Advanced Diagnostics and Optical Imaging Technologies in Cancer Research

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Methods and Technologies Development".

Deadline for manuscript submissions: 31 December 2025 | Viewed by 13216

Special Issue Editor


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Guest Editor
1. Department of Oncologic Dermatology, Elias Emergency University Hospital, Carol Davila University of Medicine and Pharmacy, No. 37 Dionisie Lupu Str, 030167 Bucharest, Romania
2. Clinic of Dermatology, Elias Emergency University Hospital, No. 17 Marasti Blvd, 011461 Bucharest, Romania
Interests: dermatology
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Special Issue Information

Dear Colleagues,

Medical imaging represents an important step in understanding human morphology and physiology, but above all, it dramatically changed the way in which doctors evaluate, diagnose, monitor and treat diseases. Classic imaging methods, such as ultrasound, CT scan, MRI and radionuclide imaging (PET, SPECT), that have been used for decades are currently considered the standard-of-care in the diagnosis and treatment monitoring of many pathological conditions.

Nevertheless, cancer is the disease of the 21st century, being potentially devastating and unfortunately having an increasing incidence. Although the prognosis is favourable in early stages for the majority of cancers, the situation changes significantly in the case of late diagnosis, in spite of emergency novel therapies. Therefore, there is a real and increasing need for non-invasive, rapid and precise methods of diagnosis.

In dermato-oncology, the benefits of dermoscopy are already widely acknowledged as a popular method of diagnosis and follow-up. However, fewer colleagues know and work with other methods such as high-frequency ultrasound (HFUS) and reflectance confocal microscopy (RCM). However, these comprise only a small number of the large spectrum of cutaneous imaging techniques, with no less than eleven optical imaging methods being available for improving diagnostic accuracy. Additionally, in clinical practice, no single imaging method is ideal for all skin conditions, hence the need for a multimodal approach. The same principle can be applied to all other medical specialities that are currently characterized by the need to use combined imaging techniques for screening, diagnosis and follow-up.

Improving the standardization of non-invasive imaging techniques in medicine will allow clinical practitioners to better diagnose and monitor cancers over time and achieve better diagnostic accuracy, ultimately improving the patient’s quality of life and lowering healthcare costs.

Since great innovations in optical imaging have often been the result of the collaboration between clinical practitioners, medical researchers and engineers, I invite all physicians and engineers alike, who are experimenting with modern optical and laser digital devices for the digital diagnosis of cancer to submit your work to this Special Issue.

Moreover, compiling several techniques and perspectives of use in different specialties in the same issue represents a first step toward the emergence of combined techniques and the improvement in diagnostic accuracy of the techniques already used. I hope the collection of our published papers will remain a pillar of collaboration throughout all medical specialities and gather a great variety of outdated and novel imaging techniques and their role in the management of cancer.

Multimodal and AI-assisted approaches are welcomed. Potential topics include, but are not limited to:

  • Digital dermoscopy and total body mapping;
  • High-frequency ultrasound (HFUS) and dermoscopically guided HFUS (DG-HFUS);
  • Reflectance confocal microscopy (RCM);
  • Optical coherence tomography (OCT), LC-OCT and cross-polarization optical coherence tomography (CP OCT);
  • Diffuse optical tomography (DOT), diffuse optical imaging and diffuse optical spectroscopy;
  • Multi-spectral imaging and photoacoustic tomography;
  • Raman imaging and shifted excitation Raman differential spectroscopy (SERDS);
  • Diffuse optical spectroscopy (DOS);
  • Fluorescence imaging and confocal laser endomicroscopy with fluoresceint sodium;
  • Laser Doppler and speckle imaging;
  • macroscopic fluorescence lifetime imaging (macro-FLIM);
  • Multi-spectral optoacoustic tomography (MSOT), also known as functional photoacoustic tomography (fPAT);
  • Stereoscopic digital mammography (SDM), digital breast tomosynthesis (DBT) and dedicated breast computed tomography (BCT);
  • Electrical impedance spectroscopy (EIS) and microwave imaging spectroscopy (MIS);
  • Nonlinear optical imaging (NLOI): two-photon excitation fluorescence (TPEF) and second harmonic generation (SHG);
  • White light interference-phase microscopy;
  • Rapid scanning laser-emission microscopy (LEM).

