Milind Rajadhyaksha, PhD

I am a mechanical and optical engineer and principal investigator in the Optical Imaging Laboratory in the Dermatology Service. My research focuses on creating novel confocal microscopes and endoscopes for imaging skin and head and neck cancers, and translating this technology to clinical applications in screening, diagnostics and surgical guidance.

Current active technology projects include the development of line-scanning confocal microscopes for imaging skin cancer in vivo and a confocal endoscope for imaging oral precancers in vivo. Another project that combines instrumentation with translational studies is the development of confocal mosaicing microscopy for rapid detection of basal cell carcinomas in excised tissue from Mohs surgery, with the goal of enabling real-time pathology at the bedside. Translational projects include (1) the preoperative mapping of lentigo maligna melanomas and amelanotic melanomas on patients in vivo to guide precise surgical excision, (2) mapping of residual basal cell carcinomas in shave biopsies, to guide biopsy and surgery and to serve as a test model for intraoperative imaging, and (3) in partnership with our head and neck surgeons, mapping of cancer margins in excised tissue to guide surgery.

A multicenter clinical study is in progress to determine the sensitivity and specificity of reflectance confocal microscopy for the in vivo diagnosis of melanoma. A collaboration with Northeastern University in Boston is focused on developing machine learning-based classification algorithms for “image understanding” analysis and detection of morphologic features in reflectance confocal images of skin cancers, to train and assist clinicians in reading and diagnosis. An exciting new idea is to combine imaging for diagnosis and image-guided laser surgery of non-melanoma skin cancers in vivo, to enable Mohs-like pathology, diagnosis and treatment directly on the patient in real-time.

Publications

Iftimia N, Ferguson RD, Mujat M, Patel AH, Zhang EZ, Fox W, Rajadhyaksha M. Combined reflectance confocal microscopy/optical coherence tomography imaging for skin burn assessment. Biomed Opt Express. 2013 Apr 8;4(5):680-95

Abeytunge S, Li Y, Larson B, Peterson G, Seltzer E, Toledo-Crow R, Rajadhyaksha M. Confocal microscopy with strip mosaicing for rapid imaging over large areas of excised tissue. J Biomed Opt. 2013 Jun;18(6):61227. doi: 10.1117/1.JBO.18.6.061227.

Gareau DS, Jeon H, Nehal KS, Rajadhyaksha M. Rapid screening of cancer margins in tissue with multimodal confocal microscopy. J Surg Res. 2012 Dec;178(2):533-8. doi: 10.1016/j.jss.2012.05.059. Epub 2012 Jun 7.

Kurugol S, Dy JG, Brooks DH, Rajadhyaksha M. Pilot study of semiautomated localization of the dermal/epidermal junction in reflectance confocal microscopy images of skin. J Biomed Opt. 2011 Mar;16(3):036005. doi: 10.1117/1.3549740.

Karen JK, Gareau DS, Dusza SW, Tudisco M, Rajadhyaksha M, Nehal KS. Detection of basal cell carcinomas in Mohs excisions with fluorescence confocal mosaicing microscopy. Br J Dermatol. 2009 Jun;160(6):1242-50. doi: 10.1111/j.1365-2133.2009.09141.x. Epub 2009 Mar 30.