Using serial optical biopsies to monitor the keratinocyte skin‑cancer response to minimally invasive treatment

Non-invasive optical imaging provides a novel approach for monitoring the treatment response of keratinocyte cancers, reducing reliance on repeated surgical biopsies. We applied a multimodal microscopy system - combining reflectance confocal microscopy (RCM), two-photon fluorescence (TPF) microscopy, and second harmonic generation (SHG) microscopy - to track rumor cell dynamics after treatment. In our preliminary results of 58 lesions, including basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and actinic keratosis (AK), treated with curettage and electrodessication (ED&C), surgical excision, cryotherapy, topical immuno/chemotherapy, or photodynamic therapy, we identified abnormal features such as tumor aggregates, atypical vasculature, and disorganized epidermal cellular distribution with marked pleomorphism (wide variation in cell size and shape). These features typically resolved post-treatment, but in cases where residual or recurrence did occur, early detection was achieved with this imaging system.