Dr. Vlad Mihai Voiculescu
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Cancers is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • digital diagnostics
  • advanced diagnostics
  • optical imaging
  • medical images
  • artificial intelligence
  • image analysis
  • laser technologies

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Published Papers (8 papers)

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Research

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12 pages, 1762 KiB  
Article
Line-Field Confocal Optical Coherence Tomography: Is One Hour of Training Sufficient for Diagnosing Basal Cell Carcinoma?
by Elisa Cinotti, Martina D’Onghia, Alessandra Cartocci, Sofia Lo Conte, Lorenzo Barbarossa, Clara Tavernier, Giovanni Rubegni, Linda Tognetti, Mariano Suppa and Pietro Rubegni
Cancers 2025, 17(5), 826; https://doi.org/10.3390/cancers17050826 - 27 Feb 2025
Viewed by 470
Abstract
Background/Objectives: Basal cell carcinoma (BCC) is the most common malignancy, characterised by local invasiveness and the potential for tissue destruction. Diagnosing BCC can be challenging, particularly for less experienced dermatologists. Line-field confocal optical coherence tomography (LC-OCT), a new noninvasive optical technique, has become [...] Read more.
Background/Objectives: Basal cell carcinoma (BCC) is the most common malignancy, characterised by local invasiveness and the potential for tissue destruction. Diagnosing BCC can be challenging, particularly for less experienced dermatologists. Line-field confocal optical coherence tomography (LC-OCT), a new noninvasive optical technique, has become increasingly useful in clinical practice, allowing in vivo imaging at cellular resolution. This study aimed to evaluate the impact of a 1 h structured training session on the ability of dermatology residents to diagnose BCC using LC-OCT. Methods: Eight dermatology residents with different levels of LC-OCT experience (no experienced and low experience in LC-OCT) participated alongside an expert dermatologist as a benchmark. Overall, participants evaluated 40 histopathologically confirmed lesions (20 BCC, 20 non-BCC) before and after training, with and without the inclusion of dermoscopic images. Results: We observed a significant improvement in diagnostic accuracy post-training, especially among inexperienced users, with a 20% reduction in false negatives and a 35% reduction in false positives. When the dermoscopic images were included, further improvements were noted, with the accuracy increasing by an additional 5%. The overall diagnostic rate for inexperienced readers increased from 48% to 76% after training and to 81% with the addition of dermoscopic images in the course. Conclusions: Our study highlights the effectiveness of short, targeted training in enhancing the diagnostic utility of LC-OCT, emphasising its potential for broader clinical adoption to improve BCC detection. Full article
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10 pages, 2408 KiB  
Article
Benign or Malignant? Ex Vivo Confocal Laser Scanning Microscopy for Bedside Histological Assessment of Melanocytic Lesions
by Maximilian Deußing, Lisa Buttgereit, Michaela Maurer, Alisa Swarlik, Lara Stärr, Andreas Ohlmann, Katrin Kerl-French, Michael Flaig, Elke C. Sattler, Lars E. French and Daniela Hartmann
Cancers 2025, 17(1), 151; https://doi.org/10.3390/cancers17010151 - 6 Jan 2025
Viewed by 1038
Abstract
Objective: Ex vivo confocal laser scanning microscopy (EVCM) is an emerging imaging technique, which offers rapid tissue examination. While the current literature shows promising results in the evaluation of non-melanoma skin cancer, only limited research exists on the application of EVCM in melanocytic [...] Read more.
