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Optical coherence tomography of actinic keratoses and basal cell carcinomas – differentiation by quantification of signal intensity and layer thickness
Author(s) -
Schuh S.,
Kaestle R.,
Sattler E. C.,
Welzel J.
Publication year - 2016
Publication title -
journal of the european academy of dermatology and venereology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.655
H-Index - 107
eISSN - 1468-3083
pISSN - 0926-9959
DOI - 10.1111/jdv.13569
Subject(s) - medicine , actinic keratoses , stratum corneum , optical coherence tomography , histology , epidermis (zoology) , dermatology , dyskeratosis , pathology , basal cell , hyperkeratosis , ophthalmology , anatomy
Background Previous studies have shown that actinic keratoses ( AK s) and basal cell carcinomas ( BCC s) can be diagnosed by optical coherence tomography ( OCT ) based on morphological characteristics. There is a lack of systematic studies that give standardized information on signal intensity and layer thickness of AK s and BCC s. Objective The aim of this study was to find out if AK s and BCC s can be objectively diagnosed through standardized measurement of signal intensity and layer thickness and to use OCT as a non‐invasive objective method for the diagnosis and evaluation of AK s and BCC s. Additionally, tumour and skin layer thickness were investigated in correlation with histology. Methods In this experimental study, 301 lesions (188 BCC s and 113 AK s) of 125 patients were clinically as well as dermoscopically diagnosed and investigated with OCT before therapy. Normal perilesional skin served as control. Results It is possible to differentiate BCC s and AK s from normal skin in OCT due to the decrease of local signal intensity in affected skin layers in relation to adjacent healthy skin. In AK s, a strong thickness increase of the stratum corneum and epidermis compared to normal skin were observed. For the distinction between AK s and BCC s, a drop of signal intensity in the dermis of AK s towards BCC s and a thicker epidermis of AK s in contrast to BCC s were registered. All results are statistically highly significant ( P < 0.0001). Besides, a strong correlation of tumour and skin layer thickness of BCC s and AK s in OCT with histology was found. Conclusion Through standardized measurement of signal intensity and layer thickness, BCC s and AK s can be objectively diagnosed and distinguished from each other with OCT . This will further improve the use of OCT as a non‐invasive objective method for the diagnosis and treatment monitoring of these diseases.