Differentiation of Different Nonmelanoma Skin Cancer Types Using OCT.

BACKGROUND: Early detection of various types of nonmelanoma skin cancer has been a challenge in dermatology. Noninvasive examination procedures such as optical coherence tomography (OCT) play an increasingly important role, besides the established gold standard of histological tissue sample analysis. OCT is a noninvasive, cross-sectional, real-time technique that allows conclusions to be drawn with regard to the presence of pathologies. OBJECTIVE: The objective of this study was to investigate whether it is possible to distinguish between different types of nonmelanoma skin cancer using OCT or not. METHODS: A study population of a total of 25 cases, comprising 5 cases, each, of 5 tumor entities (i.e., basal cell carcinoma, superficial basal cell carcinoma, actinic keratosis, squamous cell carcinoma, and Bowen disease) was examined. Relevant lesions were scanned both centrally and peripherally in the multislice mode. All OCT images were blinded, randomized, analyzed, and evaluated by 2 clinicians experienced in OCT. RESULTS: This study demonstrated that it is possible to determine correlations between various types of tumors and recurring tumor characteristics. CONCLUSION: This study showed that it is possible to distinguish between the different nonmelanoma skin cancers by using OCT, but further prospective studies have to be conducted to validate the sensitivity and specificity of the criteria.

Optical coherence tomography for presurgical margin assessment of non-melanoma skin cancer - a practical approach.

In the clinical setting, optical coherence tomography (OCT) is applicable for the non-invasive diagnosis of skin cancer and may in particular be used for margin definition prior to excision. In this regard, OCT may improve the success rate of removing tumor lesions more effectively, preventing repetitive excision, which may subsequently result in smaller excisions. In this study, we have aimed to evaluate the applicability of OCT for in vivo presurgical margin assessment of non-melanocytic skin tumors (NMSC) and to describe the feasibility of different scanning techniques. A total number of 18 patients planned for excision of lesions suspicious of NMSC were included in this study. Based on OCT, we defined the specific tumor margins on 19 lesions preoperatively using different scanning modalities. Sixty-one margin points and five complete tumor margins were analysed on 18 patients with a total of 19 lesions including 63% basal cell carcinoma (BCC) (n = 12), 16% (n = 3) squamous cell carcinoma (SCC) and 21% of other types of skin tumors (n = 4) were classified. In 84% of the cases (n = 16), the OCT-defined lateral margins correctly indicated complete removal of the tumor. The surgical margins chosen by the surgeon never fell below the OCT-defined margin. Regarding the techniques of marginal definition, punctual tumor border scan in the perpendicular direction, with an extension of free-run scans for unsure cases can hardly be recommended. This study shows that suspected NMSC can effectively be confirmed, and furthermore, resection margin can be minimized under OCT control without reducing the rate of complete removal.