Histopathological correlates of basal cell carcinoma in the slice and en face imaging modes of high‐definition optical coherence tomography

Summary Background High‐definition optical coherence tomography ( HD ‐ OCT ) scanners have recently been developed, providing significantly higher resolution than conventional OCT .Objectives To assess the relationship between recently defined histopathological HD ‐ OCT correlates of basal cell carcinomas ( BCC ) and possible predictors for the most common tumour subtypes. Methods For HD ‐ OCT imaging, we used the Skintell ® device. Twenty‐five BCC s were histopathologically confirmed (including both vertical and horizontal haematoxylin and eosin and Alcian blue sectioning) and correlated with HD ‐ OCT images. Results In the en face mode, lobulated nodules were seen in 21/25 BCC s (84%), peripheral rimming in 18/25 (72%), epidermal disarray in 18/25 (72%) and variably refractile stroma in 22/25 (88%). In the slice imaging mode, we observed destruction of layering in 19/25 (76%) BCC s. In both the slice and en face modes a significant correlation was observed between peritumoral rimming and grey/dark oval structures and lobulated nodules. Alcian blue stains showed peritumoral mucin deposits correlating with peripheral rimming around the tumour nodules. In a logistic regression model, we did not observe significant independent micromorphological HD ‐ OCT predictors for either the solid or superficial BCC subtypes. Conclusions In agreement with recent studies we have demonstrated that HD ‐ OCT using the slice and en face imaging modes can visualize histopathological correlates of BCC , and potentially aid noninvasive diagnostics. However, using HD ‐ OCT correlation it was not possible to predict the superficial or solid BCC subtypes. For the first time we have shown that peripheral rimming in HD ‐ OCT correlates with peritumoral mucin deposition.