title: Optical techniques for the noninvasive diagnosis of skin cancer.
abstract: OBJECTIVE
  The aim of this paper is to provide an overview of the most investigated optical diagnostic techniques: optical coherence tomography, fluorescence spectrometry, reflectance spectrometry, Raman spectroscopy, and confocal microscopy.
  
  
  METHODS
  A search of three databases was conducted using specific keywords and explicit inclusion and exclusion criteria for the analysis of the performances of these techniques in the pre- and postoperative diagnosis of skin cancers.
  
  
  RESULTS
  Optical coherence tomography has shown promising results in the assessment of deep margins of skin tumors and inflammatory skin diseases, but differentiating premalignant from malignant lesions proved to be less effective. Fluorescence spectroscopy proved to be effective in revealing the biochemical composition of tissue; early detection of malignant melanoma was reliable only with stepwise two-photon excitation of melanin, while tumoral margin assessment and differential diagnosis between malignant and non-malignant lesions showed some conflicting results. Characterization of the structural properties of tissue can be made using diffuse reflectance spectrometry, and the values of the specificity and sensitivity of this method are ranging between 72-92 % and 64-92 %, respectively. Raman spectroscopy proved to have better results both in carcinoma and melanoma diagnosis with sensitivities and specificities above 90 % and high above 50 %, respectively. Confocal microscopy is the closest technique to pathological examination and has gained the most clinical acceptance, despite the need for a standardization of the interpretation algorithm.
  
