Background: Previous work with reflectance confocal microscopy (RCM) has shown high sensitivity and specificity for basal cell carcinoma (BCC); however, to date, there have been few studies in UK cohorts.
Objectives: To assess the potential of RCM to accurately diagnose BCC in a private UK secondary care, single-clinician setting, and to investigate the potential of RCM as a routine diagnostic procedure.
Methods: In total, 522 lesions where BCC featured in the differential diagnosis after clinical examination were prospectively recruited; 78 lesions were subsequently excluded. We used an arm-mounted confocal microscope unless access to the lesion was awkward and required a handheld probe to be used. The likelihood of BCC was scored for each modality (clinical examination, dermoscopy and RCM), with each diagnosis building on the last. Histology was assessed by a single blinded histopathologist. The study was registered with ClinicalTrials.gov (NCT03509415).
Results: The analysis included 444 lesions (327 BCCs) from 326 patients. The median maximum lesion diameter was 6 mm. The sensitivity and specificity for BCC were 69.4% [95% confidence interval (CI) 64.1-74.4] and 53.0% (95% CI 43.6-62.3), respectively, for clinical examination alone; 91.8% (95% CI 88.3-94.5) and 41.0% (95% CI 32.0-50.5), respectively, for clinical examination plus dermoscopy; and 98.8% (95% CI 96.9-99.7) and 85.5% (95% CI 77.8-91.3), respectively, for clinical examination plus dermoscopy plus RCM. For RCM, the positive predictive value in diagnosing BCC was 95.0% (95% CI 92.1-97.1) and the negative predictive value was 96.2% (95% CI 90.4-98.9). The area under the curve increased from 0.61 to 0.66 to 0.92 as the respective modalities were added.
Conclusions: This study demonstrates that RCM can reliably and quickly diagnose BCC, and that the addition of RCM to dermoscopy permits higher diagnostic accuracy for BCC in the UK. The specificity and sensitivity of the RCM diagnosis did not alter significantly with experience, reflecting the ease and speed of acquiring the skills required to use this modality.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1093/bjd/ljae356 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
A cross-sectional study comparing passive and eccentric modes of an isokinetic dynamometer to assess eccentric torque in trained athletes: Methodological considerations.
Eur J Sport Sci
February 2025
Department of Sport and Health Sciences and Social Work, Oxford Brookes University, Oxford, UK.
Some technical limitations to using the eccentric mode to measure peak eccentric strength of the hamstrings (PTH) were raised. PTH also has limited validity to predict performance or injury risk factor. Therefore, our aim was to compare PTH and other isokinetic variables tested in the eccentric and passive modes.
View Article and Find Full Text PDFExploring Individual Differences in Interoception Among Athletes Based on a Three-Dimensional Construct of Interoception.
Psychophysiology
January 2025
School of Psychology, Beijing Sport University, Beijing, China.
Previous studies demonstrated that sensorimotor training enhances interoceptive abilities. Athletes are highly engaged in performance-driven physical training and often incorporate-to varying degrees-sensorimotor training into their routines. In this study, we investigated the role of individual differences in interoception by comparing professional athletes of different performance levels and both sexes with recreational athletes and controls, applying a three-dimensional model of interoception.
View Article and Find Full Text PDFPrecision in Liver Diagnosis: Varied Accuracy Across Subgroups and the Need for Variable Thresholds in Diagnosis of MASLD.
Liver Int
February 2025
Department of Epidemiology and Data Science, Amsterdam University Medical Centres, Amsterdam, The Netherlands.
Background And Aims: The performance of non-invasive liver tests (NITs) is known to vary across settings and subgroups. We systematically evaluated whether the performance of three NITs in detecting advanced fibrosis in patients with metabolic dysfunction-associated steatotic liver disease (MASLD) varies with age, sex, body mass index (BMI), type 2 diabetes mellitus (T2DM) status or liver enzymes.
Methods: Data from 586 adult LITMUS Metacohort participants with histologically characterised MASLD were included.
Abuse potential and analgesic efficacy of intravenous hydromorphone bolus administration among hospitalized patients with cancer pain: A double-blind, double dummy, randomized crossover trial.
Cancer
February 2025
Department of Palliative, Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer, Houston, Texas, USA.
Background: There is much concern that opioids administered as intravenous (iv) bolus for pain relief may inadvertently increase their risk for abuse. However, there is insufficient data to support this. The authors compared the abuse liability potential, analgesic efficacy, and adverse effect profile of fast (iv push) versus slow (iv piggyback) administration of iv hydromorphone among hospitalized patients requiring iv opioids for pain.
View Article and Find Full Text PDFAssociation of Alzheimer's and Lewy body disease pathology with basal forebrain volume and cognitive impairment.
Alzheimers Res Ther
January 2025
Department of Neurology, University Medical Center Rostock, 18147, Rostock, Germany.
Background: Degeneration of the basal forebrain cholinergic system is a hallmark feature shared by Alzheimer's disease (AD) and Lewy body disease (LBD) whereas hippocampus atrophy is more specifically related to AD. We aimed to investigate the relationship between basal forebrain and hippocampus atrophy, cognitive decline, and neuropathology in a large autopsy sample.
Methods: Data were obtained from the National Alzheimer's Coordinating Center (NACC).
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!