Abstract
Background
Autofluorescence (AF)-Raman spectroscopy is a technique that can detect tumour tissue in
surgically excised skin specimens. The technique does not require tissue fixation, staining,
labelling or sectioning, and provides quantitative diagnosis maps within 30 minutes.
Objectives
To explore the clinical application of AF-Raman microscopy to detect residual basal cell
carcinoma (BCC) positive margins in ex-vivo skin specimens excised during real-time Mohs
surgery. To investigate the ability to analyse skin specimens from different parts of the head-
and-neck areas and detect the BCC subtypes (nodular, infiltrative and superficial BCC).
Methods
Fifty Mohs tissue layers (50 patients) were investigated: 27 split samples (two halves) and 23
full-face samples. The AF-Raman results were compared to frozen section histology, carried
out intra-operatively by the Mohs surgeon and post-operatively by dermato-pathologists. The
latter was used as the standard of reference.
Results
The AF-Raman analysis was completed within the target time of 30 minutes and was able to
detect all sub-types of BCC. For the split specimens, the AF-Raman analysis covered 97% of
the specimen surface area and detected 8 out of 9 BCC positive layers (similar to the Mohs
surgeons). For the full-face specimens, poorer contact between tissue and cassette coverslip led
to lower analysis coverage of the specimen surface area (92%), decreasing the detection rate
(4 out of 6 positives for BCC).
Conclusions
These preliminary results for the split specimens demonstrate the feasibility of AF-Raman
microscopy for rapid assessment of Mohs layers for BCC presence. However, for full-face
specimens, further work is required to improve the contact between the tissue and the coverslip
to increase sensitivity.
Autofluorescence (AF)-Raman spectroscopy is a technique that can detect tumour tissue in
surgically excised skin specimens. The technique does not require tissue fixation, staining,
labelling or sectioning, and provides quantitative diagnosis maps within 30 minutes.
Objectives
To explore the clinical application of AF-Raman microscopy to detect residual basal cell
carcinoma (BCC) positive margins in ex-vivo skin specimens excised during real-time Mohs
surgery. To investigate the ability to analyse skin specimens from different parts of the head-
and-neck areas and detect the BCC subtypes (nodular, infiltrative and superficial BCC).
Methods
Fifty Mohs tissue layers (50 patients) were investigated: 27 split samples (two halves) and 23
full-face samples. The AF-Raman results were compared to frozen section histology, carried
out intra-operatively by the Mohs surgeon and post-operatively by dermato-pathologists. The
latter was used as the standard of reference.
Results
The AF-Raman analysis was completed within the target time of 30 minutes and was able to
detect all sub-types of BCC. For the split specimens, the AF-Raman analysis covered 97% of
the specimen surface area and detected 8 out of 9 BCC positive layers (similar to the Mohs
surgeons). For the full-face specimens, poorer contact between tissue and cassette coverslip led
to lower analysis coverage of the specimen surface area (92%), decreasing the detection rate
(4 out of 6 positives for BCC).
Conclusions
These preliminary results for the split specimens demonstrate the feasibility of AF-Raman
microscopy for rapid assessment of Mohs layers for BCC presence. However, for full-face
specimens, further work is required to improve the contact between the tissue and the coverslip
to increase sensitivity.
| Original language | English |
|---|---|
| Pages (from-to) | 498-507 |
| Number of pages | 10 |
| Journal | Journal of the European Academy of Dermatology and Venerology |
| Volume | 3 |
| Issue number | 2 |
| Early online date | 14 Dec 2023 |
| DOIs | |
| Publication status | Published - 4 Jun 2024 |