  
  CONCLUSIONS
  In conclusion, these optical techniques proved to be effective in the diagnosis of skin cancer, but further studies are needed in finding the appropriate method or combination of methods that can have wide clinical applications.
authors.affiliation: National Institute of Research and Development for Optoelectronics INOE 2000, 409 Atomistilor Street, PO Box MG5, 077125 Magurele, Ilfov, Romania. mantonina_calin@yahoo.com
authors.forename: Mihaela Antonina
authors.initials: MA
authors.lastname: Calin
authors.forename: Sorin Viorel
authors.initials: SV
authors.lastname: Parasca
authors.forename: Roxana
authors.initials: R
authors.lastname: Savastru
authors.forename: Marian Romeo
authors.initials: MR
authors.lastname: Calin
authors.forename: Simona
authors.initials: S
authors.lastname: Dontu
mesh_terms: D006801:Humans; D008545:Melanoma / Q000175:diagnosis*; D018613:Microscopy, Confocal; D061848:Optical Imaging; D012680:Sensitivity and Specificity; D012878:Skin Neoplasms / Q000175:diagnosis*; D013050:Spectrometry, Fluorescence; D013059:Spectrum Analysis, Raman; D041623:Tomography, Optical Coherence
references.citation: Dermatol Surg. 2012 Feb;38(2):215-23
references.pmid: 22093365
references.citation: J Invest Dermatol. 2001 Dec;117(6):1452-7
references.pmid: 11886508
references.citation: J Am Acad Dermatol. 2006 Jul;55(1):88-97
references.pmid: 16781299
references.citation: Arch Dermatol. 2008 Dec;144(12):1597-608
references.pmid: 19075142
references.citation: Br J Dermatol. 2010 Dec;163(6):1218-28
references.pmid: 20874785
references.citation: J Biophotonics. 2012 Mar;5(3):240-54
references.pmid: 22308093
references.citation: J Dermatol Sci. 2005 Nov;40(2):85-94
references.pmid: 16139481
references.citation: J Biomed Opt. 2008 Jan-Feb;13(1):014017
references.pmid: 18315375
references.citation: Gastrointest Endosc. 2000 Apr;51(4 Pt 1):474-9
references.pmid: 10744825
references.citation: Eur J Dermatol. 2009 Mar-Apr;19(2):135-40
references.pmid: 19106058
references.citation: J Biomed Opt. 2009 May-Jun;14(3):034033
references.pmid: 19566326
references.citation: Acta Cir Bras. 2010 Aug;25(4):351-6
references.pmid: 20676494
references.citation: J Invest Dermatol. 2004 Feb;122(2):443-9
references.pmid: 15009728
references.citation: Anal Chem. 2007 Apr 1;79(7):2658-73
references.pmid: 17338507
references.citation: G Ital Dermatol Venereol. 2012 Apr;147(2):171-8
references.pmid: 22481580
references.citation: J Biomed Opt. 2012 Jul;17(7):077003
references.pmid: 22894516
references.citation: Cancer Res. 2012 May 15;72(10):2491-500
references.pmid: 22434431
references.citation: J Biomed Opt. 2008 Jan-Feb;13(1):014003
references.pmid: 18315361
references.citation: Med Eng Phys. 2005 Apr;27(3):237-44
references.pmid: 15694607
references.citation: Dermatology. 2007;215(4):365-72
references.pmid: 17912001
references.citation: Ann Biomed Eng. 2009 Aug;37(8):1546-59
references.pmid: 19521772
references.citation: Dermatol Surg. 2008 May;34(5):610-9
references.pmid: 18261097
references.citation: Lasers Surg Med. 2012 Apr;44(4):271-6
references.pmid: 22170313
references.citation: Dermatol Surg. 2009 Jun;35(6):965-72
references.pmid: 19397661
references.citation: Arch Dermatol. 2004 Sep;140(9):1127-32
references.pmid: 15381554
references.citation: J Am Acad Dermatol. 2003 May;48(5):727-34
references.pmid: 12734502
references.citation: Lasers Surg Med. 2010 Dec;42(10):716-27
references.pmid: 21246575
references.citation: Ann Biomed Eng. 2009 Jul;37(7):1464-73
references.pmid: 19365729
references.citation: J Invest Dermatol. 2010 Aug;130(8):2080-91
references.pmid: 20393481
references.citation: Photodiagnosis Photodyn Ther. 2012 Dec;9(4):293-8
references.pmid: 23200008
references.citation: Vasc Med. 2009 Feb;14(1):63-71
references.pmid: 19144781
references.citation: Nanomedicine. 2012 Jul;8(5):545-58
references.pmid: 22024196
references.citation: Endoscopy. 2007 Jul;39(7):599-605
references.pmid: 17611914
references.citation: Photodermatol Photoimmunol Photomed. 2008 Apr;24(2):67-71
references.pmid: 18353085
references.citation: Prog Retin Eye Res. 2008 Jan;27(1):45-88
references.pmid: 18036865
references.citation: J Biomed Opt. 2005 Nov-Dec;10(6):064020
references.pmid: 16409085
references.citation: J Biomed Opt. 2011 Jul;16(7):077006
references.pmid: 21806286
references.citation: Ned Tijdschr Geneeskd. 2005 Aug 20;149(34):1884-91
references.pmid: 16136741
references.citation: J Biomed Opt. 2002 Oct;7(4):618-27
references.pmid: 12421130
references.citation: Dermatol Surg. 2007 Apr;33(4):421-5; discussion 425-6
references.pmid: 17430375
references.citation: J Biomed Opt. 2006 May-Jun;11(3):34010
references.pmid: 16822060
references.citation: J Biomed Opt. 2006 Mar-Apr;11(2):021003
references.pmid: 16674178
references.citation: Dermatology. 2010;220(1):15-24
references.pmid: 19907131
references.citation: J Clin Dent. 2003;14(1):7-10
references.pmid: 12619263
references.citation: J Biomed Opt. 2012 Oct;17(10):107004
references.pmid: 23052563
references.citation: Appl Opt. 2010 Apr 1;49(10):1707-19
references.pmid: 20357850
references.citation: Wiley Interdiscip Rev Nanomed Nanobiotechnol. 2010 Jul-Aug;2(4):349-66
references.pmid: 20564463
references.citation: Photodermatol Photoimmunol Photomed. 2010 Dec;26(6):297-302
references.pmid: 21091787
references.citation: Pigment Cell Melanoma Res. 2011 Jun;24(3):438-45
references.pmid: 21457482
references.citation: Acta Derm Venereol. 2012 Mar;92(2):132-7
references.pmid: 22002855
references.citation: Br J Dermatol. 2010 Jun;162(6):1370-6
references.pmid: 20302577
references.citation: Klin Oczna. 2010;112(4-6):138-46
references.pmid: 20825070
references.citation: Photomed Laser Surg. 2007 Dec;25(6):482-6
references.pmid: 18158749
references.citation: Br J Dermatol. 2008 Feb;158(2):329-33
references.pmid: 18215250
references.citation: J Biomed Opt. 2009 Sep-Oct;14(5):054031
references.pmid: 19895133
references.citation: Lasers Surg Med. 2007 Oct;39(9):687-95
references.pmid: 17960754
references.citation: Biomed Opt Express. 2012 Oct 1;3(10):2395-404
references.pmid: 23082281
references.citation: Acta Cir Bras. 2010 Oct;25(5):434-9
references.pmid: 20877954
references.citation: Photodiagnosis Photodyn Ther. 2012 Jun;9(2):132-41
references.pmid: 22594983
references.citation: Lasers Surg Med. 2009 Feb;41(2):96-103
references.pmid: 19226578
references.citation: Lasers Surg Med. 2008 Sep;40(7):461-7
references.pmid: 18727020
references.citation: J Am Acad Dermatol. 2006 Sep;55(3):408-12
references.pmid: 16908344
references.citation: J Eur Acad Dermatol Venereol. 2013 Jan;27(1):e97-104
references.pmid: 22540280
references.citation: Dermatology. 1995;191(2):93-8
references.pmid: 8520074
references.citation: Comput Methods Programs Biomed. 1995 Jul;47(2):131-46
references.pmid: 7587160
references.citation: Skin Res Technol. 2008 Aug;14(3):364-9
references.pmid: 19159385
references.citation: Arch Dermatol Res. 2009 Apr;301(4):289-94
references.pmid: 18979108
references.citation: Actas Dermosifiliogr. 2009 Dec;100 Suppl 2:59-69
references.pmid: 20096164
references.citation: J Invest Dermatol. 2007 Dec;127(12):2759-65
references.pmid: 17657243
references.citation: J Biomed Opt. 2011 Feb;16(2):020501
references.pmid: 21361657
references.citation: Dermatol Pract Concept. 2012 Apr 30;2(2):202a10
references.pmid: 23785598
references.citation: J Am Acad Dermatol. 2004 Feb;50(2):220-8
references.pmid: 14726876
references.citation: Br J Dermatol. 2009 Dec;161(6):1307-16
references.pmid: 19566662
references.citation: Technol Cancer Res Treat. 2003 Dec;2(6):525-35
references.pmid: 14640764
references.citation: Cancer Res. 2012 Jun 1;72(11):2738-45
references.pmid: 22491533
references.citation: Cancer Res. 2006 Mar 15;66(6):3317-22
references.pmid: 16540686
references.citation: Annu Rev Phys Chem. 1996;47:555-606
references.pmid: 8930102
references.citation: Croat Med J. 1999 Sep;40(3):346-52
references.pmid: 10411961
references.citation: Cancer. 2006 Jul 1;107(1):193-200
references.pmid: 16615102
references.citation: Clin Exp Dermatol. 2007 Jul;32(4):423-9
references.pmid: 17459066
references.citation: Annu Int Conf IEEE Eng Med Biol Soc. 2008;2008:3107-9
references.pmid: 19163364