Department of Dermatology and Allergology, Joint Authority for Päijät-Häme Health and Wellbeing, Lahti, Finland.
Department of Dermatology, Tampere University and Tampere University Hospital, Tampere, Finland.
J Eur Acad Dermatol Venereol. 2019 Jan;33(1):71-78. doi: 10.1111/jdv.15102. Epub 2018 Jun 20.
Basal cell carcinoma (BCC) is the most common skin cancer in the Caucasian population. Eighty per cent of BCCs are located on the head and neck area. Clinically ill-defined BCCs often represent histologically aggressive subtypes, and they can have subtle subclinical extensions leading to recurrence and the need for re-excisions.
The aim of this pilot study was to test the feasibility of a hyperspectral imaging system (HIS) in vivo in delineating the preoperatively lateral margins of ill-defined BCCs on the head and neck area.
Ill-defined BCCs were assessed clinically with a dermatoscope, photographed and imaged with HIS. This was followed by surgical procedures where the BCCs were excised at the clinical border and the marginal strip separately. HIS, with a 12-cm field of view and fast data processing, records a hyperspectral graph for every pixel in the imaged area, thus creating a data cube. With automated computational modelling, the spectral data are converted into localization maps showing the tumour borders. Interpretation of these maps was compared to the histologically verified tumour borders.
Sixteen BCCs were included. Of these cases, 10 of 16 were the aggressive subtype of BCC and 6 of 16 were nodular, superficial or a mixed type. HIS delineated the lesions more accurately in 12 of 16 of the BCCs compared to the clinical evaluation (4 of 16 wider and 8 of 16 smaller by HIS). In 2 of 16 cases, the HIS-delineated lesion was wider without histopathological confirmation. In 2 of 16 cases, HIS did not detect the histopathologically confirmed subclinical extension.
HIS has the potential to be an easy and fast aid in the preoperative delineation of ill-defined BCCs, but further adjustment and larger studies are warranted for an optimal outcome.
基底细胞癌（BCC）是白种人群中最常见的皮肤癌。80%的 BCC 位于头颈部。临床上边界不清晰的 BCC 通常代表组织学上侵袭性较强的亚型，它们可能有细微的亚临床扩展，导致复发和需要再次切除。
本初步研究旨在测试在头颈部临床定义不明确的 BCC 术前评估中，使用高光谱成像系统（HIS）进行横向边界描绘的可行性。
使用皮肤镜对不明确的 BCC 进行评估，拍照并用 HIS 进行成像。随后进行手术，将 BCC 在临床边界和边缘条带处分别切除。HIS 具有 12cm 的视场和快速的数据处理能力，为成像区域的每个像素记录一个高光谱图，从而创建一个数据立方体。通过自动化计算建模，将光谱数据转换为定位图，显示肿瘤边界。这些地图的解释与组织学验证的肿瘤边界进行比较。
共纳入 16 例 BCC。其中，10 例为侵袭性 BCC，6 例为结节状、浅表或混合性。与临床评估相比，HIS 在 16 例 BCC 中的 12 例中更准确地描绘了病变（4 例 HIS 比临床评估宽，8 例 HIS 比临床评估窄）。在 2 例 BCC 中，HIS 界定的病变范围较宽，但无组织病理学证实。在 2 例 BCC 中，HIS 未检测到组织病理学证实的亚临床扩展。
HIS 有可能成为术前描绘临床定义不明确的 BCC 的简便快速辅助手段，但需要进一步调整和更大规模的研究以获得最佳结果。
