title: Optical coherence tomography for presurgical margin assessment of non-melanoma skin cancer - a practical approach.
abstract: In the clinical setting, optical coherence tomography (OCT) is applicable for the non-invasive diagnosis of skin cancer and may in particular be used for margin definition prior to excision. In this regard, OCT may improve the success rate of removing tumor lesions more effectively, preventing repetitive excision, which may subsequently result in smaller excisions. In this study, we have aimed to evaluate the applicability of OCT for in vivo presurgical margin assessment of non-melanocytic skin tumors (NMSC) and to describe the feasibility of different scanning techniques. A total number of 18 patients planned for excision of lesions suspicious of NMSC were included in this study. Based on OCT, we defined the specific tumor margins on 19 lesions preoperatively using different scanning modalities. Sixty-one margin points and five complete tumor margins were analysed on 18 patients with a total of 19 lesions including 63% basal cell carcinoma (BCC) (n = 12), 16% (n = 3) squamous cell carcinoma (SCC) and 21% of other types of skin tumors (n = 4) were classified. In 84% of the cases (n = 16), the OCT-defined lateral margins correctly indicated complete removal of the tumor. The surgical margins chosen by the surgeon never fell below the OCT-defined margin. Regarding the techniques of marginal definition, punctual tumor border scan in the perpendicular direction, with an extension of free-run scans for unsure cases can hardly be recommended. This study shows that suspected NMSC can effectively be confirmed, and furthermore, resection margin can be minimized under OCT control without reducing the rate of complete removal.
authors.affiliation: Department of Dermatology, Venereology and Allergology, Skin Cancer Centre Charité, Charité Campus Mitte, Charité-Universitätsmedizin Berlin, Berlin, Germany. seyed-arash.alawi@charite.de
authors.forename: Seyed Arash
authors.initials: SA
authors.lastname: Alawi
authors.forename: Monika
authors.initials: M
authors.lastname: Kuck
authors.forename: Caroline
authors.initials: C
authors.lastname: Wahrlich
authors.forename: Sebastian
authors.initials: S
authors.lastname: Batz
authors.forename: Gordon
authors.initials: G
authors.lastname: McKenzie
authors.forename: Joachim W
authors.initials: JW
authors.lastname: Fluhr
authors.forename: Juergen
authors.initials: J
authors.lastname: Lademann
authors.forename: Martina
authors.initials: M
authors.lastname: Ulrich
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002280:Basal Cell Carcinoma / Q000473:pathology / Q000601:surgery; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008875:Middle Aged; D015580:Mohs Surgery; D057234:Preoperative Period; D015203:Reproducibility of Results; D012878:Skin Neoplasms / Q000473:pathology* / Q000601:surgery*; D041623:Tomography, Optical Coherence
keywords: Mohs surgery; non-melanoma skin cancer; optical coherence tomography; tumor margin assessment