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Milind Rajadhyaksha - One of the best experts on this subject based on the ideXlab platform.

  • Use of ex vivo confocal scanning laser microscopy during Mohs Surgery for nonmelanoma skin cancers.
    Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.], 2020
    Co-Authors: Vinh Q Chung, Kishwer S Nehal, Peter J Dwyer, Milind Rajadhyaksha, Gregg M Menaker, Carlos Charles, S Brian Jiang
    Abstract:

    Ex vivo confocal scanning laser microscopy offers rapid optical reflectance imaging of excised tissue without conventional frozen histopathology that can potentially expedite Mohs Surgery. The objective was to determine the feasibility of using ex vivo confocal scanning laser microscopy during Mohs Surgery for detecting residual basal cell carcinoma and squamous cell carcinoma. One-hundred fifteen Stage I Mohs Surgery excisions (92 basal cell carcinoma, 23 squamous cell carcinoma) were imaged with acetowhitening and confocal scanning laser microscopy and compared to conventional Mohs frozen histologic sections for normal and tumor features. Large aggregates of residual tumor such as nodular basal cell carcinoma were easily detected by ex vivo confocal scanning laser microscopy, whereas smaller tumor foci were not consistently identified. Confocal morphology of tumor subtypes is described. Ex vivo confocal scanning laser microscopy can potentially expedite Mohs Surgery in rapidly detecting large nodular basal cell carcinomas without conventional frozen histopathology. Further improvements in instrumentation and image quality are necessary to allow broader application and acceptance of this novel technology in Mohs Surgery.

  • intraoperative imaging during Mohs Surgery with reflectance confocal microscopy initial clinical experience
    Journal of Biomedical Optics, 2015
    Co-Authors: Eileen S Flores, Anthony M. Rossi, Miguel Cordova, Kivanc Kose, William Phillips, S Kishwer M D Nehal, Milind Rajadhyaksha
    Abstract:

    Mohs Surgery for the removal of nonmelanoma skin cancers (NMSCs) is performed in stages, while being guided by the examination for residual tumor with frozen pathology. However, preparation of frozen pathology at each stage is time consuming and labor intensive. Real-time intraoperative reflectance confocal microscopy (RCM), combined with video mosaicking, may enable rapid detection of residual tumor directly in the surgical wounds on patients. We report our initial experience on 25 patients, using aluminum chloride for nuclear contrast. Imaging was performed in quadrants in the wound to simulate the Mohs surgeon’s examination of pathology. Images and videos of the epidermal and dermal margins were found to be of clinically acceptable quality. Bright nuclear morphology was identified at the epidermal margin and detectable in residual NMSC tumors. The presence of residual tumor and normal skin features could be detected in the peripheral and deep dermal margins. Intraoperative RCM imaging may enable detection of residual tumor directly on patients during Mohs Surgery, and may serve as an adjunct for frozen pathology. Ultimately, for routine clinical utility, a stronger tumor-to-dermis contrast may be necessary, and also a smaller microscope with an automated approach for imaging in the entire wound in a rapid and controlled manner.

  • Fluorescence Confocal Mosaicing Microscopy of Basal Cell Carcinomas to Potentially Guide Mohs Surgery
    IEEE Transactions on Biomedical Engineering, 2008
    Co-Authors: Daniel S. Gareau, Kishwer S Nehal, Billy Huang, Yongbiao Li, Iana Aranda, Milind Rajadhyaksha
    Abstract:

    Fluorescence confocal mosaicing detects basal cell carcinomas in 10-20 mm-large Mohs surgical skin excisions within 5-9 minutes, compared to 20-45 minutes for frozen histology. Confocal mosaicing microscopy may enable rapid pathology-at-the-bedside to guide Mohs Surgery.

