Morphometric Optical Imaging of Microporated Nail Tissue: An Investigation of Intermethod Agreement, Reliability, and Technical Limitations.
intermethod agreement
laser ablation
nail
noninvasive imaging
Journal
Lasers in surgery and medicine
ISSN: 1096-9101
Titre abrégé: Lasers Surg Med
Pays: United States
ID NLM: 8007168
Informations de publication
Date de publication:
08 2021
08 2021
Historique:
revised:
17
06
2020
received:
12
02
2020
accepted:
20
07
2020
pubmed:
10
8
2020
medline:
27
7
2021
entrez:
10
8
2020
Statut:
ppublish
Résumé
While optical imaging is a useful technique to quantitate morphological differences and treatment effects, comparative investigations of the various techniques are lacking. This study aimed at evaluating intermethod agreement, reliability, and technical limitations of wide-field microscopy (WFM), reflectance confocal microscopy (RCM), and optical coherence tomography (OCT) for morphometry by assessing fractionally ablated nail tissue. Fifty healthy nail clippings were processed with a fractionated CO The repeatability varied substantially between methods and target measurements. The level of intermethod agreement for thickness measurements performed with calipers, WFM, and OCT was high (tau-c ≥ 0.7; ICC ≥ 0.8; PCC ≥ 0.9). RCM could only image 28 out of 50 samples due to its limited penetration depth. OCT demonstrated the highest repeatability of all imaging techniques (CoV 4-7%) and nail thickness showed the highest measurement reliability (α = 0.92). Micropore dimensions correlated strongest between OCT and RCM (tau-c/ICC/PCC ≥ 0.5). All modalities were prone to artifacts, which may have adversely affected measurement variation and intermethod agreement. Intermethod agreement and reliability appear to be highly dependent on the specific modality and target measurement. To reap the benefits of each technique while mitigating their limitations, an integrated approach to optical imaging is recommended. Lasers Surg. Med. © 2020 Wiley Periodicals LLC.
Sections du résumé
BACKGROUND AND OBJECTIVES
While optical imaging is a useful technique to quantitate morphological differences and treatment effects, comparative investigations of the various techniques are lacking. This study aimed at evaluating intermethod agreement, reliability, and technical limitations of wide-field microscopy (WFM), reflectance confocal microscopy (RCM), and optical coherence tomography (OCT) for morphometry by assessing fractionally ablated nail tissue.
STUDY DESIGN/MATERIALS AND METHODS
Fifty healthy nail clippings were processed with a fractionated CO
RESULTS
The repeatability varied substantially between methods and target measurements. The level of intermethod agreement for thickness measurements performed with calipers, WFM, and OCT was high (tau-c ≥ 0.7; ICC ≥ 0.8; PCC ≥ 0.9). RCM could only image 28 out of 50 samples due to its limited penetration depth. OCT demonstrated the highest repeatability of all imaging techniques (CoV 4-7%) and nail thickness showed the highest measurement reliability (α = 0.92). Micropore dimensions correlated strongest between OCT and RCM (tau-c/ICC/PCC ≥ 0.5). All modalities were prone to artifacts, which may have adversely affected measurement variation and intermethod agreement.
CONCLUSION
Intermethod agreement and reliability appear to be highly dependent on the specific modality and target measurement. To reap the benefits of each technique while mitigating their limitations, an integrated approach to optical imaging is recommended. Lasers Surg. Med. © 2020 Wiley Periodicals LLC.
Types de publication
Comparative Study
Evaluation Study
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
838-848Subventions
Organisme : American Society for Laser Medicine and Surgery
ID : ASLMS educational grant (CRM:0003557)
Organisme : Innovation Fund Denmark: Industrial research
ID : grant (7038-00085A)
Commentaires et corrections
Type : CommentIn
Informations de copyright
© 2020 Wiley Periodicals LLC.
