Handheld reflectance confocal microscopy with radial video mosaicing showed utility in mapping lentigo maligna and lentigo maligna melanoma.
The prospective trial included patients with biopsy-proven lentigo maligna and lentigo maligna melanoma of the head and neck who were seeking consultation for possible surgical intervention at the Memorial Sloan Kettering Cancer Center between March 1, 2016 and March 31, 2017. Thirty-two patients underwent handheld reflectance confocal microscopy with radial video mosaicing and 22 patients with 23 lesions were treated with a staged surgical intervention.
The primary endpoint was clinical lesion size and area, along with lentigo maligna and lentigo maligna melanoma area based on radial video mosaicing data, the size of the surgical defect area as estimated by mosaicing, and the observed surgical defect area. The researchers also compared the margins in each quadrant according to radial video mosaicing with the actual surgical margins.
Results showed a mean surgical defect area estimated with handheld reflectance confocal microscopy with radial video mosaicing of 6.34 cm2. In comparison, “the mean area of surgical excision with clear margins was 7.74 cm2,” researchers wrote.
In an analysis that controlled for factors including patient age and history of surgical experience, the margins were 0.76 mm (P < .001) larger than those estimated by handheld radial video mosaicing.
“Mapping of lentigo maligna using [handheld reflectance confocal microscopy with radial video mosaicing] can help spare healthy tissue by reducing the number of biopsies needed in clinically uncertain areas and may be used to plan treatment of [lentigo maligna] and [lentigo maligna melanoma] and counsel patients appropriately,” the researchers concluded. – by Rob Volansky
Disclosure: The authors report associations with Caliber Imaging and Diagnostics (formerly Lucid Inc.), which is the company that manufactures and sells the VivaScope confocal microscope.