Skin Imaging and Technology Center

Alexander Witkowski analyzing a confocal microscopy image

Advanced imaging technology for non-invasive diagnosis of skin cancers

Reflectance confocal microscopy (RCM) is a non-invasive, laser screening method that enables a trained dermatologist to visualize lesions (moles) at the cellular level. With high resolution dermoscopic images a confocal expert can differentiate between moles that should be biopsied or not as well as diagnose certain types of skin cancers. The RCM process is completely painless, and offers in-vivo, real time evaluation of the skin.

Reflectance confocal microscopy assists with detecting skin cancers at their earliest stages and can reduce invasive biopsies of concerning moles by up to 50%.

Patients who would particularly benefit from this imaging technology include individuals with:

  • Many, or unusual looking moles
  • A personal or family history of melanoma
  • Concerns in cosmetically sensitive areas, in particular the face and neck
Learn about Reflectance Confocal Microscopy at OHSU

The confocal laser uses a water immersible objective lens allowing it to focus at multiple depths.  The contrast is provided by the differences in refraction index of organelles and other microscructures.  Melanin and melanosomes are a strong source of contrast, rendering melanocytic cells particularly evident by means of this screening technology.  The lateral resolution of RCM is similar to that of a light microscope and therefore is considered to give dermatologists a cellular view of your skin lesion (mole), virtually and in real time.

The entire process takes 5 to 10 minutes per skin lesion.  This procedure is painless, meaning no needles, pain, blood, wounds or healing needed.  RCM screening is safe for pregnant women and children.

There is no specific preparation for a virtual biopsy with RCM.  This procedure can be done same day in the clinic.  Please avoid wearing makeup during your skin exam.

Thanks to RCM we can identify a melanoma at the earliest stages possible and help to reduce both morbidity and mortality from this disease.  Due to melanocytes in the skin that have a high reflective index this technology is useful to differentiate good from bad moles.

RCM shows high sensitivity and specificity, approaching 97% when 3 of 5 criteria are present in basal cell carcinoma diagnosis.  This technology is now used to diagnose this type of skin cancer during the same visit and help streamline the treatment process and avoid patient waiting times for biopsy results.

Our team