Dynamic optical coherence tomography of skin blood vessels – proposed terminology and practical guidelines

Ulrich, Martina; Themstrup, Lotte; Carvalho, Nathalie De; Ciardo, Silvana; Holmes, Jon; Whitehead, R.; Welzel, Julia; Jemec, Gregor B. E.; Pellacani, Giovanni

doi:10.1111/jdv.14508

Cited by 47 publications

(63 citation statements)

References 10 publications

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“…To evaluate the vascular features in the D‐OCT images, we applied the terminology and guidelines described in the paper by Ulrich et al some of which include identifying prominent vascular shapes and evaluating the D‐OCT images at three predefined skin depths of 150, 300 and 500 μm. As described in previous publications, we used specialized software (Michelson Diagnostics and University of Modena and Reggio Emilia, Modena, Italy) that detects the skin surface and allows the images to be viewed at desired depths below the skin surface.…”

Section: Methodsmentioning

confidence: 99%

In vivo differentiation of common basal cell carcinoma subtypes by microvascular and structural imaging using dynamic optical coherence tomography

Themstrup

Carvalho

Nielsen

et al. 2018

Experimental Dermatology

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The subtype of basal cell carcinoma (BCC) influences the choice of treatment. Optical coherence tomography (OCT) is a non-invasive imaging tool, and a recent development of an angiographic version of OCT has extended the application of OCT to image the cutaneous microvasculature (so-called dynamic OCT, D-OCT). This study explores D-OCT's ability to differentiate the common BCC subtypes by microvascular and structural imaging. Eighty-one patients with 98 BCC lesions, consisting of three subtypes: 27 superficial BCC (sBCC), 55 nodular BCC (nBCC) and 16 infiltrative BCC (iBCC) were D-OCT scanned at three European dermatology centres. Blinded evaluations of microvascular and structural features were performed, followed by extensive statistical analysis of risk ratio (RR) and multiple correspondence analysis. nBCC lesions displayed most characteristic structural and vascular features. Serpiginous vessels, branching vessels, vessels creating a circumscribed figure and sharply demarcated hyporeflective ovoid structures in the dermis were all associated with a higher risk of the subtype being nBCC. The presence of highly present lines and dark peripheral borders at the margin of ovoid structures was negatively associated with iBCC. Lastly, the finding of hyporeflective ovoid structures protruding from epidermis correlated with sBCC. We identified various microvascular and structural D-OCT features that may aid non-invasive identification of BCC subtypes. This would allow clinicians to individualize and optimize BCC treatment as well as aid follow-up of non-surgical treatment.

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Section: Methodsmentioning

confidence: 99%

In vivo differentiation of common basal cell carcinoma subtypes by microvascular and structural imaging using dynamic optical coherence tomography

Themstrup

Carvalho

Nielsen

et al. 2018

Experimental Dermatology

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“…The skin was not prepared prior to scanning . Each D‐OCT scan consisted of 120 cross‐sectional B‐scans and took approximately 20 seconds to obtain . In total, 1036 scans were eligible for analysis.…”

Section: Methodsmentioning

confidence: 99%

“…D‐OCT enables visualization of microvasculature by detecting motion of red blood cells by repeatedly scanning the same locations . D‐OCT images are presented in cross‐sectional and “en face” view and illustrate the relationship between vessels and structures . Technical aspects of D‐OCT and guidelines for image analysis have been described .…”

Section: Introductionmentioning

confidence: 99%

“…D‐OCT images are presented in cross‐sectional and “en face” view and illustrate the relationship between vessels and structures . Technical aspects of D‐OCT and guidelines for image analysis have been described . The D‐OCT vascular morphology has primarily been studied in non‐melanoma skin cancer (NMSC), where vascular shapes and patterns were found to differ among keratinocyte skin cancers and within subtypes of basal cell carcinomas (BCC) .…”

Section: Introductionmentioning

confidence: 99%

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Vascular morphology in normal skin studied with dynamic optical coherence tomography

