Vascular feature identification in actinic keratosis grades I-III using dynamic optical coherence tomography with automated, quantitative analysis.
Actinic keratosis
Angiography
Dynamic optical coherence tomography
Non-invasive imaging
OCTAVA
Skin microvasculature
Journal
Archives of dermatological research
ISSN: 1432-069X
Titre abrégé: Arch Dermatol Res
Pays: Germany
ID NLM: 8000462
Informations de publication
Date de publication:
15 Jun 2024
15 Jun 2024
Historique:
received:
08
04
2024
accepted:
26
04
2024
revised:
08
04
2024
medline:
15
6
2024
pubmed:
15
6
2024
entrez:
15
6
2024
Statut:
epublish
Résumé
Clinical grading of actinic keratosis (AK) is based on skin surface features, while subclinical alterations are not taken into consideration. Dynamic optical coherence tomography (D-OCT) enables quantification of the skin´s vasculature, potentially helpful to improve the link between clinical and subclinical features. We aimed to compare microvascular characteristics across AK grades using D-OCT with automated vascular analysis. This explorative study examined AK and photodamaged skin (PD) on the face or scalp. AKs were clinically graded according to the Olsen Classification scheme before D-OCT assessment. Using an open-source software tool, the OCT angiographic analyzer (OCTAVA), we quantified vascular network features, including total and mean vessel length, mean vessel diameter, vessel area density (VAD), branchpoint density (BD), and mean tortuosity from enface maximum intensity projection images. Additionally, we performed subregional analyses on selected scans to overcome challenges associated with imaging through hyperkeratosis (each lesion group; n = 18). Our study included 45 patients with a total of 205 AKs; 93 grade I lesions, 65 grade II, 47 grade III and 89 areas with PD skin. We found that all AK grades were more extensively vascularized relative to PD, as shown by greater total vessel length and VAD (p ≤ 0.009). Moreover, AKs displayed a disorganized vascular network, with higher BD in AK I-II (p < 0.001), and mean tortuosity in AK II-III (p ≤ 0.001) than in PD. Vascularization also increased with AK grade, showing significantly greater total vessel length in AK III than AK I (p = 0.029). Microvascular quantification of AK unveiled subclinical, quantitative differences among AK grades I-III and PD skin. D-OCT-based microvascular assessment may serve as a supplement to clinical AK grading, potentially raising perspectives to improve management strategies.
Identifiants
pubmed: 38878217
doi: 10.1007/s00403-024-03022-z
pii: 10.1007/s00403-024-03022-z
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
391Informations de copyright
© 2024. The Author(s).
Références
de Berker D, McGregor JM, Mohd Mustapa MF et al (2017) British Association of Dermatologists’ guidelines for the care of patients with actinic keratosis 2017. Br J Dermatol 176:20–43. https://doi.org/10.1111/bjd.15107
doi: 10.1111/bjd.15107
pubmed: 28098380
Eisen DB, Asgari MM, Bennett DD et al (2021) Guidelines of care for the management of actinic keratosis. J Am Acad Dermatol 85:e209–e233. https://doi.org/10.1016/j.jaad.2021.02.082
doi: 10.1016/j.jaad.2021.02.082
pubmed: 33820677
Werner RN, Sammain A, Erdmann R et al (2013) The natural history of actinic keratosis: a systematic review. Br J Dermatol 169:502–518. https://doi.org/10.1111/bjd.12420
doi: 10.1111/bjd.12420
pubmed: 23647091
