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Proceedings Paper

Combined reflectance confocal microscopy-optical coherence tomography for detection and deep margin assessment of basal cell carcinomas: a clinical study (Conference Presentation)
Author(s): Aditi Sahu; Oriol Yelamos; Nicusor Iftimia; Miguel Cordova; Christi Alessi-Fox; Melissa Gill; Gopi Maguluri; Stephen Dusza; Cristian Navarrete; Salvador Gonzalez; Anthony Rossi; Ashfaq Marghoob; Milind Rajadhyaksha; Chih-Shan Jason Chen

Paper Abstract

The limited sampling of biopsy and histopathology can lead to incomplete and/or inaccurate assessment of basal cell carcinomas (BCCs), subtypes and depth, which can affect diagnosis and treatment outcome. Reflectance confocal microscopy (RCM) combined with optical coherence tomography (OCT) can help achieve comprehensive 3-dimensional sampling in vivo, which may improve the diagnostic accuracy and margin assessment of BCCs. In a clinical study, we tested a combined RCM-OCT probe on 85 patients, with either clinically-suspicious (n=60, in intact skin) or biopsy-proven BCCs (n=25, in scarred skin). We correlated BCC features in RCM and OCT images with histopathology, calculated diagnostic accuracy and correlated depth predicted by OCT with histopathologically measured depth. The main features were small tumors extending from the basal cell layer at the dermal-epidermal junction; small and large tumor nests; in dermis; dark silhouettes; dilated blood vessels; horn cyst and bright peritumoral stroma. Deeper features such as necrosis and intratumoral mucin pools were correlated on OCT and histology. Higher sensitivity and negative predictive value (100%) and comparable specificity (48% vs 56% on RCM) and positive predictive value (82.19 vs 84.59 % on RCM) were observed for the combined RCM-OCT device for diagnosis of all lesions (n=85). Relatively higher specificity (94.1%) and positive predictive value (75%) were observed in the clinically suspicious lesions (n=60, in intact skin). High correlation was observed (R=0.86) between the OCT predicted depth and histopathologically measured depth. Therefore, RCM-OCT imaging may be prospectively used to comprehensively diagnose suspicious BCC lesions, determine subtype and triage for treatment.

Paper Details

Date Published: 4 March 2019
Proc. SPIE 10871, Multimodal Biomedical Imaging XIV, 108710K (4 March 2019); doi: 10.1117/12.2510953
Show Author Affiliations
Aditi Sahu, Memorial Sloan-Kettering Cancer Ctr. (United States)
Oriol Yelamos, Univ. de Barcelona (Spain)
Nicusor Iftimia, Physical Sciences Inc. (United States)
Miguel Cordova, Memorial Sloan-Kettering Cancer Ctr. (United States)
Christi Alessi-Fox, Caliber Imaging & Diagnostics, Inc. (United States)
Melissa Gill, SUNY Downstate Medical Ctr. (United States)
Gopi Maguluri, Physical Sciences Inc. (United States)
Stephen Dusza, Memorial Sloan-Kettering Cancer Ctr. (United States)
Cristian Navarrete, Memorial Sloan-Kettering Cancer Ctr. (United States)
Salvador Gonzalez, Alcala Univ. (Spain)
Anthony Rossi, Memorial Sloan-Kettering Cancer Ctr. (United States)
Ashfaq Marghoob, Memorial Sloan-Kettering Cancer Ctr. (United States)
Milind Rajadhyaksha, Memorial Sloan-Kettering Cancer Ctr. (United States)
Chih-Shan Jason Chen, Memorial Sloan-Kettering Cancer Ctr. (United States)

Published in SPIE Proceedings Vol. 10871:
Multimodal Biomedical Imaging XIV
Fred S. Azar; Xavier Intes; Qianqian Fang, Editor(s)

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