Line-field optical coherence tomography: in vivo diagnosis of basal cell carcinoma subtypes compared with histopathology.
Journal
Clinical and experimental dermatology
ISSN: 1365-2230
Titre abrégé: Clin Exp Dermatol
Pays: England
ID NLM: 7606847
Informations de publication
Date de publication:
Dec 2021
Dec 2021
Historique:
accepted:
25
05
2021
pubmed:
29
5
2021
medline:
4
2
2022
entrez:
28
5
2021
Statut:
ppublish
Résumé
Basal cell carcinoma (BCC) is the most common skin cancer in the general population. Treatments vary from Mohs surgery to topical therapy, depending on the subtype. Dermoscopy, reflectance confocal microscopy (RCM) and optical coherence tomography (OCT) have gained a foothold in daily clinical practice to optimize diagnosis and subtype-oriented treatment. The new technique of line-field confocal OCT (LC-OCT) allows imaging at high resolution and depth, but its use has not yet been investigated in larger studies. To evaluate the main LC-OCT criteria for the diagnosis and subtyping of BCC compared with histopathology, OCT and RCM. In total, 52 histopathologically confirmed BCCs were evaluated for imaging criteria. Their frequency, predictive values and ROC curves were calculated. A multinominal regression with stepwise variables selection to distinguish BCC subtypes was performed. Nodular BCCs were mainly characterized by atypical keratinocytes, altered dermoepidermal junction (DEJ), tumour nests in the dermis, dark clefting, prominent vascularization and white hyper-reflective stroma. Superficial BCCs showed a thickening of the epidermis due to a series of tumour lobules with clear connection to the DEJ (string of pearls pattern). Infiltrative BCCs were characterized by elongated hyporeflective tumour strands, surrounded by bright collagen (shoal of fish pattern). The overall BCC subtype agreement between LC-OCT and conventional histology was 90.4% (95% CI 79.0-96.8). LC-OCT allows noninvasive, real-time identification of BCCs and their subtypes in vertical, horizontal and three-dimension mode compared with histology, RCM and OCT. Further larger studies are needed to better explore the clinical applications of this promising device.
Sections du résumé
BACKGROUND
BACKGROUND
Basal cell carcinoma (BCC) is the most common skin cancer in the general population. Treatments vary from Mohs surgery to topical therapy, depending on the subtype. Dermoscopy, reflectance confocal microscopy (RCM) and optical coherence tomography (OCT) have gained a foothold in daily clinical practice to optimize diagnosis and subtype-oriented treatment. The new technique of line-field confocal OCT (LC-OCT) allows imaging at high resolution and depth, but its use has not yet been investigated in larger studies.
AIM
OBJECTIVE
To evaluate the main LC-OCT criteria for the diagnosis and subtyping of BCC compared with histopathology, OCT and RCM.
METHODS
METHODS
In total, 52 histopathologically confirmed BCCs were evaluated for imaging criteria. Their frequency, predictive values and ROC curves were calculated. A multinominal regression with stepwise variables selection to distinguish BCC subtypes was performed.
RESULTS
RESULTS
Nodular BCCs were mainly characterized by atypical keratinocytes, altered dermoepidermal junction (DEJ), tumour nests in the dermis, dark clefting, prominent vascularization and white hyper-reflective stroma. Superficial BCCs showed a thickening of the epidermis due to a series of tumour lobules with clear connection to the DEJ (string of pearls pattern). Infiltrative BCCs were characterized by elongated hyporeflective tumour strands, surrounded by bright collagen (shoal of fish pattern). The overall BCC subtype agreement between LC-OCT and conventional histology was 90.4% (95% CI 79.0-96.8).
CONCLUSION
CONCLUSIONS
LC-OCT allows noninvasive, real-time identification of BCCs and their subtypes in vertical, horizontal and three-dimension mode compared with histology, RCM and OCT. Further larger studies are needed to better explore the clinical applications of this promising device.
Types de publication
Comparative Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1471-1481Subventions
Organisme : Ludwig-Maximilians-Universität München
ID : 10-22
Informations de copyright
© 2021 The Authors. Clinical and Experimental Dermatology published by John Wiley & Sons Ltd on behalf of British Association of Dermatologists.
Références
Peris K, Fargnoli MC, Garbe C et al. Diagnosis and treatment of basal cell carcinoma: European consensus-based interdisciplinary guidelines. Eur J Cancer 2019; 118: 10-34.
Nori S, Rius-Díaz F, Cuevas J et al. Sensitivity and specificity of reflectance-mode confocal microscopy for in vivo diagnosis of basal cell carcinoma: a multicenter study. J Am Acad Dermatol 2004; 51: 923-30.
Garbarino F, Migliorati S, Farnetani F et al. Nodular skin lesions: correlation of reflectance confocal microscopy and optical coherence tomography features. J Eur Acad Dermatol Venereol 2020; 34: 101-11.
Manfredini M, Arginelli F, Dunsby C et al. High-resolution imaging of basal cell carcinoma: a comparison between multiphoton microscopy with fluorescence lifetime imaging and reflectance confocal microscopy. Skin Res Technol 2013; 19: e433-43.
Paganelli A, Garbarino F, Ciardo S et al. Disguised basal cell carcinomas: how to track them down with reflectance confocal microscopy. J Eur Acad Dermatol Venereol 2020; 34: e68-70.
Peccerillo F, Mandel V, Di Tullio F et al. Lesions mimicking melanoma at dermoscopy confirmed basal cell carcinoma: evaluation with reflectance confocal microscopy. Dermatology 2019; 235: 35-44.
