title: 'En face' ex vivo reflectance confocal microscopy to help the surgery of basal cell carcinoma of the eyelid.
abstract: BACKGROUND
  Ex vivo confocal microscopy is a recent imaging technique for the perioperative control of skin tumour margins. Up to date, it has been used in the fluorescence mode and with vertical sections of the specimen margins. The aim of this study was to evaluate its use in the reflectance mode and with a horizontal ('en face') scanning of the surgical specimen in a series of basal cell carcinoma of the eyelid.
  
  
  METHODS
  Prospective consecutive cohort study was performed at the University Hospital of Saint-Etienne, France.
  
  
  METHODS
  Forty-one patients with 42 basal cell carcinoma of the eyelid participated in this study.
  
  
  METHODS
  Basal cell carcinomas were excised with a 2-mm-wide clinically safe margin. The surgical specimens were analysed under ex vivo confocal microscopy in the reflectance mode and with an en face scanning in order to control at a microscopic level if the margins were free from tumour invasion. Histopathogical examination was later performed in order to compare the results.
  
  
  METHODS
  Sensitivity and specificity of ex vivo confocal microscopy for the presence of tumour-free margins.
  
  
  RESULTS
  Ex vivo confocal microscopy results were consistent with histopathology in all cases (tumour-free margins in 40 out of 42 samples; sensitivity and specificity of 100%).
  
  
  CONCLUSIONS
  Ex vivo confocal microscopy in the reflectance mode with an 'en face' scanning can control tumour margins of eyelid basal cell carcinomas and optimize their surgical management. This procedure has the advantage on the fluorescent mode of not needing any contrast agent to examine the samples.
authors.affiliation: Department of Ophthalmology, University Hospital of St-Etienne, Saint Etienne, France.|Department of Biology, Engineering and Imaging of Corneal Graft Laboratory, Institute of Research in Sciences and Health Engineering, EA2512, Jean Monnet University, Saint-Etienne, France.
authors.forename: Marine
authors.initials: M
authors.lastname: Espinasse
authors.affiliation: Department of Dermatology, University Hospital of St-Etienne, Saint Etienne, France.
authors.forename: Elisa
authors.identifier: http://orcid.org/0000-0002-4009-0659
authors.initials: E
authors.lastname: Cinotti
authors.affiliation: Department of Ophthalmology, University Hospital of St-Etienne, Saint Etienne, France.|Department of Biology, Engineering and Imaging of Corneal Graft Laboratory, Institute of Research in Sciences and Health Engineering, EA2512, Jean Monnet University, Saint-Etienne, France.
authors.forename: Damien
authors.initials: D
authors.lastname: Grivet
authors.affiliation: Department of Dermatology, University Hospital of St-Etienne, Saint Etienne, France.
authors.forename: Bruno
authors.initials: B
authors.lastname: Labeille
authors.affiliation: Department of Oral and Maxillofacial Surgery, University Hospital of St-Etienne, Saint Etienne, France.
authors.forename: Virginie
authors.initials: V
authors.lastname: Prade
authors.affiliation: Department of Pathology, University Hospital of St-Etienne, Saint Etienne, France.
authors.forename: Catherine
authors.initials: C
authors.lastname: Douchet
authors.affiliation: Department of Dermatology, University Hospital of St-Etienne, Saint Etienne, France.
authors.forename: Frédéric
authors.initials: F
authors.lastname: Cambazard
authors.affiliation: Department of Ophthalmology, University Hospital of St-Etienne, Saint Etienne, France.|Department of Biology, Engineering and Imaging of Corneal Graft Laboratory, Institute of Research in Sciences and Health Engineering, EA2512, Jean Monnet University, Saint-Etienne, France.|University Institute of France, Paris, France.
authors.forename: Gilles
authors.initials: G
authors.lastname: Thuret
authors.affiliation: Department of Ophthalmology, University Hospital of St-Etienne, Saint Etienne, France.|Department of Biology, Engineering and Imaging of Corneal Graft Laboratory, Institute of Research in Sciences and Health Engineering, EA2512, Jean Monnet University, Saint-Etienne, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Gain
authors.affiliation: Department of Dermatology, University Hospital of St-Etienne, Saint Etienne, France.
authors.forename: Jean Luc
authors.initials: JL
authors.lastname: Perrot
mesh_terms: D000368:Aged; D002280:Basal Cell Carcinoma / Q000473:pathology* / Q000601:surgery; D005142:Eyelid Neoplasms / Q000473:pathology* / Q000601:surgery; D005143:Eyelids / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D018613:Microscopy, Confocal / Q000379:methods*; D013508:Ophthalmologic Surgical Procedures; D011446:Prospective Studies; D015203:Reproducibility of Results
keywords: basal cell carcinoma; confocal microscopy; eyelid; imaging; surgery