: How accurate is reflectance confocal microscopy (RCM) to predict whether a basal cell carcinoma (BCC) is infiltrative or superficial? Reflectance confocal microscopy (RCM) is a noninvasive imaging technique that has been

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How accurate is reflectance confocal microscopy (RCM) to predict whether a basal cell carcinoma (BCC) is infiltrative or superficial?
Reflectance confocal microscopy (RCM) is a noninvasive imaging technique that has been used to diagnose basal cell carcinoma (BCC). How accurate is RCM to predict whether a BCC is infiltrative or superficial?
The 2006 study {2} was inconclusive:

Limitations: The pigmented BCCs imaged in this study were predominantly nodular; a different set or additional criteria may be necessary for detection of infiltrative and metatypical BCCs.

The 2016 study {1} focused on superficial basal cell carcinoma (sBCC) but only looked at 3 cases.
Motivations:

Understanding if RCM is a decent replacement for a biopsy to diagnose BCC.
Superficial BCCs can be treated quite well with Imiquimod 5% cream (US brand: Aldara) but Imiquimod not doesn't work as well on infiltrative BCCs, which typically requires surgery (Mohs if cosmesis is important or old-fashioned excision).

References:

{1} Ghita, Mihaela A., Constantin Caruntu, Adrian E. Rosca, Harillaq Kaleshi, Ana Caruntu, Liliana Moraru, Anca Oana Docea et al. "Reflectance confocal microscopy and dermoscopy for in vivo, non-invasive skin imaging of superficial basal cell carcinoma." Oncology letters 11, no. 5 (2016): 3019-3024. dx.doi.org/10.3892%2Fol.2016.4354 ; www.ncbi.nlm.nih.gov/pmc/articles/PMC4840988/ {2} Agero, Anna Liza Chan, Klaus J. Busam, Cristiane Benvenuto-Andrade, Alon Scope, Melissa Gill, Ashfaq A. Marghoob, Salvador González, and Allan C. Halpern. "Reflectance confocal microscopy of pigmented basal cell carcinoma." Journal of the American Academy of Dermatology 54, no. 4 (2006): 638-643. doi.org/10.1016/j.jaad.2005.11.1096

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