Références
Sklar LR , Burnett CT , Waibel JS , Moy RL , Ozog DM . Laser assisted drug delivery: A review of an evolving technology. Lasers Surg Med 2014;46:249-262. https://doi.org/10.1002/lsm.22227
Ibrahim O , Wenande E , Hogan S , Arndt KA , Haedersdal M , Dover JS . Challenges to laser-assisted drug delivery: Applying theory to clinical practice. Lasers Surg Med 2018;50:20-27. https://doi.org/10.1002/lsm.22769
Bhatta AK , Keyal U , Huang X , Zhao JJ . Fractional carbon-dioxide (CO2) laser-assisted topical therapy for the treatment of onychomycosis. J Am Acad Dermatol 2016;74:916-923. https://doi.org/10.1016/j.jaad.2015.12.002
El-Aal EBA , Abdo HM , Ibrahim SM , Eldestawy MT . Fractional carbon dioxide laser assisted delivery of topical tazarotene versus topical tioconazole in the treatment of onychomycosis. J Dermatol Treat 2018;30:277-282. https://doi.org/10.1080/09546634.2018.1509046
de Morais OO , Costa IMC , Gomes CM , Shinzato DH , Ayres GMC , Cardoso RM . The use of the Er:YAG 2940nm laser associated with amorolfine lacquer in the treatment of onychomycosis. An Bras Dermatol 2013;88:847-849. https://doi.org/10.1590/abd1806-4841.20131932
Zhou BR , Lu Y , Permatasari F , et al. The efficacy of fractional carbon dioxide (CO2) laser combined with luliconazole 1% cream for the treatment of onychomycosis: A randomized, controlled trial. Medicine (Baltimore) 2016;95:e5141. https://doi.org/10.1097/MD.0000000000005141
Shi J , Li J , Huang H , et al. The efficacy of fractional carbon dioxide (CO2) laser combined with terbinafine hydrochloride 1% cream for the treatment of onychomycosis. J Cosmet Laser Ther 2017;19:353-359. https://doi.org/10.1080/14764172.2017.1334925
de Oliveira GB , Antonio JR , Antonio CR , Tomé FA . The association of fractional CO2 laser 10.600nm and photodynamic therapy in the treatment of onychomycosis. An Bras Dermatol 2015;90:468-471. https://doi.org/10.1590/abd1806-4841.20153588
Lim E-H , Seo Y-J , Lee J-H , Im M . Onychodystrophy treated using fractional carbon dioxide laser therapy and topical steroids: New treatment options for nail dystrophy. Dermatol Surg 2013;39:1931-1933. https://doi.org/10.1111/dsu.12365
Zhang J , Lu S , Huang H , Li X , Cai W , Ma J , Xi L . Combination therapy for onychomycosis using a fractional 2940-nm Er:YAG laser and 5% amorolfine lacquer. Lasers Med Sci 2016;31:1391-1396. https://doi.org/10.1007/s10103-016-1990-z
Taudorf EH , Haak CS , Erlendsson AM , et al. Fractional ablative erbium YAG laser: Histological characterization of relationships between laser settings and micropore dimensions. Lasers Surg Med 2014;46:281-289. https://doi.org/10.1002/lsm.22228
Cinotti E , Labeille B , Cambazard F , Perrot J-L . Confocal microscopy for special sites and special uses. Dermatol Clin 2016;34:477-485. https://doi.org/10.1016/j.det.2016.05.010
von Braunmühl T . Optical coherence tomography. Dermatology Venereology 2015;66:499-503. https://doi.org/10.1007/s00105-015-3607-z
Cinotti E , Fouilloux B , Perrot JL , Labeille B , Douchet C , Cambazard F . Confocal microscopy for healthy and pathological nail. J Eur Acad Dermatol Venereol 2014;28:853-858. https://doi.org/10.1111/jdv.12330
Werner B , Antunes A . Microscopic examination of normal nail clippings. Dermatol Pract Concept 2013;3:9-14. https://doi.org/10.5826/dpc.0303a04
Fuchs CSK , Andersen AJB , Ardigo M , Philipsen PA , Haedersdal M , Mogensen M . Acne vulgaris severity graded by in vivo reflectance confocal microscopy and optical coherence tomography. Lasers Surg Med 2019;51:104-113. https://doi.org/10.1002/lsm.23008
