title: Confocal laser scanning microscopy vs 3-dimensional histologic imaging in basal cell carcinoma.
abstract: OBJECTIVE
  To compare ex vivo confocal laser scanning microscopy (CLSM), which offers rapid images without the need for tissue processing, vs 3-dimensional histologic imaging, the criterion standard treatment for basal cell carcinomas in high-risk areas of the face.
  
  
  METHODS
  Single-center prospective trial.
  
  
  METHODS
  Dermatosurgical unit of a university hospital. Patients Seventy-two consecutive surgically removed basal cell carcinomas were examined using CLSM vs standard paraffin-embedded 3-dimensional histologic imaging. Interventions A total of 312 images, including 73 midsections, 196 lateral margins, 23 "muffins," and 20 "bread loaf sections," were obtained using CLSM. Immediately after surgery, the CLSM images were evaluated by the surgeon. The following day, the 3-dimensional histologic slides were evaluated and compared with the CLSM images.
  
  
  METHODS
  Diagnostic accuracy of ex vivo CLSM to detect tumor strands of basal cell carcinomas and the practicality of using CLSM vs 3-dimensional histologic slides in micrographic surgery.
  
  
  RESULTS
  The sensitivity of CLSM reached 94.0% in midsections, 73.7% in lateral margins, 80.0% in muffins, and 80.0% in bread loaf sections. The CLSM images were evaluated by the surgeon within 7.5 minutes.
  
  
  CONCLUSIONS
  Confocal laser scanning microscopy lacks high sensitivity to detect small tumor strands of basal cell carcinomas. In the future, CLSM may represent a time-saving and less expensive alternative to cryostat histopathologic examination.
authors: Department of Dermatology, University Hospital, Eberhard Karls University, Liebermeisterstrasse 25, Tübingen, Germany.
authors: Sarah
authors: S
authors: Ziefle
authors: Deborah
authors: D
authors: Schüle
authors: Helmut
authors: H
authors: Breuninger
authors: Wilfried
authors: W
authors: Schippert
authors: Matthias
authors: M
authors: Moehrle
mesh_terms: D002280:Basal Cell Carcinoma / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D005145:Face / Q000473:pathology; D006785:Hospitals, University; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D018613:Microscopy, Confocal / Q000379:methods*; D015580:Mohs Surgery / Q000379:methods; D016612:Paraffin Embedding; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D012878:Skin Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery