Histological correlates of optical coherence tomography in non-melanoma skin cancer.
BACKGROUND
Non-melanoma skin cancer (NMSC) is rarely fatal but is now the most common malignancy occurring in white populations, accounting for 70% of the cost of managing skin cancer. Optical coherence tomography (OCT) has the potential to improve diagnostic accuracy and help delineate pre-surgical margins in NMSC. Its widespread clinical acceptance awaits the accumulation of evidence from studies of direct histological comparisons.


METHODS
In this study, seventy-eight subjects presenting with skin lesions, including 28 NMSCs, were imaged using the VivoSight OCT scanner and a biopsy taken. Haemotoxylin and eosin stained histology sections were compared with the OCT images.


RESULTS
The depth of superficial basal cell carcinoma (BCC) lesions (<1 mm) can be measured accurately using OCT. A low-strength OCT signal at the periphery of the cell nests seen in superficial and nodular BCC is identified as corresponding to cellular palisading. A weak inverse linear correlation (r(2) = 0.3) is found between the optical attenuation coefficient measured on OCT and the nuclear-cytoplasmic ratio (N/C) of cells determined from histology.


CONCLUSIONS
OCT has clinical value in providing accurate dimensional measurement of superficial BCC and in identifying the presence of peripheral palisading in nodular BCC.
Medical Physics Department, Guy's and St Thomas' NHS Foundation Trust, London. andrew.coleman@gstt.nhs.uk
Andrew John
AJ
Coleman
Thomas James
TJ
Richardson
Guy
G
Orchard
Ayesha
A
Uddin
Min Joo
MJ
Choi
Katie Elizabeth
KE
Lacy
D000328:Adult; D000368:Aged; D001706:Biopsy; D002280:Basal Cell Carcinoma / Q000473:pathology*; D002294:Carcinoma, Squamous Cell / Q000473:pathology*; D002467:Cell Nucleus / Q000473:pathology; D003593:Cytoplasm / Q000473:pathology; D003937:Diagnosis, Differential; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D017492:Keratosis, Seborrheic / Q000473:pathology; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D009506:Nevus / Q000473:pathology; D015203:Reproducibility of Results; D012867:Skin / Q000473:pathology; D012878:Skin Neoplasms / Q000473:pathology*; D041623:Tomography, Optical Coherence / Q000379:methods* / Q000592:standards