Objective: Ex vivo confocal laser scanning microscopy (EVCM) is an emerging imaging technique, which offers rapid tissue examination. While the current literature shows promising results in the evaluation of non-melanoma skin cancer, only limited research exists on the application of EVCM in melanocytic lesions. This study aimed to assess the utility of EVCM in the characterization of melanocytic lesions and compare its findings with gold-standard histopathology. Methods: A total of 130 skin lesions, including 76 benign and 54 malignant melanocytic lesions, were prospectively collected and imaged using EVCM. Three blinded investigators were asked to identify characteristic morphologic features observed in the lesions and classify them into benign vs. malignant. The results were then compared with the corresponding histopathology. Sensitivity and specificity were calculated using contingency tables to assess the diagnostic performance. Results: The application of EVCM allowed for the visualization of cellular and tissue-level details, including cellular pleomorphism and atypical melanocytes. A comprehensive list of benign and malignant features identified by EVCM was compiled. Using these diagnostic criteria, the imaging of the inexperienced and dermatohistopathology-experienced investigator reached 67.7% concordance, and the imaging trained dermatologist obtained 69.2% agreement with dermatohistopathology in differentiating benign vs. malignant lesions. The imaging-trained dermatohistopathologist performed best with concordance up to 79.2%. Conclusions: In conclusion, EVCM is a promising technique for the rapid assessment of melanocytic lesions. Our study provides a comprehensive overview of morphologic EVCM features, which will contribute to the development of diagnostic algorithms for accurate diagnosis and appropriate treatment planning. Further studies are needed to evaluate its clinical utility and validate our diagnostic criteria. Full article
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9 pages, 11545 KiB  
Article
Cutting-Edge Technology Without Cutting: Treating Skin Cancer in This Era—A Case Series
by Babar Rao, Alexis Moreno, Muhammad Shahmir Abbasi, Noah Musolff, Bianca Sanabria and Vlad Voiculescu
Cancers 2024, 16(21), 3557; https://doi.org/10.3390/cancers16213557 - 22 Oct 2024
Viewed by 1540
Abstract
Background: Traditional treatment methods for non-melanoma skin cancer (NMSC) include surgical excision with histological evaluation, yet advancements such as reflectance confocal microscopy (RCM) and superficial radiation therapy (SRT) offer non-invasive management alternatives. This study aims to evaluate the use of RCM for the [...] Read more.
Background: Traditional treatment methods for non-melanoma skin cancer (NMSC) include surgical excision with histological evaluation, yet advancements such as reflectance confocal microscopy (RCM) and superficial radiation therapy (SRT) offer non-invasive management alternatives. This study aims to evaluate the use of RCM for the evaluation of treatment outcomes after SRT in managing localized NMSC. Methods: A prospective interventional case series study was conducted on patients treated for NMSC with SRT between March 2020 and December 2023. Suspected NMSC lesions were initially evaluated with a handheld dermoscope and then imaged at multiple depths using a VivaScope 1500 RCM. Two dermatologists trained in RCM reviewed the images. Confirmed NMSC lesions were biopsied and treated with SRT, followed by RCM imaging at six months post-treatment to assess cancer clearance, scarring, and inflammation. Results: Of the 38 lesions (composed of SCC (24) and BCC (14)) treated affecting the 29 patients, all lesions showed no residual tumor activity upon conducting follow-up RCM (100% clearance). Scarring and mild erythema were noted clinically. Six lesions demonstrated moderate to severe inflammation at a 6-month follow-up. Conclusions: This study demonstrates successful non-invasive management of localized NMSC using RCM and SRT. RCM was able to non-invasively demonstrate complete tumor clearance achieved by SRT with minimal adverse effects. These findings support considering the use of RCM and SRT as primary diagnostic, monitoring, and treatment options for NMSC without the need for biopsies, especially for elderly patients or those unsuitable for surgery due to medical conditions. Full article
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22 pages, 7116 KiB  
Article
Statistical Analysis of Gastric Cancer Cells Response to Broadband Terahertz Radiation with and without Contrast Nanoparticles
by Oliver Daniel Schreiner, Diana Socotar, Romeo Cristian Ciobanu, Thomas Gabriel Schreiner and Bogdan Ionel Tamba
Cancers 2024, 16(13), 2454; https://doi.org/10.3390/cancers16132454 - 4 Jul 2024
Cited by 3 | Viewed by 1557
Abstract
The paper describes the statistical analysis of the response of gastric cancer cells and normal cells to broadband terahertz radiation up to 4 THz, both with and without the use of nanostructured contrast agents. The THz spectroscopy analysis was comparatively performed under the [...] Read more.
The paper describes the statistical analysis of the response of gastric cancer cells and normal cells to broadband terahertz radiation up to 4 THz, both with and without the use of nanostructured contrast agents. The THz spectroscopy analysis was comparatively performed under the ATR procedure and transmission measurement procedure. The statistical analysis was conducted towards multiple pairwise comparisons, including a support medium (without cells) versus a support medium with nanoparticles, normal cells versus normal cells with nanoparticles, and, respectively, tumor cells versus tumor cells with nanoparticles. When generally comparing the ATR procedure and transmission measurement procedure for a broader frequency domain, the differentiation between normal and tumor cells in the presence of contrast agents is superior when using the ATR procedure. THz contrast enhancement by using contrast agents derived from MRI-related contrast agents leads to only limited benefits and only for narrow THz frequency ranges, a disadvantage for THz medical imaging. Full article
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12 pages, 964 KiB  
Article
Interest of Integrated Whole-Body PET/MR Imaging in Gastroenteropancreatic Neuroendocrine Neoplasms: A Retro-Prospective Study
by Camelia Abid, Jenny Tannoury, Mathieu Uzzan, Edouard Reizine, Sébastien Mulé, Julia Chalaye, Alain Luciani, Emmanuel Itti and Iradj Sobhani
Cancers 2024, 16(13), 2372; https://doi.org/10.3390/cancers16132372 - 28 Jun 2024
Cited by 1 | Viewed by 1109
Abstract
Introduction and aim: Simultaneous positron emission tomography/magnetic resonance imaging (PET-MRI) combines the high sensitivity of PET with the high specificity of MRI and is a tool for the assessment of gastroenteropancreatic neuroendocrine neoplasms (G-NENs). However, it remains poorly evaluated with no clear recommendations [...] Read more.
Introduction and aim: Simultaneous positron emission tomography/magnetic resonance imaging (PET-MRI) combines the high sensitivity of PET with the high specificity of MRI and is a tool for the assessment of gastroenteropancreatic neuroendocrine neoplasms (G-NENs). However, it remains poorly evaluated with no clear recommendations in current guidelines. Thus, we evaluated the prognostic impact of PET-MRI in G-NEN patients. Methods: From June 2017 to December 2021, 71 G-NEN patients underwent whole-body PET-MRI for staging and/or follow-up purposes. A whole-body emission scan with 18F-6-fluoro-L-dihydroxyphenylalanine (18FDOPA, n = 30), 18F-fluoro-2-deoxy-D-glucose (18FDG, n = 21), or 68Ga-(DOTA(0)-Phe(1)-Tyr(3))-octreotide (68Ga-DOTATOC, n = 20) with the simultaneous acquisition of a T1-Dixon sequence and diffusion-weighed imaging (DWI), followed by a dedicated step of MRI sequences with a Gadolinium contrast was performed. The patients underwent PET-MRI every 6–12 months during the follow-up period until death. Over this period, 50 patients with two or more PET-MRI were evaluated. Results: The mean age was 61 [extremes, 31–92] years. At the baseline, PET-MRI provided new information in 12 cases (17%) as compared to conventional imaging: there were more metastases in eight, an undescribed location (myocardia) in two, and an unknown primary location in two cases. G grading at the baseline influenced overall survival. During the follow-up (7–381 months, mean 194), clinical and therapy managements were influenced by PET-MRI in three (6%) patients due to new metastases findings when neither overall, nor disease-free survivals in these two subgroups (n = 12 vs. n = 59), were different. Conclusion: Our study suggests that using PET/MRI with the appropriate radiotracer improves the diagnostic performance with no benefit on survival. Further studies are warranted to evaluate the cost-effectiveness of this procedure. Full article
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Review

Jump to: Research

33 pages, 5027 KiB  
Review
Devices and Methods for Dosimetry of Personalized Photodynamic Therapy of Tumors: A Review on Recent Trends
by Polina Alekseeva, Vladimir Makarov, Kanamat Efendiev, Artem Shiryaev, Igor Reshetov and Victor Loschenov
Cancers 2024, 16(13), 2484; https://doi.org/10.3390/cancers16132484 - 8 Jul 2024
Cited by 1 | Viewed by 2252
Abstract
Significance: Despite the widespread use of photodynamic therapy in clinical practice, there is a lack of personalized methods for assessing the sufficiency of photodynamic exposure on tumors, depending on tissue parameters that change during light irradiation. This can lead to different treatment results. [...] Read more.
Significance: Despite the widespread use of photodynamic therapy in clinical practice, there is a lack of personalized methods for assessing the sufficiency of photodynamic exposure on tumors, depending on tissue parameters that change during light irradiation. This can lead to different treatment results. Aim: The objective of this article was to conduct a comprehensive review of devices and methods employed for the implicit dosimetric monitoring of personalized photodynamic therapy for tumors. Methods: The review included 88 peer-reviewed research articles published between January 2010 and April 2024 that employed implicit monitoring methods, such as fluorescence imaging and diffuse reflectance spectroscopy. Additionally, it encompassed computer modeling methods that are most often and successfully used in preclinical and clinical practice to predict treatment outcomes. The Internet search engine Google Scholar and the Scopus database were used to search the literature for relevant articles. Results: The review analyzed and compared the results of 88 peer-reviewed research articles presenting various methods of implicit dosimetry during photodynamic therapy. The most prominent wavelengths for PDT are in the visible and near-infrared spectral range such as 405, 630, 660, and 690 nm. Conclusions: The problem of developing an accurate, reliable, and easily implemented dosimetry method for photodynamic therapy remains a current problem, since determining the effective light dose for a specific tumor is a decisive factor in achieving a positive treatment outcome. Full article
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32 pages, 1883 KiB  
Review
Photodynamic Therapy for Eye, Ear, Laryngeal Area, and Nasal and Oral Cavity Diseases: A Review
by Wojciech Domka, Dorota Bartusik-Aebisher, Wiktoria Mytych, Angelika Myśliwiec, Klaudia Dynarowicz, Grzegorz Cieślar, Aleksandra Kawczyk-Krupka and David Aebisher
Cancers 2024, 16(3), 645; https://doi.org/10.3390/cancers16030645 - 2 Feb 2024
Cited by 1 | Viewed by 2312
Abstract
Photodynamic therapy (PDT) has emerged as a promising modality for the treatment of various diseases. This non-invasive approach utilizes photosensitizing agents and light to selectively target and destroy abnormal cells, providing a valuable alternative to traditional treatments. Research studies have explored the application [...] Read more.
Photodynamic therapy (PDT) has emerged as a promising modality for the treatment of various diseases. This non-invasive approach utilizes photosensitizing agents and light to selectively target and destroy abnormal cells, providing a valuable alternative to traditional treatments. Research studies have explored the application of PDT in different areas of the head. Research is focusing on a growing number of new developments and treatments for cancer. One of these methods is PDT. Photodynamic therapy is now a revolutionary, progressive method of cancer therapy. A very important feature of PDT is that cells cannot become immune to singlet oxygen. With this therapy, patients can avoid lengthy and costly surgeries. PDT therapy is referred to as a safe and highly selective therapy. These studies collectively highlight the potential of PDT as a valuable therapeutic option in treating the head area. As research in this field progresses, PDT may become increasingly integrated into the clinical management of these conditions, offering a balance between effectiveness and minimal invasiveness. Full article
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23 pages, 3826 KiB  
Review
Digitally Enhanced Methods for the Diagnosis and Monitoring of Treatment Responses in Actinic Keratoses: A New Avenue in Personalized Skin Care
by Cristina Soare, Elena Codruta Cozma, Ana Maria Celarel, Ana Maria Rosca, Mihai Lupu and Vlad Mihai Voiculescu
Cancers 2024, 16(3), 484; https://doi.org/10.3390/cancers16030484 - 23 Jan 2024
Cited by 5 | Viewed by 2107
Abstract
Non-melanocytic skin cancers represent an important public health problem due to the increasing incidence and the important local destructive potential. Thus, the early diagnosis and treatment of precancerous lesions (actinic keratoses) is a priority for the dermatologist. In recent years, non-invasive skin imaging [...] Read more.
Non-melanocytic skin cancers represent an important public health problem due to the increasing incidence and the important local destructive potential. Thus, the early diagnosis and treatment of precancerous lesions (actinic keratoses) is a priority for the dermatologist. In recent years, non-invasive skin imaging methods have seen an important development, moving from simple observational methods used in clinical research, to true diagnostic and treatment methods that make the dermatologist’s life easier. Given the frequency of these precancerous lesions, their location on photo-exposed areas, as well as the long treatment periods, with variable, imprecise end-points, the need to use non-invasive imaging devices is increasingly evident to complete the clinical observations in the diagnosis and treatment of these lesions, with the aim of increasing accuracy and decreasing the adverse effects due to long treatment duration. This is the first review that brings together all skin imaging methods (dermoscopy, reflectance confocal microscopy, ultrasonography, dermoscopy-guided high frequency ultrasonography, and optical coherence tomography) used in the evaluation of actinic keratoses and their response to different treatment regimens. Full article
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