Fuchs CSK , Ortner VK , Mogensen M , Philipsen PA , Haedersdal M . Transfollicular delivery of gold microparticles in healthy skin and acne vulgaris, assessed by in vivo reflectance confocal microscopy and optical coherence tomography. Lasers Surg Med 2019. https://doi.org/10.1002/lsm.23076
Farzin B , Gentric J-C , Pham M , et al. Agreement studies in radiology research. Diagn Interv Imaging 2017;98:227-233. https://doi.org/10.1016/j.diii.2016.05.014
Bankier AA , Levine D , Halpern EF , Kressel HY . Consensus interpretation in imaging research: Is there a better way? Radiology 2010;257:14-17. https://doi.org/10.1148/radiol.10100252
Farren L , Shayler S , Ennos AR . The fracture properties and mechanical design of human fingernails. J Exp Biol 2004;207:735-741. https://doi.org/10.1242/jeb.00814
Giavarina D . Understanding Bland Altman analysis. Biochem Medica 2015;25:141-151. https://doi.org/10.11613/BM.2015.015
Phatak AG , Nimbalkar SM . Method comparison (agreement) studies: Myths and rationale. J Clin Diagn Res 2017;11:JI01-JI03. https://doi.org/10.7860/JCDR/2017/23897.9314
Liu J , Tang W , Chen G , Lu Y , Feng C , Tu XM . Correlation and agreement: Overview and clarification of competing concepts and measures. Shanghai Arch Psychiatry 2016;28:115-120.
Dhalla A-HZ , Migacz JV , Izatt JA . Crosstalk rejection in parallel optical coherence tomography using spatially incoherent illumination with partially coherent sources. Opt Lett 2010;35:2305-2307. https://doi.org/10.1364/OL.35.002305
Sattler E , Kaestle R , Rothmund G , Welzel J . Confocal laser scanning microscopy, optical coherence tomography and transonychial water loss for in vivo investigation of nails: CLSM, OCT and TOWL for in vivo investigation of nails. Br J Dermatol 2012;166:740-746. https://doi.org/10.1111/j.1365-2133.2011.10730.x
Mogensen M , Thomsen JB , Skovgaard LT , Jemec GBE . Nail thickness measurements using optical coherence tomography and 20-MHz ultrasonography. Br J Dermatol 2007;157:894-900.
Turani Z , Fatemizadeh E , Xu Q , Daveluy S , Mehregan D , Avanaki MRN . Refractive index correction in optical coherence tomography images of multilayer tissues. J Biomed Opt 2018;23:070501-070504. https://doi.org/10.1117/1.JBO.23.7.070501
Israelsen NM , Maria M , Mogensen M , et al. The value of ultrahigh resolution OCT in dermatology-Delineating the dermo-epidermal junction, capillaries in the dermal papillae and vellus hairs. Biomed Opt Express 2018;9:2240-2265. https://doi.org/10.1364/BOE.9.002240
Huang Y-C , Chou C-L , Chiang Y-Y . Efficacy of pulsed dye laser plus topical tazarotene versus topical tazarotene alone in psoriatic nail disease: A single-blind, intrapatient left-to-right controlled study. Lasers Surg Med 2013;45:102-107. https://doi.org/10.1002/lsm.22122
Elmorsy EH , Abou Khadr NA , Taha AAA , Aziz DMA . Long-pulsed Nd:YAG (1,064 nm) laser versus Q-switched Nd:YAG (1,064 nm) laser for treatment of onychomycosis [published online ahead of print December 5, 2019]. Lasers Surg Med 2019. https://doi.org/10.1002/lsm.23200
Ortiz AE , Avram MM , Wanner MA . A review of lasers and light for the treatment of onychomycosis. Lasers Surg Med 2014;46:117-124. https://doi.org/10.1002/lsm.22211
Tsai M-T , Tsai T-Y , Shen S-C , Ng C , Lee Y-J , Lee J-D , Yang C-H . Evaluation of laser-assisted trans-nail drug delivery with optical coherence tomography. Sensors 2016;16:2111. https://doi.org/10.3390/s16122111