surgery expedites bedside assessment of excision margins in recurrent basal cell carcinoma. Dermatology 227:89–92CrossRefPubMed
16.
Zurück zum Zitat Hartmann D, Ruini C, Mathemeier L, Bachmann MR, Dietrich A, Ruzicka T, von Braunmühl T (2015) Identification of ex-vivo confocal laser scanning microscopic features of melanocytic lesions and their histological correlates. Submitted Hartmann D, Ruini C, Mathemeier L, Bachmann MR, Dietrich A, Ruzicka T, von Braunmühl T (2015) Identification of ex-vivo confocal laser scanning microscopic features of melanocytic lesions and their histological correlates. Submitted
17.
Zurück zum Zitat Engelhardt J, Knebel W (1993) Konfokale Laserscanning-Mikroskopie. Physik Unserer Zeit 24:70–78CrossRef Engelhardt J, Knebel W (1993) Konfokale Laserscanning-Mikroskopie. Physik Unserer Zeit 24:70–78CrossRef
18.
19.
Zurück zum Zitat Fitzpatrick TB (1975) Soleil et peau [Sun and skin]. J Med Esth Chir Dermatol 2:33–34 Fitzpatrick TB (1975) Soleil et peau [Sun and skin]. J Med Esth Chir Dermatol 2:33–34
20.
Zurück zum Zitat Fitzpatrick TB (1986) Ultraviolet-induced pigmentary changes: benefits and hazards. Curr Probl in Dermatol 15:25–38 Fitzpatrick TB (1986) Ultraviolet-induced pigmentary changes: benefits and hazards. Curr Probl in Dermatol 15:25–38
21.
Zurück zum Zitat Longo C, Ragazzi M, Gardini S, Moscarella E, Argenziano G (2015) Ex vivo fluorescence confocal microscopy of eccrine syringomatous carcinoma: a report of 2 cases. JAMA Dermatol 151:1034–1036CrossRefPubMed Longo C, Ragazzi M, Gardini S, Moscarella E, Argenziano G (2015) Ex vivo fluorescence confocal microscopy of eccrine syringomatous carcinoma: a report of 2 cases. JAMA Dermatol 151:1034–1036CrossRefPubMed
22.
Zurück zum Zitat Debarbieux S, Gaspar R, Depaepe L, Dalle S, Balme B, Thomas L (2015) Intraoperative diagnosis of nonpigmented nail tumours with ex vivo fluorescence confocal microscopy: 10 cases. Br J Dermatol 172:1037–1044CrossRefPubMed Debarbieux S, Gaspar R, Depaepe L, Dalle S, Balme B, Thomas L (2015) Intraoperative diagnosis of nonpigmented nail tumours with ex vivo fluorescence confocal microscopy: 10 cases. Br J Dermatol 172:1037–1044CrossRefPubMed
23.
Zurück zum Zitat Pflugfelder A, Kochs C, Blum A, Capellaro M, Czeschik C, Dettenborn T, Dill D, Dippel E, Eigentler T, Feyer P, Follmann M, Frerich B, Ganten M, Gärtner J, Gutzmer R, Hassel J, Hauschild A, Hohenberger P, Hübner J, Kaatz M, Kleeberg UR, Kölbl O, Kortmann R, Krause-Bergmann A, Kurschat P, Leiter U, Link H, Loquai C, Löser C, Mackensen A, Meier F, Mohr P, Möhrle M, Nashan D, Reske S, Rose C, Sander C, Satzger I, Schiller M, Schlemmer H, Strittmatter G, Sunderkötter C, Swoboda L, Trefzer U, Voltz R, Vordermark D, Weichenthal M, Werner A, Wesselmann S, Weyergraf AJ, Wick W, Garbe C, Schadendorf D (2013) Malignant melanoma S3-guideline “Diagnosis, therapy and follow-up of melanoma”. J Dtsch Dermatol Ges 11:1–116PubMed Pflugfelder A, Kochs C, Blum A, Capellaro M, Czeschik C, Dettenborn T, Dill D, Dippel E, Eigentler T, Feyer P, Follmann M, Frerich B, Ganten M, Gärtner J, Gutzmer R, Hassel J, Hauschild A, Hohenberger P, Hübner J, Kaatz M, Kleeberg UR, Kölbl O, Kortmann R, Krause-Bergmann A, Kurschat P, Leiter U, Link H, Loquai C, Löser C, Mackensen A, Meier F, Mohr P, Möhrle M, Nashan D, Reske S, Rose C, Sander C, Satzger I, Schiller M, Schlemmer H, Strittmatter G, Sunderkötter C, Swoboda L, Trefzer U, Voltz R, Vordermark D, Weichenthal M, Werner A, Wesselmann S, Weyergraf AJ, Wick W, Garbe C, Schadendorf D (2013) Malignant melanoma S3-guideline “Diagnosis, therapy and follow-up of melanoma”. J Dtsch Dermatol Ges 11:1–116PubMed
24.