Ulrich M, Themstrup L, de Carvalho N et al. Dynamic optical coherence tomography in dermatology. Dermatology 2016; 232: 298-311.
Boone M, Suppa M, Pellacani G et al. High-definition optical coherence tomography algorithm for discrimination of basal cell carcinoma from clinical BCC imitators and differentiation between common subtypes. J Eur Acad Dermatol Venereol 2015; 29: 1771-80.
Dinnes J, Deeks JJ, Chuchu N et al. Reflectance confocal microscopy for diagnosing keratinocyte skin cancers in adults. Cochrane Database Syst Rev 2018; (12): CD013191.
Longo C, Lallas A, Kyrgidis A et al. Classifying distinct basal cell carcinoma subtype by means of dermatoscopy and reflectance confocal microscopy. J Am Acad Dermatol 2014; 71: 716-24.e1.
Sinx KAE, van Loo E, Tonk EHJ et al. Optical coherence tomography for noninvasive diagnosis and subtyping of basal cell carcinoma: a prospective cohort study. J Invest Dermatol 2020; 140: 1962-7.
Ferrante di Ruffano L, Dinnes J, Deeks JJ et al. Optical coherence tomography for diagnosing skin cancer in adults. Cochrane Database Syst Rev 2018; (12): CD013189.
Pedrazzani M, Breugnot J, Rouaud-Tinguely P et al. Comparison of line-field confocal optical coherence tomography images with histological sections: validation of a new method for in vivo and non-invasive quantification of superficial dermis thickness. Skin Res Technol 2020; 26: 398-404.
Ruini C, Sattler E. Konfokale Line-Field-OCT: die eierlegende Wollmilchsau? [Line-field confocal optical coherence tomography: the golden goose?] (in German). Aktuelle Dermatol. 2020; 46: 148-51.
Monnier J, Tognetti L, Miyamoto M et al. In vivo characterization of healthy human skin with a novel, non-invasive imaging technique: line-field confocal optical coherence tomography. J Eur Acad Dermatol Venereol 2020; 34: 2914-21.
Ruini C, Schuh S, Pellacani G et al. In vivo imaging of Sarcoptes scabiei infestation using line-field confocal optical coherence tomography. J Eur Acad Dermatol Venereol 2020; 34: e808-9.
Ruini C, Schuh S, Sattler E, Welzel J. Line-field confocal optical coherence tomography - practical applications in dermatology and comparison with established imaging methods. Skin Res Technol 2021; 27: 340-52.
Suppa M, Fontaine M, Dejonckheere G et al. Line-field confocal optical coherence tomography of basal cell carcinoma: a descriptive study. J Eur Acad Dermatol Venereol 2020; 27: 340-52.
Ogien J, Levecq O, Azimani H, Dubois A. Dual-mode line-field confocal optical coherence tomography for ultrahigh-resolution vertical and horizontal section imaging of human skin in vivo. Biomed Opt Express 2020; 11: 1327.
Dubois A, Levecq O, Azimani H et al. Line-field confocal time-domain optical coherence tomography with dynamic focusing. Opt Express 2018; 26: 33534-42.
Ogien J, Daures A, Cazalas M et al. Line-field confocal optical coherence tomography for three-dimensional skin imaging. Front Optoelectron 2020; 13: 381-92.
Holmes J, von Braunmühl T, Berking C et al. Optical coherence tomography of basal cell carcinoma: influence of location, subtype, observer variability and image quality on diagnostic performance. Br J Dermatol 2018; 178: 1102-10.
Themstrup L, De Carvalho N, Nielsen SM et al. In vivo differentiation of common basal cell carcinoma subtypes by microvascular and structural imaging using dynamic optical coherence tomography. Exp Dermatol 2018; 27: 156-65.
De Carvalho N, Schuh S, Kindermann N et al. Optical coherence tomography for margin definition of basal cell carcinoma before micrographic surgery-recommendations regarding the marking and scanning technique. Skin Res Technol 2018; 24: 145-51.
Welzel J, Schuh S. [Non-invasive diagnostics in dermatology] (in German). J Dtsch Dermatol Ges 2017; 15: 999-1017.
Olsen J, Themstrup L, De Carvalho N et al. Diagnostic accuracy of optical coherence tomography in actinic keratosis and basal cell carcinoma. Photodiagnosis Photodyn Ther 2016; 16: 44-9.
Ulrich M, Braunmuehl T, Kurzen H et al. The sensitivity and specificity of optical coherence tomography for the assisted diagnosis of nonpigmented basal cell carcinoma: an observational study. Br J Dermatol 2015; 173: 428-35.
Schuh S, Kaestle R, Sattler EC, Welzel J. Optical coherence tomography of actinic keratoses and basal cell carcinomas - differentiation by quantification of signal intensity and layer thickness. J Eur Acad Dermatol Venereol 2016; 30: 1321-6.
Gill M, Sahu A, Alessi-Fox C et al. Angulated small nests and cords: key diagnostic histologic features of infiltrative basal cell carcinoma can be identified using integrated reflectance confocal microscopy-optical coherence tomography. J Cutan Pathol 2020; 48: 53-65.
Dubois A, Levecq O, Azimani H et al. Line-field confocal optical coherence tomography for high-resolution noninvasive imaging of skin tumors. J Biomed Opt 2018; 23: 1-9.
Cohen PR, Schulze KE, Nelson BR. Basal cell carcinoma with mixed histology: a possible pathogenesis for recurrent skin cancer. Dermatol Surg 2006; 32: 542-51.