Ren, J., Lax, R., Krueger, J. G., Browning, J., Carucci, J., White, K., … & Gareau, D. S. (2020). Detecting nodular basal cell carcinoma in pathology imaging using deep learning image segmentation. In Photonics in Dermatology and Plastic Surgery 2020 (Vol. 11211, p. 112110D). International Society for Optics and Photonics.
Gareau, D. S., Krueger, J. G., Hawkes, J. E., Lish, S. R., Dietz, M. P., Mülberger, A. G., … & Carucci, J. A. (2017). Line scanning, stage scanning confocal microscope (LSSSCM). Biomedical Optics Express, 8(8), 3807-3815.
Mu, E. W., Lewin, J. M., Stevenson, M. L., Meehan, S. A., Carucci, J. A., & Gareau, D. S. (2016). Use of digitally stained multimodal confocal mosaic images to screen for nonmelanoma skin cancer. JAMA Dermatology, 152(12), 1335-1341.
Gareau, D. S., Bar, A., Snaveley, N. R., Lee, K., Chen, N. W., Swanson, N., … & Jacques, S. L. (2012). Tri-modal confocal mosaics detect residual invasive squamous cell carcinoma in Mohs surgical excisions. Journal of Biomedical Optics, 17(6), 066018.
For rapid, intra-operative pathological margin assessment to guide staged cancer excisions, multimodal confocal mosaic scan image wide surgical margins (approximately 1 cm) with sub-cellular resolution and mimic the appearance of conventional hematoxylin and eosin histopathology (H&E). The goal of this work is to combine three confocal imaging modes: acridine orange fluorescence (AO) for labeling nuclei, eosin fluorescence (Eo) for labeling cytoplasm, and endogenous reflectance (R) for marking collagen and keratin. Absorption contrast is achieved by alternating the excitation wavelength: 488 nm (AO fluorescence) and 532 nm (Eo fluorescence). Superposition and false-coloring of these modes mimics H&E, enabling detection of cutaneous squamous cell carcinomas (SCC). The sum of mosaic Eo+R is false-colored pink to mimic the appearance of eosin, while the AO mosaic is false-colored purple to mimic the appearance of hematoxylin in H&E. In this study, mosaics of 10 Mohs surgical excisions containing invasive SCC, and five containing only normal tissue were subdivided for digital presentation equivalent to 4 × histology. Of the total 50 SCC and 25 normal sub-mosaics presented, two reviewers made two and three type-2 errors (false positives), respectively. Limitations to precisely mimic H&E included occasional elastin staining by AO. These results suggest that confocal mosaics may effectively guide staged SCC excisions in skin and other tissues.
Gareau, D. S., Karen, J. K., Dusza, S. W., Tudisco, M., Nehal, K. S., & Rajadhyaksha, M. (2009). Sensitivity and specificity for detecting basal cell carcinomas in Mohs excisions with confocal fluorescence mosaicing microscopy. Journal of Biomedical Optics, 14(3), 034012.
Gareau, D. S. (2009). Feasibility of digitally stained multimodal confocal mosaics to simulate histopathology. Journal of Biomedical Optics, 14(3), 034050.
Gareau, D. S., Patel, Y. G., Li, Y., Aranda, I., Halpern, A. C., Nehal, K. S., & Rajadhyaksha, M. (2009). Confocal mosaicing microscopy in skin excisions: a demonstration of rapid surgical pathology. Journal of Microscopy, 233(1), 149-159.