PMID- 35411961
OWN - NLM
STAT- MEDLINE
DCOM- 20220719
LR  - 20230415
IS  - 1600-0846 (Electronic)
IS  - 0909-752X (Print)
IS  - 0909-752X (Linking)
VI  - 28
IP  - 4
DP  - 2022 Jul
TI  - Visualization of energy-based device-induced thermal tissue alterations using 
      bimodal ex-vivo confocal microscopy with digital staining. A proof-of-concept 
      study.
PG  - 564-570
LID - 10.1111/srt.13155 [doi]
AB  - BACKGROUND: Ex-vivo confocal microscopy (EVCM) enables examination of tissue 
      alterations immediately after treatment with energy-based devices (EBDs). This 
      proof-of-concept study aimed to describe EBD-induced tissue effects in ex-vivo 
      porcine skin after treatment with microneedle radiofrequency (MNRF) and ablative 
      fractional CO(2) -laser (AFL) using EVCM. MATERIALS AND METHODS: Ex-vivo porcine 
      skin was treated with MNRF and AFL. Three cryosections from each intervention 
      were stained with acridine orange (AO) and scanned with EVCM. Reflectance 
      confocal microscopy (RCM, 638 nm) and fluorescence confocal microscopy (FCM, 
      488 nm) images were captured and evaluated individually, after image fusion, and 
      after digital hematoxylin and eosin (H&E) staining. RESULTS: Bimodal EVCM was 
      able to visualize EBD-induced thermal alterations in porcine skin. In RCM mode, 
      the full width and depth of the vertically aligned microscopic treatment zones 
      (MTZs) were displayed with clear demarcation to surrounding intact skin. In FCM 
      mode, the ablation of the epidermis after AFL was prominent in contrast with the 
      almost intact epidermis observed in MNRF treated skin. In fusion mode, 
      fluorescence signal from AO marked the surrounding coagulation zone (CZ) from 
      both interventions, with enhanced discrimination between ablation and 
      coagulation. Digitally H&E-stained images closely resembled conventional 
      histopathology but proved superior in terms of visualization of the CZ. 
      CONCLUSION: Bimodal EVCM with digital H&E-staining facilitates the identification 
      and qualitative evaluation of thermal alterations induced by treatment with EBD. 
      By providing high-resolution images comparable to standard histology, EVCM is a 
      useful tool in the research and development of EBD to visualize and evaluate 
      device-tissue interactions.
CI  - (c) 2022 The Authors. Skin Research and Technology published by John Wiley & Sons 
      Ltd.
FAU - Fredman, Gabriella
AU  - Fredman G
AD  - Department of Dermatology, University Hospitals of Copenhagen, Bispebjerg and 
      Frederiksberg, Copenhagen, Denmark.
FAU - Christensen, Rikke Louise
AU  - Christensen RL
AD  - Department of Dermatology, University Hospitals of Copenhagen, Bispebjerg and 
      Frederiksberg, Copenhagen, Denmark.
FAU - Ortner, Vinzent Kevin
AU  - Ortner VK
AD  - Department of Dermatology, University Hospitals of Copenhagen, Bispebjerg and 
      Frederiksberg, Copenhagen, Denmark.
FAU - Haedersdal, Merete
AU  - Haedersdal M
AD  - Department of Dermatology, University Hospitals of Copenhagen, Bispebjerg and 
      Frederiksberg, Copenhagen, Denmark.
LA  - eng
PT  - Journal Article
DEP - 20220412
PL  - England
TA  - Skin Res Technol
JT  - Skin research and technology : official journal of International Society for 
      Bioengineering and the Skin (ISBS) [and] International Society for Digital 
      Imaging of Skin (ISDIS) [and] International Society for Skin Imaging (ISSI)
JID - 9504453
SB  - IM
MH  - Animals
MH  - *Epidermis
MH  - Microscopy, Confocal/methods
MH  - Microscopy, Fluorescence
MH  - *Skin/diagnostic imaging/pathology
MH  - Staining and Labeling
MH  - Swine
PMC - PMC9907604
OTO - NOTNLM
OT  - acridine orange
OT  - coagulation zone
OT  - ex-vivo confocal microscopy
OT  - fractional CO2-laser
OT  - microscopic ablation zone
OT  - radiofrequency microneedling
EDAT- 2022/04/13 06:00
MHDA- 2022/07/20 06:00
PMCR- 2022/04/12
CRDT- 2022/04/12 08:40
PHST- 2021/10/07 00:00 [received]
PHST- 2022/03/09 00:00 [accepted]
PHST- 2022/04/13 06:00 [pubmed]
PHST- 2022/07/20 06:00 [medline]
PHST- 2022/04/12 08:40 [entrez]
PHST- 2022/04/12 00:00 [pmc-release]
AID - SRT13155 [pii]
AID - 10.1111/srt.13155 [doi]
PST - ppublish
SO  - Skin Res Technol. 2022 Jul;28(4):564-570. doi: 10.1111/srt.13155. Epub 2022 Apr 
      12.