ReportSensitivity and specificity of reflectance-mode confocal microscopy for in vivo diagnosis of basal cell carcinoma: A multicenter study
Section snippets
Patients
This was a retrospective multicenter international study performed at the following 4 centers: Wellman Laboratories of Photomedicine at Massachusetts General Hospital in Boston; the Division of Dermatology at Loma Linda University Medical School in Loma Linda, Calif; the Dermatology Service at Hospital Guadalajara at Alcala University in Madrid, Spain; and the private practice of Dermatology and Dermatologic Surgery in Rochester, NY.
In all, 145 patients with 152 skin lesions were recruited for
Characteristics of the data set
The distribution of the 152 lesions in terms of gender of the patient, topographic location, dermatologic diagnoses represented, and BCC subtypes are shown in Table I. Of particular significance is the total number of BCC diagnoses in this dataset (No. 83), which gives us a confidence level of 95% and a maximum estimation error of 6%. This means that the number of BCC lesions in our study is sufficient to confidently calculate sensitivity and specificity with a maximum error of estimation of 6%
Discussion
RCM is a promising noninvasive, high-resolution imaging tool that evaluates the skin in vivo at the level of good histologic detail. This retrospective study was conducted as a multicenter effort to estimate the sensitivity and specificity of RCM for the in vivo diagnosis of BCC.
We found that RCM is sensitive and specific for the in vivo diagnosis of BCC, with the presence of polarized nuclei being both the most sensitive and specific RCM criterion. We found that the presence of 4 or more
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Supported in part by National Institutes of Health National Institute for Occupational Safety and Health grant RO1 OH04029.
Disclosure: Dr Goldgeier was a member of the Scientific Advisory Board of Lucid Inc, the company that commercialized the imaging system used for real-time reflectance-mode confocal laser scanning microscopy. In addition, the imaging system used in some of the centers was originally provided by this company.
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Current affiliation for Dr Nori is the Department of Dermatology and Skin Surgery, Roger Williams Medical Center, Providence, Rhode Island. Dr González holds a joint appointment at the Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, New York.