Optical coherence tomography of basal cell carcinoma: density and signal attenuation.
BACKGROUND
Basal cell carcinoma (BCC) is the most prevalent malignancy in Caucasians. Optical coherence tomography (OCT) is a non-invasive optical imaging technology using the principle of interferometry. OCT has shown a great potential in diagnosing, monitoring, and follow-up of BCC. So far most OCT studies on the subject of BCC have had a qualitative focus, i.e. on morphological analysis of the OCT images. The aim of this study was to explore the use of quantitative OCT measurements, density, and attenuation coefficient in BCC lesions as a way to improve the OCT evaluation of BCC.


METHODS
The study was based on OCT images of 58 histologically verified BCC lesions and the corresponding normal adjacent skin. The study population was divided into two groups based on the OCT morphology of the BCC lesions: the "Disrupt BCC group" and the "Nodular BCC group". Density and attenuation coefficients were measured in the OCT images by specially designed software and the regions of interests (ROI) were placed directly on (ROI1) and under the visible BCC lesions (ROI2). The results were compared to the OCT images of normal adjacent skin.


RESULTS
Disrupt BCC group: The densities of BCC lesions were significant lower (P = 0.002), than the normal skin in ROI1. Attenuation measurements were found to be significantly greater (P = 0.012) in BCC lesions compared to normal skin in ROI1. Nodular BCC group: Attenuation measurements were found to be significantly lower (P = 0.017) in BCC lesions compared to normal skin in ROI1.


CONCLUSIONS
Our study suggests a quantitative potential of OCT in the context of BCC. This study is exploratory and requires independent verification.
Department of Dermatology, Roskilde Hospital, Health Sciences Faculty, University of Copenhagen, Copenhagen, Denmark. zpt884@alumni.ku.dk.
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Yücel
Department of Dermatology, Roskilde Hospital, Health Sciences Faculty, University of Copenhagen, Copenhagen, Denmark.
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Themstrup
Department of Engineering "Enzo Ferrari", University of Modena and Reggio Emilia, Modena, Italy.
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M
Manfredi
Department of Dermatology, Roskilde Hospital, Health Sciences Faculty, University of Copenhagen, Copenhagen, Denmark.
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Jemec
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D002280:Basal Cell Carcinoma / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology*; D003720:Densitometry / Q000379:methods*; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D008027:Light; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012542:Scattering, Radiation; D012680:Sensitivity and Specificity; D012867:Skin / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology*; D012878:Skin Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology; D041623:Tomography, Optical Coherence / Q000379:methods*
attenuation coefficient; basal cell carcinoma; density; optical coherence tomography; quantitative OCT measurements