Schmitz L, Broganelli MD, Boada A (2022) Classifying actinic keratosis: What the reality of everyday clinical practice shows us. In: JDDonline - J. Drugs Dermatol. https://jddonline.com/articles/classifying-actinic-keratosis-what-the-reality-of-everyday-clinical-practice-shows-us-S1545961622P0845X/ . Accessed 17 Oct 2022
Olsen EA, Abernethy ML, Kulp-Shorten C et al (1991) A double-blind, vehicle-controlled study evaluating masoprocol cream in the treatment of actinic keratoses on the head and neck. J Am Acad Dermatol 24:738–743. https://doi.org/10.1016/0190-9622(91)70113-g
doi: 10.1016/0190-9622(91)70113-g
pubmed: 1869646
Schmitz L, Kahl P, Majores M et al (2016) Actinic keratosis: correlation between clinical and histological classification systems. J Eur Acad Dermatol Venereol 30:1303–1307. https://doi.org/10.1111/jdv.13626
doi: 10.1111/jdv.13626
pubmed: 26955898
Schuh S, Holmes J, Ulrich M et al (2017) Imaging blood vessel morphology in skin: dynamic optical coherence tomography as a novel potential diagnostic tool in dermatology. Dermatol Ther 7:187–202. https://doi.org/10.1007/s13555-017-0175-4
doi: 10.1007/s13555-017-0175-4
Ulrich M, Themstrup L, De Carvalho N et al (2016) Dynamic optical coherence tomography in dermatology. Dermatology 232:298–311. https://doi.org/10.1159/000444706
doi: 10.1159/000444706
pubmed: 27104356
Untracht GR, Matos RS, Dikaios N et al (2021) OCTAVA: an open-source toolbox for quantitative analysis of optical coherence tomography angiography images. PLoS ONE 16:e0261052. https://doi.org/10.1371/journal.pone.0261052
doi: 10.1371/journal.pone.0261052
pubmed: 34882760
pmcid: 8659314
Dirschka T, Gupta G, Micali G et al (2017) Real-world approach to actinic keratosis management: practical treatment algorithm for office-based dermatology. J Dermatol Treat 28:431–442. https://doi.org/10.1080/09546634.2016.1254328
doi: 10.1080/09546634.2016.1254328
Ulrich M, Themstrup L, de Carvalho N et al (2016) Dynamic optical coherence tomography in dermatology. Dermatol Basel Switz 232:298–311. https://doi.org/10.1159/000444706
doi: 10.1159/000444706
Ulrich M, Themstrup L, de Carvalho N et al (2018) Dynamic optical coherence tomography of skin blood vessels - proposed terminology and practical guidelines. J Eur Acad Dermatol Venereol JEADV 32:152–155. https://doi.org/10.1111/jdv.14508
doi: 10.1111/jdv.14508
pubmed: 28776772
Hormel TT, Huang D, Jia Y (2021) Artifacts and artifact removal in optical coherence tomographic angiography. Quant Imaging Med Surg 11:1120–1133. https://doi.org/10.21037/qims-20-730
doi: 10.21037/qims-20-730
pubmed: 33654681
pmcid: 7829161
Themstrup L, De Carvalho N, Nielsen SM et al (2018) In vivo differentiation of common basal cell carcinoma subtypes by microvascular and structural imaging using dynamic optical coherence tomography. Exp Dermatol 27:156–165. https://doi.org/10.1111/exd.13479
doi: 10.1111/exd.13479
pubmed: 29215761
Themstrup L, Pellacani G, Welzel J et al (2017) In vivo microvascular imaging of cutaneous actinic keratosis, Bowen’s disease and squamous cell carcinoma using dynamic optical coherence tomography. J Eur Acad Dermatol Venereol JEADV 31:1655–1662. https://doi.org/10.1111/jdv.14335
doi: 10.1111/jdv.14335
pubmed: 28502083
Markowitz O, Schwartz M, Minhas S, Siegel DM (2016) Speckle-variance optical coherence tomography: a novel approach to skin cancer characterization using vascular patterns. Dermatol Online J 22:13030/qt7w10290r
