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Cancers: Line-field confocal optical coherence tomography improves accuracy and confidence in the diagnosis of basal cell carcinoma in suspicious lesions

 Last Update: 2022-04-23
 Source: Internet
 Author: User

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Basal cell carcinoma (BCC) has developed into the most common type of skin cancer in recent decades
.

The gold standard for diagnosis includes biopsy or excision of suspicious lesions and histopathological examination

The purpose of this study was to: validate the diagnostic value of LC-OCT for clinical basal cell carcinoma in a real-life setting and to test the ability to differentiate superficial and other basal cell carcinoma subtypes compared with dermoscopy and histopathology
.

In addition, we review the morphological LC-OCT criteria for BCC and provide an overview of the main diagnostic pitfalls

We prospectively enrolled 182 lesions in 154 patients referred to our department to confirm or rule out a diagnosis of basal cell carcinoma
.

Dermoscopy and LC-OCT images were independently assessed by two experts

Figure 1 Nodular basal cell carcinoma of the lower leg in a 68-year-old female patient
.

(a,b) LC-OCT images

Figure 2 Cystic nodular basal cell carcinoma in the nasolabial fold of a 76-year-old patient
.

(A) (200×) and (B) (100×): HE stained sections

Figure 3 Nodular basal cell carcinoma of the right temple in a 64-year-old man
.

(A) (20×) and (B) (100×): HE stained sections of tumor histology

Figure 4 A 58-year-old male patient with infectious rickets in the forehead
.

(A) (100×) and (B) (40×): Hematoxylin-eosin (HE) stained sections

Figure 5 A 70-year-old male patient with nasal sebaceous hyperplasia
.

(A) LC-OCT image

Compared with non-basal cell carcinoma, the most specific morphological LC-OCT criteria for basal cell carcinoma are: unclear dermis-epidermal junction (DEJ), hyporeflective tumor lobules, and dull margins
.
The most relevant feature of superficial basal cell carcinoma (SBCC) is a string of pearls without epidermal thinning
.
Compared with dermoscopy alone, LC-OCT has significantly improved diagnostic confidence, sensitivity, and specificity in detecting basal cell carcinoma in clinically suspicious lesions
.
Operator training in image acquisition is fundamental to achieving the best results
.
LC-OCT can perform not only the differential diagnosis of basal cell carcinoma at the bedside, but also the subtyping of basal cell carcinoma
.

The most specific morphological LC-OCT criteria for basal cell carcinoma are: unclear dermis-epidermal junction (DEJ), hyporeflective tumor lobules, and dull margins
.
The most relevant feature of superficial basal cell carcinoma (SBCC) is a string of pearls without epidermal thinning
.

Source: Gust C, Schuh S, Welzel J, Line-Field Confocal Optical Coherence Tomography Increases the Diagnostic Accuracy and Confidence for Basal Cell Carcinoma in Equivocal Lesions: A Prospective Study.
Cancers (Basel) 2022 Feb 21;14(4)

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