Assessment of tumor thickness in melanocytic skin lesions: comparison of optical coherence tomography, 20-MHz ultrasound and histopathology.
BACKGROUND
Accurate assessment of vertical tumor size is important for surgical treatment planning of melanocytic skin lesions. High-frequency ultrasound (HFUS) is frequently used for this purpose, but overestimation of tumor thickness is known as a problem especially in thin melanocytic lesions. Optical coherence tomography (OCT) as a new imaging technique might be a promising alternative.


OBJECTIVE
To evaluate the ability of OCT to accurately determine the vertical tumor thickness of melanocytic skin lesions and to compare it with HFUS and histopathology in order to improve surgical planning.


METHODS
In this single-center study, 26 melanocytic lesions were imaged by OCT and HFUS. Vertical lesion dimensions of both methods were compared with histopathological measurements.


RESULTS
Bland-Altman plots for OCT and histopathology as well as for HFUS and histopathology revealed better agreement for OCT and histopathology concerning tumor thickness measurements. Tumor thickness values for the melanocytic lesions measured by OCT presented a median tumor thickness of 0.31 mm (range 0.10-0.77) compared to a median tumor thickness of 0.25 mm (range 0.06-1.5) measured by histopathology. The median tumor thickness of HFUS was 0.44 mm (range 0.23-1.1). A Spearman correlation procedure including the correlation coefficient (r) showed a stronger relationship between OCT and histopathology (r = 0.734) compared to HFUS and histopathology (r = 0.390).


CONCLUSIONS
On the basis of this smaller study cohort, OCT seems to be more exact than HFUS as far as thickness determination of thin melanocytic skin lesions is concerned.
Department of Dermatology and Allergology, University of Bonn, Bonn, Germany.
Torsten
T
Hinz
Lin-Kristin
LK
Ehler
Harald
H
Voth
Ines
I
Fortmeier
Tobias
T
Hoeller
Thorsten
T
Hornung
Monika-Hildegard
MH
Schmid-Wendtner
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004416:Dysplastic Nevus Syndrome / Q000000981:diagnostic imaging / Q000473:pathology*; D005260:Female; D006801:Humans; D018327:Hutchinson's Melanotic Freckle / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D008545:Melanoma / Q000000981:diagnostic imaging / Q000473:pathology*; D008875:Middle Aged; D009508:Nevus, Pigmented / Q000000981:diagnostic imaging / Q000473:pathology*; D011859:Radiography; D012878:Skin Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D018709:Statistics, Nonparametric; D041623:Tomography, Optical Coherence; D014463:Ultrasonography