title: Polarization-sensitive optical coherence tomography of invasive basal cell carcinoma.
abstract: Skin cancer is the most common human malignancy, with basal cell carcinoma (BCC) the most frequent type. Aggressive forms of BCC are associated with extensive dermal invasion and destruction of collagen. Surgery is the most common treatment, but identification of tumor borders is a challenge. Polarization-sensitive optical coherence tomography (PS-OCT) is an optical method to examine collagen birefringence. To date, it has not been exploited for cancer management. As part of a pilot exploratory study to examine the use of OCT in skin cancer, we examined several tumors that pose a challenge to the surgeon due to their large size and histological subtype. In normal perilesional skin, OCT identifies epidermal and dermal structure; PS-OCT identified dermal birefringence. In BCC, tumors lost normal structure and gained the appearance of lobular impressions. PS-OCT identified an alteration of dermal birefringence. Examination of a border area revealed a gradual transition from more normal appearing image to frank tumor. These results indicate that PS-OCT can identify features that distinguish normal skin from tumor and may have the potential to guide surgeons in the treatment of aggressive skin cancer.
authors.affiliation: Wellman Center of Photomedicine, Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, 50 Blossom Street, Boston, Massachusetts 02114, USA. jstrasswimmer@PARTNERS.ORG
authors.forename: John
authors.initials: J
authors.lastname: Strasswimmer
authors.forename: Mark C
authors.initials: MC
authors.lastname: Pierce
authors.forename: B Hyle
authors.initials: BH
authors.lastname: Park
authors.forename: Victor
authors.initials: V
authors.lastname: Neel
authors.forename: Johannes F
authors.initials: JF
authors.lastname: de Boer
mesh_terms: D000368:Aged; D001718:Birefringence; D002280:Basal Cell Carcinoma / Q000473:pathology*; D006801:Humans; D008859:Microscopy, Polarization; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D010865:Pilot Projects; D012867:Skin / Q000473:pathology; D012878:Skin Neoplasms / Q000473:pathology*; D041623:Tomography, Optical Coherence