Morphology of basal cell carcinoma in high definition optical coherence tomography: en‐face and slice imaging mode, and comparison with histology

Abstract

Background Optical coherence tomography (OCT) allows real-time, in vivo examination of basal cell carcinoma

A novel imaging approach to periocular basal cell carcinoma: In vivo optical coherence tomography and histological correlates

“…20,21 Fourier Domain OCT showed epidermal thinning, superficial crusting and rarefaction of the hair follicles; these features have not been described in HD-OCT reports. [14][15][16] In keeping with our results, HD-OCT investigations have shown epidermal disarray in en-face scans and destruction of layering of the epidermis and dermis in slice mode scans with similar detection rates between the two imaging modes. [14][15][16] The original OCT diagnostic criteria for BCC lesions were described by Olmedo et al using conventional OCT. 11 In our study, Fourier domain imaging showed dark lobular patterns of BCC nests and bright margins of collagen compression in 100%; decreased reflectance at the borders of the lobules was seen in 73% of the lesions, whereas dilated blood vessels were detected in only 33%, in keeping with previous studies.…”

“…[14][15][16] The original OCT diagnostic criteria for BCC lesions were described by Olmedo et al using conventional OCT. 11 In our study, Fourier domain imaging showed dark lobular patterns of BCC nests and bright margins of collagen compression in 100%; decreased reflectance at the borders of the lobules was seen in 73% of the lesions, whereas dilated blood vessels were detected in only 33%, in keeping with previous studies. 15,18 The additional feature of central necrosis was observed in 20% of lesions and suggested the BCC growth pattern with fast progressive enlargement outgrowing the tissue blood supply.…”

“…By contrast, HD-OCT allows a higher resolution of 3 μ in tissue, however the tissue penetration and the field of view of HD-OCT are limited to 750 μm and 1.8 × 1.5 mm respectively; the imaging probe requires a gel as coupling medium which could possibly cause side irritation in the periocular region. [14][15][16] We classified the OCT characteristics of nodular BCC based on the anatomical distribution of the features with respect to the epidermis, the BCC lesion and the surrounding structures of the dermis.…”

“…4 In view of the increasing incidence of BCC worldwide, non-invasive in vivo diagnostic techniques have been investigated, including reflectance confocal microscopy (RCM), 5,6 high frequency ultrasound (HFUS), 7,8 conventional optical coherence tomography (OCT) [9][10][11][12][13] and high-definition OCT (HD-OCT). [14][15][16] Previous investigators demonstrated that RCM was a valuable tool in BCC diagnosis; however RCM required specific operator training and long contact time with the patient, achieving a penetration depth of approximately 250 μm, compared to 2 mm obtained with conventional OCT. 5,6 HFUS was validated for the definition of BCC tumor thickness, although it was found to have insufficient specificity in the diagnosis of BCC. 7,8 OCT was initially described in 1995 17 for imaging of the retina and anterior chamber of the eye and was rapidly adopted in several medical fields due to its ease of use, non-invasiveness and short contact time with patients.…”

“…[14][15][16] Despite the higher resolution, the clinical applications of current HD-OCT devices are limited by a shallow penetration depth of 750 μ and a small field of view of 1.8 mm by 1.5 mm.…”