Department of Dermatology, Hôpital Erasme, Université Libre de Bruxelles, 1070 Brussels, Belgium.
Br J Dermatol. 2012 Oct;167(4):856-64. doi: 10.1111/j.1365-2133.2012.11194.x.
With the continued development of noninvasive therapies for basal cell carcinoma (BCC) such as photodynamic therapy and immune therapies, noninvasive diagnosis and monitoring become increasingly relevant. High-definition optical coherence tomography (HD-OCT) is a high-resolution imaging tool, with micrometre resolution in both transversal and axial directions, enabling visualization of individual cells up to a depth of around 570 μm, and filling the imaging gap between conventional optical coherence tomography (OCT) and reflectance confocal microscopy (RCM).
We sought to determine the feasibility of detecting BCC by this technique using criteria defined for RCM and conventional OCT and compared with histology.
In this pilot study skin lesions of 21 patients with a histologically proven BCC were imaged by HD-OCT just before excision and images analysed qualitatively.
Features for four different BCC subtypes were described in both transverse and axial directions. In general, these features were subepidermal or intradermal aggregations of cells. These islands or trabeculae were surrounded by a less refractile border corresponding with palisading and peritumoral mucin production. There was a pronounced architectural disarray of the epidermis. A variably refractile stroma together with abundant dilated peritumoral blood vessels was present. These features were comparable with histological features for each patient.
Using features already suggested by RCM and conventional OCT, the study implies that HD-OCT facilitates in vivo diagnosis of BCC and allows the distinction between different BCC subtypes for increased clinical utility.
随着基底细胞癌 (BCC) 的非侵入性治疗方法（如光动力疗法和免疫疗法）的不断发展，非侵入性诊断和监测变得越来越重要。高清光学相干断层扫描 (HD-OCT) 是一种高分辨率成像工具，具有横向和轴向的亚微米分辨率，能够可视化单个细胞，深度可达约 570μm，并填补了传统光学相干断层扫描 (OCT) 和反射共焦显微镜 (RCM) 之间的成像空白。
我们试图通过该技术使用 RCM 和传统 OCT 定义的标准来确定检测 BCC 的可行性，并与组织学进行比较。
在这项初步研究中，对 21 名经组织学证实患有 BCC 的患者的皮肤病变在切除前进行了 HD-OCT 成像，并进行了定性分析。
在横向和轴向方向上描述了四种不同 BCC 亚型的特征。通常，这些特征是表皮下或真皮内细胞聚集。这些岛状或小梁状结构被折射率较低的边界环绕，对应于栅栏状排列和肿瘤周围粘蛋白的产生。表皮的结构排列明显紊乱。存在明显的可折射基质以及丰富的扩张性肿瘤周围血管。这些特征与每位患者的组织学特征相匹配。
使用 RCM 和传统 OCT 已经提出的特征，该研究表明 HD-OCT 有助于 BCC 的体内诊断，并允许区分不同的 BCC 亚型，以提高临床实用性。
