Medicine has advanced dramatically during the last century. But when it comes to getting biopsy results, very little has changed. Consider, for example, what happens when a patient comes in to have a skin lesion biopsied for nonmelanoma skin cancer.
“The surgeon will take a little piece of the skin out,” says Michael Giacomelli, an assistant professor of biomedical engineering and of optics at the University of Rochester. “Someone in pathology will look at it weeks or even a month later under a microscope. And then, depending on what they find, the patient is notified that everything’s fine, don’t worry about it, or we need you to come back for a second appointment so we can treat you.”
Giacomelli is developing a novel imaging system, contained on a portable cart, to shorten this process to two minutes. This would enable a surgeon to immediately determine whether the lesion is cancerous and, if so, to “treat the patient during the same visit instead of stretching it out over the next month and multiple visits.”
The system—using two-photon fluorescence microscopy (TPFM)—demonstrated remarkable accuracy in a pilot study summarized recently in JAMA Dermatology. When tested on 15 biopsies of known nonmelanoma skin cancer, the technology was able to detect basal cell carcinoma with perfect accuracy (100 percent sensitivity and specificity) and squamous cell carcinoma with high accuracy (89 percent sensitivity and 100 percent specificity).