title: Multiphoton laser tomography and fluorescence lifetime imaging of basal cell carcinoma: morphologic features for non-invasive diagnostics.
abstract: Multiphoton laser tomography (MPT) combined with fluorescence lifetime imaging (FLIM) is a non-invasive imaging technique, which gives access to the cellular and extracellular morphology of the skin. The aim of our study was to assess the sensitivity and specificity of MPT/FLIM descriptors for basal cell carcinoma (BCC), to improve BCC diagnosis and the identification of tumor margins. In the preliminary study, FLIM images referring to 35 BCCs and 35 healthy skin samples were evaluated for the identification of morphologic descriptors characteristic of BCC. In the main study, the selected parameters were blindly evaluated on a test set comprising 63 BCCs, 63 healthy skin samples and 66 skin lesions. Moreover, FLIM values inside a region of interest were calculated on 98 healthy skin and 98 BCC samples. In the preliminary study, three epidermal descriptors and 7 BCC descriptors were identified. The specificity of the diagnostic criteria versus 'other lesions' was extremely high, indicating that the presence of at least one BCC descriptor makes the diagnosis of 'other lesion' extremely unlikely. FLIM values referring to BCC cells significantly differed from those of healthy skin. In this study, we identified morphological and numerical descriptors enabling the differentiation of BCC from other skin disorders and its distinction from healthy skin in ex vivo samples. In future, MPT/FLIM may be applied to skin lesions to provide direct clinical guidance before biopsy and histological examination and for the identification of tumor margins allowing a complete surgical removal.
authors.affiliation: Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy. stefania.seidenari@unimore.it
authors.forename: Stefania
authors.initials: S
authors.lastname: Seidenari
authors.forename: Federica
authors.initials: F
authors.lastname: Arginelli
authors.forename: Christopher
authors.initials: C
authors.lastname: Dunsby
authors.forename: Paul
authors.initials: P
authors.lastname: French
authors.forename: Karsten
authors.initials: K
authors.lastname: König
authors.forename: Cristina
authors.initials: C
authors.lastname: Magnoni
authors.forename: Marco
authors.initials: M
authors.lastname: Manfredini
authors.forename: Clifford
authors.initials: C
authors.lastname: Talbot
authors.forename: Giovanni
authors.initials: G
authors.lastname: Ponti
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002280:Basal Cell Carcinoma / Q000175:diagnosis / Q000473:pathology*; D016022:Case-Control Studies; D003952:Diagnostic Imaging / Q000379:methods; D005260:Female; D006801:Humans; D007834:Lasers; D008297:Male; D008875:Middle Aged; D061848:Optical Imaging / Q000379:methods*; D012680:Sensitivity and Specificity; D012867:Skin / Q000473:pathology*; D012878:Skin Neoplasms / Q000175:diagnosis / Q000473:pathology*; D014054:Tomography / Q000379:methods*