title: Confocal microscopy to guide erbium:yttrium aluminum garnet laser ablation of basal cell carcinoma: an ex vivo feasibility study.
abstract: For the removal of superficial and nodular basal cell carcinomas (BCCs), laser ablation provides certain advantages relative to other treatment modalities. However, efficacy and reliability tend to be variable because tissue is vaporized such that none is available for subsequent histopathological examination for residual BCC (and to confirm complete removal of tumor). Intra-operative reflectance confocal microscopy (RCM) may provide a means to detect residual tumor directly on the patient and guide ablation. However, optimization of ablation parameters will be necessary to control collateral thermal damage and preserve sufficient viability in the underlying layer of tissue, so as to subsequently allow labeling of nuclear morphology with a contrast agent and imaging of residual BCC. We report the results of a preliminary study of two key parameters (fluence, number of passes) vis-à-vis the feasibility of labeling and RCM imaging in human skin ex vivo, following ablation with an erbium:yttrium aluminum garnet laser.
authors.forename: Heidy
authors.initials: H
authors.lastname: Sierra
authors.forename: Bjorg A
authors.initials: BA
authors.lastname: Larson
authors.forename: Chih-Shan Jason
authors.initials: CS
authors.lastname: Chen
authors.forename: Milind
authors.initials: M
authors.lastname: Rajadhyaksha
mesh_terms: D002280:Basal Cell Carcinoma / Q000737:chemistry* / Q000601:surgery; D005240:Feasibility Studies; D006651:Histocytochemistry; D006801:Humans; D053685:Laser Therapy / Q000379:methods*; D053844:Lasers, Solid-State; D018613:Microscopy, Confocal / Q000379:methods*; D008954:Models, Biological; D012867:Skin / Q000528:radiation effects; D012878:Skin Neoplasms / Q000737:chemistry* / Q000601:surgery
references.citation: Dermatol Surg. 2005 May;31(5):538-41
references.pmid: 15962737
references.citation: Lasers Surg Med. 2011 Feb;43(2):68-71
references.pmid: 21384386
references.citation: J Microsc. 2009 Jan;233(1):149-59
references.pmid: 19196421
references.citation: Photomed Laser Surg. 2012 Apr;30(4):200-5
references.pmid: 22316283
references.citation: Dermatol Surg. 1998 Jun;24(6):653-8; discussion 658-9
references.pmid: 9648573
references.citation: Br J Dermatol. 2012 May;166(5):1069-80
references.pmid: 22251204
references.citation: Lasers Surg Med. 2004;34(2):114-9
references.pmid: 15004822
references.citation: Dermatol Pract Concept. 2012 Apr 30;2(2):202a10
references.pmid: 23785598
references.citation: Br J Dermatol. 2010 Dec;163(6):1218-28
references.pmid: 20874785
references.citation: Australas J Dermatol. 2011 Aug;52(3):179-85
references.pmid: 21834812
references.citation: Lasers Med Sci. 2011 Sep;26(5):641-4
references.pmid: 21748324
references.citation: Lasers Surg Med. 2011 Feb;43(2):72-8
references.pmid: 21384387
references.citation: J Biophotonics. 2014 Jul;7(7):534-41
references.pmid: 23509063
references.citation: J Clin Aesthet Dermatol. 2010 Jun;3(6):20-34
references.pmid: 20725548
references.citation: Semin Cutan Med Surg. 2011 Mar;30(1):14-25
references.pmid: 21540017
references.citation: Lasers Surg Med. 2008 Feb;40(2):153-8
references.pmid: 18306163
references.citation: Appl Opt. 1993 May 1;32(13):2447-54
references.pmid: 20820404
references.citation: Dermatol Surg. 2011 Apr;37(4):409-25
references.pmid: 21414072
references.citation: Lasers Surg Med. 1989;9(4):314-26
references.pmid: 2761327
references.citation: J Biomed Opt. 2007 May-Jun;12(3):034027
references.pmid: 17614735
references.citation: J Am Acad Dermatol. 2004 Dec;51(6):923-30
references.pmid: 15583584
references.citation: Dermatol Surg. 2003 Aug;29(8):839-46
references.pmid: 12859385
references.citation: J Invest Dermatol. 2012 Oct;132(10):2386-2394
references.pmid: 22718115
references.citation: Lasers Surg Med. 1989;9(4):327-37
references.pmid: 2761328
references.citation: Br J Dermatol. 2013 Jan;168(1):99-105
references.pmid: 23013443
references.citation: Arch Dermatol. 2010 Mar;146(3):283-7
references.pmid: 20231499
references.citation: Lasers Surg Med. 1997;20(3):242-7
references.pmid: 9138252