Figure 1 Sensitivity of CLSM in the diagnosis of (a) Malignant Melanoma and (b) Basal Cell Carcinoma.
Figure 2 Specificity of CLSM in the diagnosis of (a) Malignant Melanoma and (b) Basal Cell Carcinoma.
Figure 3 Positive likelihood ratio of CLSM in the diagnosis of (a) Malignant Melanoma and (b) Basal Cell Carcinoma.
Figure 4 Negative likelihood ratio of CLSM in the diagnosis of (a) Malignant Melanoma and (b) Basal Cell Carcinoma.
Figure 5Diagnostic odds ratio of CLSM in the diagnosis of (a) Malignant Melanoma and (b) Basal Cell Carcinoma.
Figure 6 SROC curve of CLSM for diagnosing (a) Malignant Melanoma and (b) Basal Cell Carcinoma.
Key words |
Ovid embase |
Ovid medline |
Pubmed |
Cochrane |
Confocal microscopy |
11769 |
9221 |
57839 |
0 |
Confocal laser scanning microscopy |
2010 |
1436 |
57839 |
0 |
Reflectance confocal microscopy |
102 |
146 |
607 |
0 |
Confocal microscopy AND skin cancer |
34 |
50 |
461 |
0 |
Confocal microscopy AND histology |
500 |
399 |
32157 |
0 |
Confocal microscopy AND skin cancer AND histology |
3 |
4 |
358 |
0 |
Table1 The number of hits obtained from each database when searching for articles using key words
Ser |
Study Author |
Study Type |
Evidence Level |
Type Of Technique Used |
Number Of Skin Cancer Lesions |
Total Number Of Lesions* |
Reference Standard |
Blinding |
Number Of Patients |
Patient Characteristics |
1 |
Nori S et al., 200421 |
Retrospective |
Ib |
In vivo CM |
83 |
137 |
Histology |
yes |
145 |
Lesions 98 male specimens, 54 female specimen |
2 |
Horn M et al., 200626 |
Retrospective |
II |
Ex vivo CM |
20 |
40 |
Histology |
yes |
20 |
Not described |
3 |
Gerger A et al., 200527 |
Prospective |
II |
In vivo CM |
27 |
57 |
Histology |
yes |
57 |
Gender and age not mentioned. Location of lesions given as 15 on back, 6 on legs, 4 on head and 1 on acral skin |
4 |
Langley R et al., 200728 |
Prospective |
II |
In vivo CM |
37 |
125 |
Histology |
no |
125 |
Age range 16-84 yrs, mean age 44.2, no gender statistics |
5 |
Guitera P |
Retrospective |
II |
In vivo CM |
29 |
73 |
Histology |
yes |
73 |
Not described for test set |
6 |
Curchin C et al.,201132 |
Retrospective |
Ib |
In vivo CM |
13 MM |
50 |
Histology |
yes |
42 |
Not described |
9 BCC |
||||||||||
7 |
Longo C |
Retrospective |
II |
In vivo CM |
32 MM |
140 |
Histology |
yes |
140 |
64 male,76 female |
28 BCC |
||||||||||
6 SCC |
||||||||||
8 |
Guitera P et al.,201231 |
Retrospective |
II |
In vivo CM |
105 MM |
356 |
Histology |
yes |
Not Available |
Total 663 patients, 309 females and 354 males. Median age 53 yrs. But patient characteristics not described separately for test set |
52 BCC |
Table 2Tabulated form of variables collected from the included studies
Ser |
Studies |
Type of Skin cancer |
Average sensitivity (%) |
Average |
Average PPV |
Average NPV |
1 |
Nori S et al., 200421 |
BCC |
82.9 |
95.7 |
97.18 |
78.79 |
2 |
Horn M et al., 200626 |
SCC |
95 |
96.25 |
96.20 |
95.06 |
3 |
Gerger A et al., 200527 |
Melanoma |
88.15 |
97.60 |
96 |
90.63 |
4 |
Langley R et al.,200728 |
Melanoma |
97.3 |
83 |
70.59 |
98.65 |
5 |
Guitera P et al.,201029 |
Melanoma |
93 |
82 |
77.14 |
94.74 |
6 |
Curchin C et al.32 |
Melanoma |
92.3 |
75 |
52.17 |
96.55 |
BCC |
66.7 |
100 |
100 |
93.18 |
||
7 |
Longo C et al.,201330
|
Melanoma |
96.5 |
94.1 |
83.78 |
99.03 |
BCC |
100 |
99.1 |
96.55 |
100 |
||
SCC |
78.12 |
87 |
21.62 |
98.89 |
||
8 |
Guitera P et al.,201231 |
Melanoma |
87.6 |
70.8 |
55.76 |
93.19 |
BCC |
100 |
88.5 |
59.77 |
100 |
Table 3Table showing sensitivities, specificities, PPV and NPV of the included studies
Skin Cancer type |
Pooled Sensitivity |
Pooled Specificity |
Pooled Positive LR |
Pooled Negative LR |
Pooled DOR |
|||||
|
Value |
95% CI |
Value |
95% CI |
Value |
95% CI |
Value |
95% CI |
Value |
95% CI |
|
0.914 |
0.871- 0.946 |
0.799 |
0.764 - 0.832 |
5.935 |
3.366 – 10.466 |
0.109 |
0.062- 0.190 |
80.075 |
23.438- 273.57 |
Basal Cell Carcinoma |
0.901 |
0.846 -0.941 |
0.926 |
0.899- 0.947 |
25.117 |
5.474-115.256 |
0.092 |
0.019-0.449 |
358.05 |
77.505- 1654.1 |
Table4 Table showing pooled sensitivities, specificities, LR and DOR of the included studies