Andersen

Olsen

Friis

et al. 2018

Experimental Dermatology

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Dynamic optical coherence tomography (D-OCT) is a non-invasive imaging technique, suitable for the study of structural and dynamic features of cutaneous microvasculature. Studies with D-OCT have primarily focused on non-melanoma skin cancer (NMSC), and a reference description of healthy skin is lacking. The aim of the study was to describe the prevalence of standard microvascular features in normal skin. A total of 280 participants without skin disease were D-OCT-scanned on four body locations: three sun-exposed areas and one unexposed: forehead, back of the neck, back of the hand and medial side of the upper arm. Frequencies of standard vascular features were reported, and relations to anatomical location and demographic data were investigated. "Dots," "lines" and "curves" were the most frequent shapes at 150 μm, 300 μm and 500 μm. "Mottle" was the predominant pattern at 150 μm and 300 μm. "Mesh" was found from 300 μm and primarily found at 500 μm. Regional differences in vascular characteristics were primarily found comparing the medial side of the arm with the other body locations. In normal skin, the most frequent shapes were "dots," "lines" and "curves," and "mottle" was present more superficially than "mesh." In conclusion, regional anatomical differences should be taken into account when evaluating D-OCT images.

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“…RCM constitutes a link between dermoscopy and histology, providing high‐resolution images that can be used to analyze architectural structure of epidermis and upper dermis . Another noninvasive imaging modality, optical coherence tomography (OCT) has shown applicability for the diagnosis of various skin diseases, including skin tumors and inflammatory skin disease, through cross‐sectional and horizontal visualization of epidermis and dermis . OCT scanning also relies on differences in the refractive indexes of the skin's layers and structures for image generation …”

Section: Introductionmentioning

confidence: 99%

Microneedle fractional radiofrequency‐induced micropores evaluated by in vivo reflectance confocal microscopy, optical coherence tomography, and histology

Hansen

Wenande

Hædersdal

et al. 2019

Skin Research and Technology

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Background Microneedle fractional radiofrequency (MNRF) is a minimally invasive technique that delivers radiofrequency (RF) energy into the skin via microneedles. Reflectance confocal microscopy (RCM) and optical coherence tomography (OCT) enable the characterization of device‐tissue interactions in in vivo skin. The aim of this study is to describe MNRF‐induced micropores using RCM and OCT imaging. Materials and methods Five healthy participants were treated with a 7 × 7 array of 1500 μm microneedles on two adjacent areas of the right hip. One area received MNRF using high RF energy while the other underwent MNRF at low RF energy. Micropore morphology was evaluated qualitatively and quantitatively with RCM and OCT. To relate imaging with histology, one participant underwent punch biopsy in both areas. Results Reflectance confocal microscopy visualized shape, content, and thermal‐induced coagulation zone (CZ) of MNRF micropores. At high RF energy, micropores showed concentric shape, contained hyperreflective granules, and coagulated tissue from epidermis to dermo‐epidermal junction (diameter 63‐85 μm). Micropores at low RF energy, presented with a stellate shape, no content and CZs that were visible only in epidermis (CZ thickness 9 μm, IQR 8‐21 μm). Evaluating OCT, high RF energy showed deeper (150 μm), more easily identifiable micropores compared to low RF energy micropores (70 μm). Histology showed tissue coagulation to a depth of 1500 μm at high RF energy, while at low RF energy, disruption was only visible in epidermis. Conclusion Microneedle fractional radiofrequency micropores show distinct characteristics in both RCM and OCT, depending on RF energy. These in vivo imaging modalities are complementary and allow combined, qualitative, and quantitative evaluation.

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Dynamic optical coherence tomography of skin blood vessels – proposed terminology and practical guidelines

Abstract: Background Dynamic optical coherence tomography (D-OCT) has recently been introduced in dermatology. In con-

Cited by 47 publications

References 10 publications

In vivo differentiation of common basal cell carcinoma subtypes by microvascular and structural imaging using dynamic optical coherence tomography

In vivo differentiation of common basal cell carcinoma subtypes by microvascular and structural imaging using dynamic optical coherence tomography

Vascular morphology in normal skin studied with dynamic optical coherence tomography

Microneedle fractional radiofrequency‐induced micropores evaluated by in vivo reflectance confocal microscopy, optical coherence tomography, and histology

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