Sigsgaard V, Themstrup L, Theut Riis P et al (2018) In vivo measurements of blood vessels’ distribution in non-melanoma skin cancer by dynamic optical coherence tomography — a new quantitative measure? Skin Res Technol 24:123–128. https://doi.org/10.1111/srt.12399
doi: 10.1111/srt.12399
pubmed: 28771885
Fargnoli MC, Piccioni A, Neri L et al (2015) Conventional vs. daylight methyl aminolevulinate photodynamic therapy for actinic keratosis of the face and scalp: an intra-patient, prospective, comparison study in Italy. J Eur Acad Dermatol Venereol JEADV 29:1926–1932. https://doi.org/10.1111/jdv.13076
doi: 10.1111/jdv.13076
pubmed: 25809617
Wiegell SR, Fabricius S, Gniadecka M et al (2012) Daylight-mediated photodynamic therapy of moderate to thick actinic keratoses of the face and scalp: a randomized multicentre study. Br J Dermatol 166:1327–1332. https://doi.org/10.1111/j.1365-2133.2012.10833.x
doi: 10.1111/j.1365-2133.2012.10833.x
pubmed: 22250644
Gutiérrez García-Rodrigo C, Pellegrini C, Piccioni A et al (2019) Single versus two-treatment schedule of methyl aminolevulinate daylight photodynamic therapy for actinic keratosis of the face and scalp: an intra-patient randomized trial. Photodiagnosis Photodyn Ther 27:100–104. https://doi.org/10.1016/j.pdpdt.2019.05.031
doi: 10.1016/j.pdpdt.2019.05.031
pubmed: 31141730
Hanahan D, Folkman J (1996) Patterns and emerging mechanisms of the angiogenic switch during tumorigenesis. Cell 86:353–364. https://doi.org/10.1016/S0092-8674(00)80108-7
doi: 10.1016/S0092-8674(00)80108-7
pubmed: 8756718
Jh L, Cy W, Gm K, Sy K (2014) Dermoscopic features of actinic keratosis and follow up with dermoscopy: a pilot study. J Dermatol 41. https://doi.org/10.1111/1346-8138.12282
Benati E, Longhitano S, Pampena R et al (2020) Digital follow-up by means of dermatoscopy and reflectance confocal microscopy of actinic keratosis treated with Imiquimod 3.75% cream. J Eur Acad Dermatol Venereol JEADV 34:1471–1477. https://doi.org/10.1111/jdv.16143
doi: 10.1111/jdv.16143
pubmed: 31838781
Wang T, Han Q, Hu W, Ren H (2022) Efficacy evaluation and dermoscopy predictors of photodynamic therapy with different pretreatments in the treatment of actinic keratosis. J Dermatol Treat 33:2853–2857. https://doi.org/10.1080/09546634.2022.2089325
doi: 10.1080/09546634.2022.2089325
Curiel-Lewandrowski C, Myrdal CN, Saboda K et al (2021) In vivo reflectance confocal microscopy as a response monitoring tool for actinic keratoses undergoing cryotherapy and photodynamic therapy. Cancers 13:5488. https://doi.org/10.3390/cancers13215488
doi: 10.3390/cancers13215488
pubmed: 34771651
pmcid: 8583298
Mazur E, Kwiatkowska D, Reich A (2023) Reflectance confocal microscopy and dermoscopy of facial pigmented and non-pigmented actinic keratosis features before and after photodynamic therapy treatment. Cancers 15:5598. https://doi.org/10.3390/cancers15235598
doi: 10.3390/cancers15235598
pubmed: 38067302
pmcid: 10705734
Ishioka P, Maia M, Rodrigues SB et al (2018) In vivo Confocal Laser Microscopy for monitoring of actinic keratosis treatment: a comparison with histopathologic assessment after treatment with topical 5% 5-fluorouracil. J Eur Acad Dermatol Venereol JEADV 32:1155–1163. https://doi.org/10.1111/jdv.14716
doi: 10.1111/jdv.14716
pubmed: 29178474
Seyed Jafari SM, Timchik T, Hunger RE (2016) In vivo confocal microscopy efficacy assessment of daylight photodynamic therapy in actinic keratosis patients. Br J Dermatol 175:375–381. https://doi.org/10.1111/bjd.14517
doi: 10.1111/bjd.14517
pubmed: 26949030