  • use of ex vivo confocal scanning laser microscopy during Mohs Surgery for nonmelanoma skin cancers
    Dermatologic Surgery, 2004
    Co-Authors: Vinh Q Chung, Kishwer S Nehal, Peter J Dwyer, Milind Rajadhyaksha, Gregg M Menaker, Carlos A Charles, Brian S Jiang
    Abstract:

    Background. Ex vivo confocal scanning laser microscopy offers rapid optical reflectance imaging of excised tissue without conventional frozen histopathology that can potentially expedite Mohs Surgery. Objective. The objective was to determine the feasibility of using ex vivo confocal scanning laser microscopy during Mohs Surgery for detecting residual basal cell carcinoma and squamous cell carcinoma. Methods. One-hundred fifteen Stage I Mohs Surgery excisions (92 basal cell carcinoma, 23 squamous cell carcinoma) were imaged with acetowhitening and confocal scanning laser microscopy and compared to conventional Mohs frozen histologic sections for normal and tumor features. Results. Large aggregates of residual tumor such as nodular basal cell carcinoma were easily detected by ex vivo confocal scanning laser microscopy, whereas smaller tumor foci were not consistently identified. Confocal morphology of tumor subtypes is described. Conclusion. Ex vivo confocal scanning laser microscopy can potentially expedite Mohs Surgery in rapidly detecting large nodular basal cell carcinomas without conventional frozen histopathology. Further improvements in instrumentation and image quality are necessary to allow broader application and acceptance of this novel technology in Mohs Surgery.

Kishwer S Nehal - One of the best experts on this subject based on the ideXlab platform.

  • Use of ex vivo confocal scanning laser microscopy during Mohs Surgery for nonmelanoma skin cancers.
    Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.], 2020
    Co-Authors: Vinh Q Chung, Kishwer S Nehal, Peter J Dwyer, Milind Rajadhyaksha, Gregg M Menaker, Carlos Charles, S Brian Jiang
    Abstract:

    Ex vivo confocal scanning laser microscopy offers rapid optical reflectance imaging of excised tissue without conventional frozen histopathology that can potentially expedite Mohs Surgery. The objective was to determine the feasibility of using ex vivo confocal scanning laser microscopy during Mohs Surgery for detecting residual basal cell carcinoma and squamous cell carcinoma. One-hundred fifteen Stage I Mohs Surgery excisions (92 basal cell carcinoma, 23 squamous cell carcinoma) were imaged with acetowhitening and confocal scanning laser microscopy and compared to conventional Mohs frozen histologic sections for normal and tumor features. Large aggregates of residual tumor such as nodular basal cell carcinoma were easily detected by ex vivo confocal scanning laser microscopy, whereas smaller tumor foci were not consistently identified. Confocal morphology of tumor subtypes is described. Ex vivo confocal scanning laser microscopy can potentially expedite Mohs Surgery in rapidly detecting large nodular basal cell carcinomas without conventional frozen histopathology. Further improvements in instrumentation and image quality are necessary to allow broader application and acceptance of this novel technology in Mohs Surgery.

  • Modernizing the Mohs Surgery Consultation: Instituting a Video Module for Improved Patient Education and Satisfaction.
    Dermatologic Surgery, 2018
    Co-Authors: Emily Newsom, Anthony M. Rossi, Stephen W. Dusza, Kishwer S Nehal
    Abstract:

    BACKGROUND: Studies show that patients recall less than half of the information given by their physicians. Use of video in medicine increases patient comprehension and satisfaction and decreases anxiety. However, studies have not elaborated on video content. OBJECTIVE: To use principles of learning with multimedia to improve the Mohs Surgery consultation. MATERIALS AND METHODS: The authors developed 2 informational videos on Mohs Surgery: traditional versus narrative. The focus of the traditional video was purely didactic. The narrative video included patient testimonials, patient-physician interaction, and animations. New Mohs Surgery patients viewed either the traditional (n = 40) or the narrative video (n = 40). Existing Mohs Surgery patients (n = 40) viewed both videos. Both groups answered questionnaires about their satisfaction. RESULTS: For new Mohs Surgery patients, no significant difference was found between the traditional and the narrative video groups because respondent satisfaction was high for both video formats. For existing Mohs Surgery patients, all respondents (100%) reported that videos were helpful for understanding Mohs Surgery; however, the majority would recommend the narrative over the traditional format (72.5% vs 27.5%, p = .01). CONCLUSION: Technology is useful for patient education because all patients preferred seeing a video to no video. Further research is needed to optimize effective multimedia use in patient education.

  • Fluorescence Confocal Mosaicing Microscopy of Basal Cell Carcinomas to Potentially Guide Mohs Surgery
    IEEE Transactions on Biomedical Engineering, 2008
    Co-Authors: Daniel S. Gareau, Kishwer S Nehal, Billy Huang, Yongbiao Li, Iana Aranda, Milind Rajadhyaksha
    Abstract:

    Fluorescence confocal mosaicing detects basal cell carcinomas in 10-20 mm-large Mohs surgical skin excisions within 5-9 minutes, compared to 20-45 minutes for frozen histology. Confocal mosaicing microscopy may enable rapid pathology-at-the-bedside to guide Mohs Surgery.

  • clinical application of dynamic telepathology in Mohs Surgery
    Dermatologic Surgery, 2005
    Co-Authors: Sean A Sukal, Klaus J Busam, Kishwer S Nehal
    Abstract:

    Background. Telepathology is an expanding technology in multiple fields for remote pathology diagnosis and consultation. The use of telepathology in Mohs Surgery has been very limited. Objective. To describe the clinical experience of using a telepathology system for intraoperative consultations on difficult frozen sections during Mohs Surgery. Materials and Methods. Intraoperative consultation with a dermatopathologist was obtained using a dynamic telepathology system for all questions arising on frozen sections during Mohs Surgery for nonmelanoma skin cancers during a 2-year period. Results. The most common reason for consultation was to distinguish basal cell carcinoma from a benign histologic simulant on Mohs frozen sections. Other uses included determining tumor histology and distinguishing inflammation from residual tumor. Conclusion. Dynamic telepathology is a useful and convenient adjunct in the Mohs Surgery practice for intraoperative consultations on difficult frozen sections. SEAN A. SUKAL, MD, PHD, KLAUS J. BUSAM, MD, AND KISHWER S. NEHAL, MD, HAVE INDICATED NO SIGNIFICANT INTEREST WITH COMMERCIAL SUPPORTERS.

  • use of ex vivo confocal scanning laser microscopy during Mohs Surgery for nonmelanoma skin cancers
    Dermatologic Surgery, 2004
    Co-Authors: Vinh Q Chung, Kishwer S Nehal, Peter J Dwyer, Milind Rajadhyaksha, Gregg M Menaker, Carlos A Charles, Brian S Jiang
    Abstract:

    Background. Ex vivo confocal scanning laser microscopy offers rapid optical reflectance imaging of excised tissue without conventional frozen histopathology that can potentially expedite Mohs Surgery. Objective. The objective was to determine the feasibility of using ex vivo confocal scanning laser microscopy during Mohs Surgery for detecting residual basal cell carcinoma and squamous cell carcinoma. Methods. One-hundred fifteen Stage I Mohs Surgery excisions (92 basal cell carcinoma, 23 squamous cell carcinoma) were imaged with acetowhitening and confocal scanning laser microscopy and compared to conventional Mohs frozen histologic sections for normal and tumor features. Results. Large aggregates of residual tumor such as nodular basal cell carcinoma were easily detected by ex vivo confocal scanning laser microscopy, whereas smaller tumor foci were not consistently identified. Confocal morphology of tumor subtypes is described. Conclusion. Ex vivo confocal scanning laser microscopy can potentially expedite Mohs Surgery in rapidly detecting large nodular basal cell carcinomas without conventional frozen histopathology. Further improvements in instrumentation and image quality are necessary to allow broader application and acceptance of this novel technology in Mohs Surgery.

Brian S Jiang - One of the best experts on this subject based on the ideXlab platform.

  • use of ex vivo confocal scanning laser microscopy during Mohs Surgery for nonmelanoma skin cancers
    Dermatologic Surgery, 2004
    Co-Authors: Vinh Q Chung, Kishwer S Nehal, Peter J Dwyer, Milind Rajadhyaksha, Gregg M Menaker, Carlos A Charles, Brian S Jiang
    Abstract:

    Background. Ex vivo confocal scanning laser microscopy offers rapid optical reflectance imaging of excised tissue without conventional frozen histopathology that can potentially expedite Mohs Surgery. Objective. The objective was to determine the feasibility of using ex vivo confocal scanning laser microscopy during Mohs Surgery for detecting residual basal cell carcinoma and squamous cell carcinoma. Methods. One-hundred fifteen Stage I Mohs Surgery excisions (92 basal cell carcinoma, 23 squamous cell carcinoma) were imaged with acetowhitening and confocal scanning laser microscopy and compared to conventional Mohs frozen histologic sections for normal and tumor features. Results. Large aggregates of residual tumor such as nodular basal cell carcinoma were easily detected by ex vivo confocal scanning laser microscopy, whereas smaller tumor foci were not consistently identified. Confocal morphology of tumor subtypes is described. Conclusion. Ex vivo confocal scanning laser microscopy can potentially expedite Mohs Surgery in rapidly detecting large nodular basal cell carcinomas without conventional frozen histopathology. Further improvements in instrumentation and image quality are necessary to allow broader application and acceptance of this novel technology in Mohs Surgery.

Vinh Q Chung - One of the best experts on this subject based on the ideXlab platform.

  • Use of ex vivo confocal scanning laser microscopy during Mohs Surgery for nonmelanoma skin cancers.
    Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.], 2020
    Co-Authors: Vinh Q Chung, Kishwer S Nehal, Peter J Dwyer, Milind Rajadhyaksha, Gregg M Menaker, Carlos Charles, S Brian Jiang
    Abstract:

    Ex vivo confocal scanning laser microscopy offers rapid optical reflectance imaging of excised tissue without conventional frozen histopathology that can potentially expedite Mohs Surgery. The objective was to determine the feasibility of using ex vivo confocal scanning laser microscopy during Mohs Surgery for detecting residual basal cell carcinoma and squamous cell carcinoma. One-hundred fifteen Stage I Mohs Surgery excisions (92 basal cell carcinoma, 23 squamous cell carcinoma) were imaged with acetowhitening and confocal scanning laser microscopy and compared to conventional Mohs frozen histologic sections for normal and tumor features. Large aggregates of residual tumor such as nodular basal cell carcinoma were easily detected by ex vivo confocal scanning laser microscopy, whereas smaller tumor foci were not consistently identified. Confocal morphology of tumor subtypes is described. Ex vivo confocal scanning laser microscopy can potentially expedite Mohs Surgery in rapidly detecting large nodular basal cell carcinomas without conventional frozen histopathology. Further improvements in instrumentation and image quality are necessary to allow broader application and acceptance of this novel technology in Mohs Surgery.

  • use of ex vivo confocal scanning laser microscopy during Mohs Surgery for nonmelanoma skin cancers
    Dermatologic Surgery, 2004
    Co-Authors: Vinh Q Chung, Kishwer S Nehal, Peter J Dwyer, Milind Rajadhyaksha, Gregg M Menaker, Carlos A Charles, Brian S Jiang
    Abstract:

    Background. Ex vivo confocal scanning laser microscopy offers rapid optical reflectance imaging of excised tissue without conventional frozen histopathology that can potentially expedite Mohs Surgery. Objective. The objective was to determine the feasibility of using ex vivo confocal scanning laser microscopy during Mohs Surgery for detecting residual basal cell carcinoma and squamous cell carcinoma. Methods. One-hundred fifteen Stage I Mohs Surgery excisions (92 basal cell carcinoma, 23 squamous cell carcinoma) were imaged with acetowhitening and confocal scanning laser microscopy and compared to conventional Mohs frozen histologic sections for normal and tumor features. Results. Large aggregates of residual tumor such as nodular basal cell carcinoma were easily detected by ex vivo confocal scanning laser microscopy, whereas smaller tumor foci were not consistently identified. Confocal morphology of tumor subtypes is described. Conclusion. Ex vivo confocal scanning laser microscopy can potentially expedite Mohs Surgery in rapidly detecting large nodular basal cell carcinomas without conventional frozen histopathology. Further improvements in instrumentation and image quality are necessary to allow broader application and acceptance of this novel technology in Mohs Surgery.

Peter J Dwyer - One of the best experts on this subject based on the ideXlab platform.

  • Use of ex vivo confocal scanning laser microscopy during Mohs Surgery for nonmelanoma skin cancers.
    Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.], 2020
    Co-Authors: Vinh Q Chung, Kishwer S Nehal, Peter J Dwyer, Milind Rajadhyaksha, Gregg M Menaker, Carlos Charles, S Brian Jiang
    Abstract:

    Ex vivo confocal scanning laser microscopy offers rapid optical reflectance imaging of excised tissue without conventional frozen histopathology that can potentially expedite Mohs Surgery. The objective was to determine the feasibility of using ex vivo confocal scanning laser microscopy during Mohs Surgery for detecting residual basal cell carcinoma and squamous cell carcinoma. One-hundred fifteen Stage I Mohs Surgery excisions (92 basal cell carcinoma, 23 squamous cell carcinoma) were imaged with acetowhitening and confocal scanning laser microscopy and compared to conventional Mohs frozen histologic sections for normal and tumor features. Large aggregates of residual tumor such as nodular basal cell carcinoma were easily detected by ex vivo confocal scanning laser microscopy, whereas smaller tumor foci were not consistently identified. Confocal morphology of tumor subtypes is described. Ex vivo confocal scanning laser microscopy can potentially expedite Mohs Surgery in rapidly detecting large nodular basal cell carcinomas without conventional frozen histopathology. Further improvements in instrumentation and image quality are necessary to allow broader application and acceptance of this novel technology in Mohs Surgery.

  • use of ex vivo confocal scanning laser microscopy during Mohs Surgery for nonmelanoma skin cancers
    Dermatologic Surgery, 2004
    Co-Authors: Vinh Q Chung, Kishwer S Nehal, Peter J Dwyer, Milind Rajadhyaksha, Gregg M Menaker, Carlos A Charles, Brian S Jiang
    Abstract:

    Background. Ex vivo confocal scanning laser microscopy offers rapid optical reflectance imaging of excised tissue without conventional frozen histopathology that can potentially expedite Mohs Surgery. Objective. The objective was to determine the feasibility of using ex vivo confocal scanning laser microscopy during Mohs Surgery for detecting residual basal cell carcinoma and squamous cell carcinoma. Methods. One-hundred fifteen Stage I Mohs Surgery excisions (92 basal cell carcinoma, 23 squamous cell carcinoma) were imaged with acetowhitening and confocal scanning laser microscopy and compared to conventional Mohs frozen histologic sections for normal and tumor features. Results. Large aggregates of residual tumor such as nodular basal cell carcinoma were easily detected by ex vivo confocal scanning laser microscopy, whereas smaller tumor foci were not consistently identified. Confocal morphology of tumor subtypes is described. Conclusion. Ex vivo confocal scanning laser microscopy can potentially expedite Mohs Surgery in rapidly detecting large nodular basal cell carcinomas without conventional frozen histopathology. Further improvements in instrumentation and image quality are necessary to allow broader application and acceptance of this novel technology in Mohs Surgery.