Sahu A, et al. - Authors ascertained the accuracy of a combined reflectance confocal microscopy (RCM)-optical coherence tomography (OCT) device for basal cell carcinoma (BCC) detection and deep margin assessment. Findings suggested a prospective use of combined RCM-OCT imaging to comprehensively diagnose lesions suggestive of BCC and triage for treatment, though further validation is required.

Methods

• Researchers conducted a pilot study on 85 lesions from 55 patients referred for physician consultation or Mohs surgery at Memorial Sloan Kettering Skin Cancer Center in Hauppauge, NY.
• They prospectively and consecutively enrolled these patients in the study between January 1, 2017, and December 31, 2017.
• For previously biopsied, histopathologically confirmed BCCs and lesions clinically or dermoscopically suggestive of BCC, patients underwent imaging, with the combined RCM-OCT probe.
• They only included the patients with available histopathologic examination after imaging.
• They gauged the improvements in sensitivity, specificity, and diagnostic accuracy for BCC using the combined RCM-OCT probe as well as the correlation between OCT-estimated depth and histopathologically measured depth.

Results

• In total, 85 lesions from 55 patients (27 [49%] were female and 28 [51%] were male with a median [range] age of 59 [21-90] years) were imaged.
• Experts performed imaging on 25 previously biopsied and histopathologically confirmed BCCs and 60 previously nonbiopsied but clinically or dermoscopically suspicious lesions.
• They correlated and validated the normal skin and BCC features with histopathologic examination.
• As per data, in previously biopsied lesions, residual tumors were detected in 12 of 25 (48%) lesions with 100% sensitivity (95% CI, 73.5%-100%) and 23.1% specificity (95% CI, 5.0%-53.8%) for combined RCM-OCT probe.
• They diagnosed BCCs in 48 of 60 (80%) lesions with 100% sensitivity (95% CI, 92.6%-100%) and 75% specificity (95% CI, 42.8%-94.5%) in previously nonbiopsied and suspicious lesions.
• They observed association between depth estimated with OCT and depth measured with histopathologic examination: the coefficient of determination (R2) was 0.75 (R=0.86; P < .001) for all lesions, 0.73 (R=0.85; P< .001) for lesions less than 500 μm deep, and 0.65 (R=0.43;P < .001) for lesions greater than 500 μm deep.