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New technology for rapid bedside skin cancer biopsy diagnosis

Basal cell carcinoma. Photo by: James Heilman, MD via Wikimedia Commons

A pilot study of a new biopsy imaging system has shown high accuracy in diagnosing non-melanoma skin cancer in two minutes—substantially faster than conventional biopsy evaluation.

In the study, published in JAMA Dermatology, the new system uses two-photon fluorescence microscopy to assess samples in as little as two minutes. It was tested on 15 biopsies of known nonmelanoma skin cancer. The researchers were able to detect basal cell carcinoma with perfect accuracy (100% sensitivity and specificity) and squamous cell carcinoma with high accuracy (89% sensitivity and 100% specificity).

Typically, the authors note, biopsied tissue is excised, fixed, paraffinized, stained, and mounted on slides before being evaluated by a dermatopathologist.

“This is how it has been done since the late 19th century,” said study author Michael G. Giacomelli, PhD, in a press release. “Billions and billions of biopsies have been done this way. Everybody is on the same page; it works great. The problem is that it is very slow.” Dr. Giacomelli is an assistant professor of biomedical engineering and optics at the University of Rochester in Rochester, N.Y.

In his role as a researcher at the University’s Wilmot Cancer Institute, Dr. Giacomelli has been developing the new system, which is small enough to be stored on a portable cart. The goal of the new system is to allow a physician to immediately determine if biopsied tissue is cancerous, which would allow them to “treat the patient during the same visit instead of stretching it out over the next month and multiple visits,” he said.

Dr. Giacomelli is now working closely with Sherrif Ibrahim, MD, PhD, an associate professor of dermatology at the University’s Medical Center, on a larger, 200-patient follow-up study. The larger study uses biopsy samples taken at random at Dr. Ibrahim’s Rochester Dermatological Surgery in nearby Victor, N.Y.

“The goal is to analyze how well the technique works in a real-world scenario, where you have a lot of people coming in and all kinds of things can show up,” Dr. Giacomelli said. “We really want to make sure that there isn’t some bizarre thing that normally has nothing to do with cancer that we somehow confuse with cancer—or something that does have something to do with cancer but we can’t image. You never know what you’re going to find once you start taking random biopsies of people.”


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