title: Diagnostic accuracy of optical coherence tomography in actinic keratosis and basal cell carcinoma.
abstract: BACKGROUND
  Early diagnosis of non-melanoma skin cancer (NMSC) is potentially possible using optical coherence tomography (OCT) which provides non-invasive, real-time images of skin with micrometre resolution and an imaging depth of up to 2mm. OCT technology for skin imaging has undergone significant developments, improving image quality substantially. The diagnostic accuracy of any method is influenced by continuous technological development making it necessary to regularly re-evaluate methods.
  
  
  OBJECTIVE
  The objective of this study is to estimate the diagnostic accuracy of OCT in basal cell carcinomas (BCC) and actinic keratosis (AK) as well as differentiating these lesions from normal skin.
  
  
  METHODS
  A study set consisting of 142 OCT images meeting selection criterea for image quality and diagnosis of AK, BCC and normal skin was presented uniformly to two groups of blinded observers: 5 dermatologists experienced in OCT-image interpretation and 5 dermatologists with no experience in OCT. During the presentation of the study set the observers filled out a standardized questionnaire regarding the OCT diagnosis. Images were captured using a commercially available OCT machine (Vivosight®, Michelson Diagnostics, UK).
  
  
  RESULTS
  Skilled OCT observers were able to diagnose BCC lesions with a sensitivity of 86% to 95% and a specificity of 81% to 98%. Skilled observers with at least one year of OCT-experience showed an overall higher diagnostic accuracy compared to inexperienced observers.
  
  
  CONCLUSIONS
  The study shows an improved diagnostic accuracy of OCT in differentiating AK and BCC from healthy skin using state-of-the-art technology compared to earlier OCT technology, especially concerning BCC diagnosis.
authors: Department of Dermatology, Zealand University Hospital, Roskilde; Health Sciences Faculty, University of Copenhagen, Denmark. Electronic address: jonao@regionsjaelland.dk.
authors: J
authors: J
authors: Olsen
authors: Department of Dermatology, Zealand University Hospital, Roskilde; Health Sciences Faculty, University of Copenhagen, Denmark.
authors: L
authors: L
authors: Themstrup
authors: Department of Dermatology, University of Modena and Reggio Emilia, Italy.
authors: N
authors: N
authors: De Carvalho
authors: Department of Dermatology, Bispebjerg University Hospital; Health Sciences Faculty, University of Copenhagen, Denmark.
authors: M
authors: M
authors: Mogensen
authors: Department of Dermatology, University of Modena and Reggio Emilia, Italy.
authors: G
authors: G
authors: Pellacani
authors: Department of Dermatology, Zealand University Hospital, Roskilde; Health Sciences Faculty, University of Copenhagen, Denmark.
authors: G B E
authors: GB
authors: Jemec
mesh_terms: D000368:Aged; D002280:Basal Cell Carcinoma / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D006801:Humans; D055623:Keratosis, Actinic / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D015588:Observer Variation; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016037:Single-Blind Method; D012878:Skin Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D041623:Tomography, Optical Coherence / Q000379:methods*; D014260:Triclosan
chemical_list: D014260:Triclosan
keywords: Actinic keratosis; Basal cell carcinoma; Dermatology; Non-invasive imaging; Non-melanoma skin cancer; Optical coherence tomography