MUHC-McGill University Ocular Pathology and Translational Research Laboratory.
MUHC-McGill University Ocular Pathology and Translational Research Laboratory.
Can J Ophthalmol. 2019 Aug;54(4):431-437. doi: 10.1016/j.jcjo.2018.09.007. Epub 2018 Nov 28.
This study aims to assess the use of optical coherence tomography (OCT) imaging for periocular skin lesions and to determine which characteristic features of these images can be correlated to histopathology.
This is an ongoing prospective study with Research Ethics Board approval.
Fifty patients over 18 years old with lesions clinically suspicious of nonmelanoma skin cancer on the periocular region were included in this study.
After consent was obtained, clinical photographs and dermatoscopic images were obtained (DermLite II Hybrid M) from the lesion and its contralateral side. Subsequently, the patient was subjected to OCT imaging using the anterior segment module of a spectral domain OCT (Optovue Avanti) and images of the contralateral skin were also obtained. Surgical excision of the lesion was performed and sent for histopathological examination as per routine treatment. OCT images were then correlated to their matching digitalized histopathology section (Philips Ultra Fast Scanner 1.6 RA).
Based on the OCT images acquired from 50 patients, 8 predominant architectural features have been correlated to histopathology: hyperkeratosis, acanthosis, loss of dermal-epidermal junction delineation, hyporeflective tumour nests, cystic structures, "bunch of grapes" nodules, hyperreflective nests, and ulcerations. Results observed from 45 malignant lesions (basal cell carcinoma, squamous cell carcinoma, and sebaceous gland carcinoma) suggest that groups of features and their layout within the same OCT image may be associated to specific tumour characteristics.
Current data suggest that anterior-segment OCT imaging is a noninvasive imaging modality for periocular lesions and may be a valuable tool to help differentiate between some tumour types before a biopsy is performed.
本研究旨在评估光学相干断层扫描（OCT）成像在眼周皮肤病变中的应用，并确定这些图像的哪些特征可以与组织病理学相关联。
这是一项正在进行的前瞻性研究，获得了伦理委员会的批准。
本研究纳入了 50 名年龄在 18 岁以上的患者，这些患者的眼周区域的病变在临床上疑似为非黑色素瘤皮肤癌。
在获得同意后，从病变及其对侧获得临床照片和皮肤镜图像（DermLite II Hybrid M）。随后，使用光谱域 OCT 的前段模块（Optovue Avanti）对患者进行 OCT 成像，并获得对侧皮肤的图像。按照常规治疗方法对病变进行手术切除，并进行组织病理学检查。然后将 OCT 图像与相应的数字化组织病理学切片进行相关性分析（Philips Ultra Fast Scanner 1.6 RA）。
根据从 50 名患者中获得的 OCT 图像，已经将 8 种主要的结构特征与组织病理学相关联：角化过度、棘皮症、表皮-真皮交界不清、低反射性肿瘤巢、囊性结构、“串珠”结节、高反射性巢和溃疡。从 45 例恶性病变（基底细胞癌、鳞状细胞癌和皮脂腺癌）中观察到的结果表明，同一 OCT 图像中的特征组及其布局可能与特定的肿瘤特征相关。
目前的数据表明，眼前段 OCT 成像技术是一种非侵入性的眼周病变成像方式，在进行活检之前，它可能是一种有价值的工具，可以帮助区分一些肿瘤类型。
