UArizona Portable Device May Bring Change to Standard of Care for Skin Cancer

With development of a handheld confocal microscopes, researchers at the University of Arizona Health Sciences want to make existing technology more affordable and accessible to a larger number of patients.

TUCSON, Ariz. – Researchers at the University of Arizona Health Sciences have developed – and are continuing to improve – a handheld device to bring the next generation of skin cancer prevention and treatment options into more patient-care settings.

Drs. Clara Curiel Lewandrowski and Dongkyun Kang prepare to do a side-by-side test of the confocal microscope and the portable unit to compare the image quality. Dr. Curiel is aligning the larger device, while Dr. Kang prepares to aim the handheld device at a nearby spot on Savannah Barber’s arm. Barber is a medical assistant at Banner – University Medical Center Tucson. (Photo: Kris Hanning/University of Arizona Health Sciences)

Described as a “portable confocal microscope” (PCM), the device is a modernized and more practical use of reflective confocal microscopy (RCM) – technology that provides non-invasive imaging of the skin. In RCM, the microscope directs a narrow laser light on a specific spot on the skin with vertical and horizontal scanning capability. This results in a real-time diagnosis that, in some cases, can bypass the need for a biopsy and lead to same-day treatment for malignant lesions.

Clara Curiel-Lewandrowski, MD, the Alan and Janice Levin Family Endowed Chair for Excellence in Cancer Research, co-director of the Skin Cancer Institute at the UArizona Cancer Center, and professor and interim chief of the Division of Dermatology, UArizona College of Medicine – Tucson, brought the technology to the university. Thanks to funding from the UArizona Technology and Research Initiative Fund (TRIF), Dr. Curiel purchased a commercial instrument for her clinical practice in 2014.

“The commercial insturment we purchased has three lasers, which allows us to expand into studies evaluating fluorescent properties,” Dr. Curiel said. “One of the benefits of having our own instrument is that other investigators can compare their imaging technology to an industry “Gold Standard”, holding FDA approval for skin assessment. That provides us the capability to provide feedback to the investigators and improve the technology.”

Dongkyun Kang, PhD, co-leader of the Cancer Imaging Program, an assistant professor of optical sciences and biomedical engineering, and BIO5 Institute member, joined the UArizona Health Sciences in 2017 with the goal to design a handheld or larger portable version of the technology that not only would be easier for clinicians to use, but would be more affordable for wider use in the patient-care setting. A commercial instrument today generally costs more than $80,000, making it too expensive for many practices and, therefore, unavailable to a large number of patients.

Dr. Clara Curiel Lewandrowski in front of a screen showing the images produced by a confocal microscope. She holds the smaller, portable version she is developing for wider use by doctors. (Photo: Kris Hanning/ University of Arizona Health Sciences)Although existing RCM technology is made with very sophisticated electrical and optical components, Dr. Kang’s lab focused on lowering manufacturing costs by developing the PCM device using an inexpensive near-infrared LED as the light source. Recent results appearing in Applied Optics, which publishes in-depth, peer-reviewed content about applications-centered research in optics, suggest the PCM device provides better image contrast and enhanced imaging depth compared to a previous smartphone-based device. That earlier device was tested to determine feasibility of using the instrument at the Infectious Diseases Institute at Makerere University in Kampala, Uganda, as a smartphone attachment to remotely diagnose Karposi’s sarcoma (involving purplish lesions on the legs, feet or face) and cervical cancer.

Based on the preliminary success of the latest PCM innovation, Dr. Kang’s lab licensed three intellectual properties through Tech Launch Arizona, the commercialization arm of the UArizona, to a startup company in California last year. Commercial versions of the newest device could look something like a large pen and would cost closer to $1,000, said Dr. Kang.

“The goal is to make it widely available to dermatologists and practitioners around the world.” Dr. Kang said. “Collaboration is very important, so we are making this technology work in the context of the patient-care setting. I work very closely with Dr. Curiel and also my collaborators in Uganda to see what we can improve.”

Dr. Dongkyun Kang works to align the laser optics to increase the light power of a portable confocal microscope he is developing with Dr. Clara Curiel Lewandrowski. (Photo: Kris Hanning/ University of Arizona Health Sciences)Drs. Curiel and Kang continue to advance the PCM device, routinely testing and comparing its performance to the commercial RCM unit and other available technologies. This process is a prime example of effective collaboration between clinicians and engineers developing novel medical technologies.

“I view confocal microscopy as the ‘future is now,’” Dr. Curiel said. “We are poised to be the institution that changes the standard of care in skin cancer prevention, diagnosis and minimally invasive therapeutics. Our advantages are that we have a large number of skin cancer cases and we have the technology to initiate the shift in practice. Now we must embrace the change.”

A version of this article appeared originally on the UArizona Health Sciences Connect website.

A photo gallery illustrating development of the PCM device can be found here.

The above video can be viewed also on YouTube.

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NOTE: Photos and video (including B-roll) associated with this release available at this link – https://arizona.box.com/s/dxju6omjo7wv9m7r92r3olwhjktdjsuy.

About the University of Arizona Cancer Center
The University of Arizona Cancer Center is the only National Cancer Institute-designated Comprehensive Cancer Center with headquarters in Arizona. The UArizona Cancer Center is supported by NCI Cancer Center Support Grant No. CA023074. With primary locations at the University of Arizona in Tucson and at Dignity Health St. Joseph’s Hospital and Medical Center in Phoenix, the Arizona Cancer Center has more than a dozen research and education offices throughout the state, with more than 300 physicians and scientists working together to prevent and cure cancer. For more information: cancercenter.arizona.edu (Follow us: YouTube).

About the University of Arizona Health Sciences
The University of Arizona Health Sciences is the statewide leader in biomedical research and health professions training. UArizona Health Sciences includes the Colleges of Medicine (Tucson and Phoenix), Nursing, Pharmacy, and the Mel and Enid Zuckerman College of Public Health, with main campus locations in Tucson and the Phoenix Biomedical Campus in downtown Phoenix. From these vantage points, Health Sciences reaches across the state of Arizona, the greater Southwest and around the world to provide next-generation education, research and outreach. A major economic engine, Health Sciences employs nearly 5,000 people, has approximately 4,000 students and 900 faculty members, and garners $200 million in research grants and contracts annually. For more information: uahs.arizona.edu (Follow us: Facebook | Twitter | YouTube | LinkedIn | Instagram).