A pilot study of fluorescence diagnosis of basal cell carcinoma using a digital flash light-based imaging system.
OBJECTIVE
Fluorescence diagnosis (FD) is a promising method for the non-invasive detection of tumor boundaries. We aimed to investigate the clinical utility of a flash light-based fluorescence imaging system.


METHODS
Sixteen patients with basal cell carcinomas were included in this pilot study. FD was performed using a 20% 5-aminolevulinic acid (ALA) cream. The FD tumor area was determined 3 h after the ALA application using a digital flash light-based fluorescence imaging system and an image analysis system. The tumor area was also assessed by means of the clinical diagnosis (CD) based on the normal colored picture. The tumors were excised following the FD procedure, but according to the clinically diagnosed lesional area.


RESULTS
Though there was a very strong correlation between the tumor areas assessed by FD and CD, the mean tumor area that was visualized by FD was significantly smaller than the tumor area determined by CD. The mean+/-SD FD/CD ratio was 0.78+/-0.11 in total. In 81.3% of cases, complete tumor excision was achieved.


CONCLUSIONS
This pilot study indicates that the FD technology may be less sensitive than CD, and refinements of the technique along with larger systematic trials on the sensitivity and specificity of FD are required.
Gambichler
Thilo
T
Department of Dermatology, Ruhr-University Bochum, Bochum, Germany. t.gambichler@klinikum-bochum.de
Moussa
Georg
G
Altmeyer
Peter
P
D000368:Aged; D000369:Aged, 80 and over; D000622:Aminolevulinic Acid; D002280:Basal Cell Carcinoma / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D003952:Diagnostic Imaging; D005260:Female; D005453:Fluorescence; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008875:Middle Aged; D017319:Photosensitizing Agents; D010865:Pilot Projects; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D012878:Skin Neoplasms / Q000175:diagnosis* / Q000473:pathology
D017319:Photosensitizing Agents; D000622:Aminolevulinic Acid