Zurück zum Zitat Clark WHJR, From L, Bernardino EA, Mihm MC (1969) The histogenesis and biologic behavior of primary human malignant melanomas of the skin. Cancer Res 29:705–727PubMed Clark WHJR, From L, Bernardino EA, Mihm MC (1969) The histogenesis and biologic behavior of primary human malignant melanomas of the skin. Cancer Res 29:705–727PubMed
25.
Zurück zum Zitat Andres C, Schneider JJ, Sander C, Braun-Falco M, Haraida S, Hein R, Ihrler S, Flaig MJ (2011) Histopathologie und molekulare pathologie (Zytogenetik). In: Berking C (ed) Maligne melanome, 6th edn. Zuckschwerdt Verlag, München, pp 42–46 Andres C, Schneider JJ, Sander C, Braun-Falco M, Haraida S, Hein R, Ihrler S, Flaig MJ (2011) Histopathologie und molekulare pathologie (Zytogenetik). In: Berking C (ed) Maligne melanome, 6th edn. Zuckschwerdt Verlag, München, pp 42–46
26.
Zurück zum Zitat Buttner P, Garbe C, Bertz J, Burg G, d’Hoedt B, Drepper H, Guggenmoos-Holzmann I, Lechner W, Lippold A, Orfanos CE (1995) Primary cutaneous melanoma. Optimized cutoff points of tumor thickness and importance of Clark’s level for prognostic classification. Cancer 75:2499–2506CrossRefPubMed Buttner P, Garbe C, Bertz J, Burg G, d’Hoedt B, Drepper H, Guggenmoos-Holzmann I, Lechner W, Lippold A, Orfanos CE (1995) Primary cutaneous melanoma. Optimized cutoff points of tumor thickness and importance of Clark’s level for prognostic classification. Cancer 75:2499–2506CrossRefPubMed
27.
Zurück zum Zitat Garbe C, Peris K, Hauschild A, Saiag P, Middleton M, Spatz A, Grob J, Malvehy J, Newton-Bishop J, Stratigos A, Pehamberger H, Eggermont A (2012) Diagnosis and treatment of melanoma. European consensus-based interdisciplinary guideline—update 2012. Eur J Cancer 46:270–283CrossRef Garbe C, Peris K, Hauschild A, Saiag P, Middleton M, Spatz A, Grob J, Malvehy J, Newton-Bishop J, Stratigos A, Pehamberger H, Eggermont A (2012) Diagnosis and treatment of melanoma. European consensus-based interdisciplinary guideline—update 2012. Eur J Cancer 46:270–283CrossRef
Metadaten
Titel
Correlation of histological and ex-vivo confocal tumor thickness in malignant melanoma
verfasst von
Daniela Hartmann
Sebastian Krammer
Cristel Ruini
Thomas Ruzicka
Tanja von Braunmühl
Publikationsdatum
07.04.2016
Verlag
Springer London
Erschienen in
Lasers in Medical Science / Ausgabe 5/2016
Print ISSN: 0268-8921
Elektronische ISSN: 1435-604X
DOI
https://doi.org/10.1007/s10103-016-1936-5

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