Confocal imaging

Confocal microscopy is a new diagnostic tool for melanoma and other skin cancers. It allows non-invasive 'optical biopsy', potentially avoiding surgical excision at the diagnostic stage.

At the Poche Centre, we use Vivascope confocal imaging. Confocal imaging is an extension of dermoscopy as it provides cellular details that the eye cannot see.

Confocal imaging is used worldwide to diagnose difficult skin lesions and has been shown to be superior for the diagnosis of some skin tumours compared to standard clinical examination. If we feel there may be a problem with your cells, your lesion may still have to be “surgically” biopsied.

The confocal imager uses a low-power laser and special optics to magnify living cells by approximately 1,000 times. Confocal images are created by the natural refractive difference within and between cells. Melanin is highly refractive and gives bright images.

How does it work?

1. A Vivacam dermatoscopic camera is used to navigate the confocal microscope to different parts of the lesion.
2. The Vivascope is then used to capture images in three dimensions within the top layers of the skin.
   • Imaging each lesion takes 5-10 minutes. A tissue ring is attached with medical adhesive to hold the skin stable and the laser tracks through the lesion in three dimensions to create vertical and horizontal maps of the cell fields. There is no pain or scarring in this procedure.
3. The image is then examined by the dermatologist.

VivaScopes have been used to evaluate a range of skin cancers and disease including melanoma, basal cell carcinoma, squamous cell carcinoma and actinic keratosis. More than 150 articles on the clinical application of reflectance confocal imaging have been published in leading scientific journals.