Bergeron Sabrina, Arthurs Bryan, Sanft Debra-Meghan, Mastromonaco Christina, Burnier Miguel N
The MUHC, McGill University Ocular Pathology and Translational Research Laboratory, McGill University, Montreal, Québec, Canada.
Department of Ophthalmology, McGill University, Montreal, Québec, Canada.
Ocul Oncol Pathol. 2021 Mar;7(2):149-158. doi: 10.1159/000511188. Epub 2020 Dec 2.
Optical coherence tomography (OCT) imaging has been used as a diagnostic tool for retinal disease for several years, and OCT apparatuses are becoming increasingly powerful. However, OCT has yet to reach its full potential in ophthalmology clinics. Alike retinal layers, it has been shown that OCT is able to generate cross-sectional images of the skin and allows visualization of skin lesions in a histopathology-like manner.
We aim to validate OCT as an imaging modality for peri-ocular skin cancer. Through a series of cases, we highlight findings for 3 common eyelid malignancies: basal cell carcinoma, squamous cell carcinoma and sebaceous carcinoma. We propose an OCT image-based signature for basal cell carcinoma.
This is a prospective study. Fifty-eight lesions suspicious of malignancy from 57 patients were subjected to OCT imaging prior to the surgical excision of the lesion. OCT images were analysed and scored according to previously identified OCT features. Eight representative examples are presented, highlighting the OCT patterns for each malignancy side by side to its corresponding histopathological sections.
Out of the 58 lesions analysed, 53 were malignant. A loss of the dermal-epidermal junction is observed in all malignant lesions. A strong link is observed between the presence of subepithelial hyporeflective nests on OCT and the diagnosis of basal cell carcinoma (present in 83% of cases). Conversely, lesions of epithelial origin such as squamous cell carcinoma are most often represented on OCT by acanthosis. Two supplementary cases, one basal cell carcinoma and one sebaceous carcinoma, are provided to illustrate how OCT imaging is a valuable tool in cases where clinical observations may be unusual.
We provide evidence supporting the use of OCT for the evaluation of peri-ocular cancers. OCT enables visualization of the skin layers in vivo, before biopsy. Our results show that certain OCT features can contribute to include or exclude a diagnosis of basal cell carcinoma. By integrating this non-invasive imaging methodology into the routine assessment of peri-ocular skin lesions, especially in health care centres where access to specialists is limited, OCT imaging can increase clinical precision, reduce delays in patient referral and enhance patient care.
光学相干断层扫描（OCT）成像作为一种视网膜疾病的诊断工具已应用多年，并且OCT设备正变得越来越强大。然而，OCT在眼科诊所尚未发挥出其全部潜力。与视网膜层类似，已有研究表明OCT能够生成皮肤的横截面图像，并能以类似组织病理学的方式观察皮肤病变。
我们旨在验证OCT作为眼周皮肤癌成像方式的有效性。通过一系列病例，我们重点介绍了3种常见眼睑恶性肿瘤的检查结果：基底细胞癌、鳞状细胞癌和皮脂腺癌。我们提出了一种基于OCT图像的基底细胞癌特征。
这是一项前瞻性研究。在对57例患者的58个可疑恶性病变进行手术切除之前，先对其进行OCT成像。根据先前确定的OCT特征对OCT图像进行分析和评分。给出了8个代表性实例，将每种恶性肿瘤的OCT图像模式与其相应的组织病理学切片并排展示。
在分析的58个病变中，53个为恶性。在所有恶性病变中均观察到真皮-表皮交界处消失。在OCT上观察到上皮下低反射巢的存在与基底细胞癌的诊断之间存在紧密联系（83%的病例中存在）。相反，上皮源性病变如鳞状细胞癌在OCT上最常表现为棘皮症。提供了两个补充病例，一个基底细胞癌和一个皮脂腺癌，以说明在临床观察可能不寻常的情况下，OCT成像如何成为一种有价值的工具。
我们提供了支持使用OCT评估眼周癌症的证据。OCT能够在活检前对体内皮肤层进行可视化观察。我们的结果表明，某些OCT特征有助于诊断或排除基底细胞癌。通过将这种非侵入性成像方法纳入眼周皮肤病变的常规评估中，特别是在专家资源有限的医疗保健中心，OCT成像可以提高临床准确性，减少患者转诊延迟并改善患者护理。
