title: Optical coherence tomography accurately identifies patients with penile (pre) malignant lesions: A single center prospective study.
abstract: BACKGROUND
  Currently, (multiple) biopsies are taken to obtain histopathological diagnosis of suspicious lesions of the penile skin. Optical coherence tomography (OCT) provides noninvasive in vivo images from which epidermal layer thickness and attenuation coefficient (μoct) can be quantified. We hypothesize that qualitative (image assessment) and quantitative (epidermal layer thickness and attenuation coefficient, μoct) analysis of penile skin with OCT is possible and may differentiate benign penile tissue from (pre) malignant penile tissue.
  
  
  METHODS
  Optical coherence tomography-imaging was performed prior to punch biopsy in 18 consecutive patients with a suspicious lesion at the outpatient clinic of the NKI-AVL. Qualitative analysis consisted of visual assessment of clear layers and a visible lower border of the lesions, quantitative analysis comprised of determination of the epidermal layer thickness and μoct. Results were grouped according to histopathology reports.
  
  
  RESULTS
  Qualitative analysis showed a statistically significant difference (P = 0.047) between benign and (pre) malignant lesions. Quantitative analysis showed that epidermal layer thickness and attenuation coefficient was significantly different between benign and (pre) malignant tissue, respectively, P = 0.001 and P < 0.001.
  
  
  CONCLUSIONS
  In this preliminary study, qualitative and quantitative analysis of OCT-images of suspicious penile lesions shows differences between benign lesions and (pre) malignant lesions. These results encourage further research in a larger study population.
authors.affiliation: Department of Surgery, NKI-AVL, Amsterdam, The Netherlands.
authors.forename: Ronni
authors.initials: R
authors.lastname: Wessels
authors.affiliation: Department of Biomedical Engineering and Physics, Amsterdam, The Netherlands ; Department of Urology, AMC-UvA, Amsterdam, The Netherlands.
authors.forename: Daniel M
authors.initials: DM
authors.lastname: De Bruin
authors.affiliation: Department of Biomedical Engineering and Physics, Amsterdam, The Netherlands.
authors.forename: Dirk J
authors.initials: DJ
authors.lastname: Faber
authors.affiliation: Department of Urology, NKI-AVL, Amsterdam, The Netherlands.
authors.forename: Simon
authors.initials: S
authors.lastname: Horenblas
authors.affiliation: Department of Urology, NKI-AVL, Amsterdam, The Netherlands.
authors.forename: Bas W G
authors.initials: BW
authors.lastname: van Rhijn
authors.affiliation: Department of Biometrics, NKI-AVL, Amsterdam, The Netherlands.
authors.forename: Andrew D
authors.initials: AD
authors.lastname: Vincent
authors.affiliation: Department of Gynaecology, NKI-AVL, Amsterdam, The Netherlands.
authors.forename: Marc
authors.initials: M
authors.lastname: van Beurden
authors.affiliation: Department of Biomedical Engineering and Physics, Amsterdam, The Netherlands.
authors.forename: Ton G
authors.initials: TG
authors.lastname: van Leeuwen
authors.affiliation: Department of Surgery, NKI-AVL, Amsterdam, The Netherlands ; Department of MIRA Institute, University of Twente, Enschede, The Netherlands.
authors.forename: Theo J M
authors.initials: TJ
authors.lastname: Ruers
keywords: Carcinoma in situ; imaging; optical coherence tomography; penile carcinoma; penile intraepithelial neoplasia