Trial Outcomes & Findings for Investigation of Mohs Surgical Margins Using Two Photon Microscopy (NCT NCT05814900)

NCT ID: NCT05814900

Last Updated: 2026-04-02

Results Overview

Sensitivity and specificity of two-photon fluorescence microscopy on Mohs surgical margins compared to frozen sections as gold standard

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

135 participants

Primary outcome timeframe

During Mohs surgery, typically less than 60 minutes

Results posted on

2026-04-02

Participant Flow

Withdrawal group was due to technical issues during frozen sectioning or specimen holder failure. The first 10 patients of the study (pre-study training) were used to develop procedures and train readers.

Participant milestones

Participant milestones
Measure
Two-photon Fluorescence Microscopy (TPFM) Imaging of Surgical Margins
Patients will be imaged with two-photon fluorescence microscopy
Overall Study
STARTED
135
Overall Study
Withdrawal
3
Overall Study
Pre-study training
10
Overall Study
COMPLETED
135
Overall Study
NOT COMPLETED
0

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Investigation of Mohs Surgical Margins Using Two Photon Microscopy

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Two-photon Fluorescence Microscopy Imaging of Surgical Margins
n=135 Participants
Patients will be imaged with two-photon fluorescence microscopy
Age, Categorical
<=18 years
0 Participants
n=5 Participants
Age, Categorical
Between 18 and 65 years
28 Participants
n=5 Participants
Age, Categorical
>=65 years
107 Participants
n=5 Participants
Sex: Female, Male
Female
66 Participants
n=5 Participants
Sex: Female, Male
Male
69 Participants
n=5 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=5 Participants
Race (NIH/OMB)
Asian
0 Participants
n=5 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=5 Participants
Race (NIH/OMB)
Black or African American
0 Participants
n=5 Participants
Race (NIH/OMB)
White
131 Participants
n=5 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=5 Participants
Race (NIH/OMB)
Unknown or Not Reported
4 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
1 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
117 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
17 Participants
n=5 Participants
Region of Enrollment
United States
135 Participants
n=5 Participants

PRIMARY outcome

Timeframe: During Mohs surgery, typically less than 60 minutes

Population: Each patient may undergo multiple Mohs micrographic surgery staged excisions. 122 first stage excisions, 44 second stage excisions and 3 third stage excisions.

Sensitivity and specificity of two-photon fluorescence microscopy on Mohs surgical margins compared to frozen sections as gold standard

Outcome measures

Outcome measures
Measure
TPFM Imaging of Surgical Margins
n=169 Mohs micrographic surgery excisions
Patients will be imaged with TPFM
Agreement Between Frozen Sections and Two Photon Fluorescence Microscopy on Mohs Margins
Sensitivity
72.7 Percentage
Interval 57.2 to 85.0
Agreement Between Frozen Sections and Two Photon Fluorescence Microscopy on Mohs Margins
Specificity
96.8 Percentage
Interval 92.0 to 99.1

SECONDARY outcome

Timeframe: During Mohs surgery, typically less than 60 minutes

Population: Each patient may undergo multiple Mohs micrographic surgery staged excisions. 122 first stage excisions, 44 second stage excisions and 3 third stage excisions.

Calculation of specificity using frozen sections as the gold standard but accounting for frozen section artifacts that lead to incorrect treatment outcome. For example, initially positive on frozen section margins but negative on two-photon fluorescence microscopy because cryosectioning to produce a flat slide has sectioned 100s of microns deeper into the margin and into the tumor is counted as a false positive for frozen section.

Outcome measures

Outcome measures
Measure
TPFM Imaging of Surgical Margins
n=169 Mohs micrographic surgery excisions
Patients will be imaged with TPFM
Specificity of Frozen Sections and Two-photon Fluorescence Microscopy Accounting for Errors Caused Frozen Section Artifacts
Two-photon fluorescence microscopy specificity
97.8 Percentage
Interval 93.6 to 99.5
Specificity of Frozen Sections and Two-photon Fluorescence Microscopy Accounting for Errors Caused Frozen Section Artifacts
Frozen section specificity
91.1 Percentage
Interval 85.0 to 95.3

SECONDARY outcome

Timeframe: During Mohs surgery, typically less than 60 minutes

Population: Each patient may undergo multiple Mohs micrographic surgery staged excisions. 122 first stage excisions, 44 second stage excisions and 3 third stage excisions.

Calculation of sensitivity using frozen sections as the gold standard but accounting for frozen section artifacts that lead to incorrect treatment outcome. For example, initially negative on frozen section margins but positive on TPFM because a cryosectioning artifact has removed the area of pathology are counted as false negative on frozen sections.

Outcome measures

Outcome measures
Measure
TPFM Imaging of Surgical Margins
n=169 Mohs micrographic surgery excisions
Patients will be imaged with TPFM
Sensitivity of Frozen Sections and Two-photon Fluorescence Microscopy on True Margin Diagnosis
Two-photon fluorescence microscopy sensitivity
97.1 Percentage
Interval 84.7 to 99.9
Sensitivity of Frozen Sections and Two-photon Fluorescence Microscopy on True Margin Diagnosis
Frozen section sensitivity
94.1 Percentage
Interval 80.3 to 99.3

Adverse Events

Two-photon Fluorescence Microscopy Imaging of Surgical Margins

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Michael Giacomelli

University of Rochester

Phone: 5852766260

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place