A biopsy alternative?

Confocal Microscopy

Confocal microscopy (CM) is an optical imaging technique where laser light is focussed onto a defined spot at a specific depth and increased optical resolution is achieved by means of a spacial pinhole to block out-of-focus light in image formation.

CM has been used in the evaluation of skin cancer.  ‘Ex vivo’ (outside the living) for faster pathology assessment with greater accuracy for Moh’s surgery. And ‘in vivo’ (within the living or patient) providing high resolution images which are optically scanned in slices without need for a surgical biopsy.  

Unfortunately, as described in the British Journal of Dermatology, the availability of this procedure is limited due to the lack of reimbursement, low number of dedicated units, elevated cost and time consuming nature of the procedure in busy clinical settings.