Journal of the American Academy of Dermatology · 2013
In vivo confocal microscopy in clinical practice: comparison of bedside diagnostic accuracy of a trained physician and distant diagnosis of an expert reader.
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Rao Babar K, Mateus Rosa, Wassef Cindy, Pellacani Giovanni
Аннотация
BACKGROUND: Reflectance confocal microscopy (RCM) is an imaging tool that allows the visualization of cellular details without biopsy. To our knowledge, RCM sensitivity and specificity has not been studied in a telemedicine setting.
OBJECTIVE: We sought to assess RCM diagnostic accuracy in a support teleconsultation setting.
METHODS: Between June 2010 and September 2011, 340 lesions were imaged using a confocal scanning microscope. The images were evaluated by 2 readers, one on site, and the other at a distance.
RESULTS: A total of 334 cases were included. For each reader the sensitivity was greater than 90% and specificity for each reader was greater than 60%. Both readers had a combined sensitivity of 98.6% and 44% specificity.
LIMITATIONS: RCM may be limited in the correct classification of epithelial tumors.
CONCLUSIONS: RCM is a tool in the clinical diagnosis of skin lesions, providing a high diagnostic accuracy in teleconsultation use.
OBJECTIVE: We sought to assess RCM diagnostic accuracy in a support teleconsultation setting.
METHODS: Between June 2010 and September 2011, 340 lesions were imaged using a confocal scanning microscope. The images were evaluated by 2 readers, one on site, and the other at a distance.
RESULTS: A total of 334 cases were included. For each reader the sensitivity was greater than 90% and specificity for each reader was greater than 60%. Both readers had a combined sensitivity of 98.6% and 44% specificity.
LIMITATIONS: RCM may be limited in the correct classification of epithelial tumors.
CONCLUSIONS: RCM is a tool in the clinical diagnosis of skin lesions, providing a high diagnostic accuracy in teleconsultation use.