Department of Dermatology, University of Pisa, Pisa, Italy.
Department of Dermatology, Azienda Ospedaliero-Universitaria Ospedale Pediatrico Meyer, Florence, Italy.
Skin Res Technol. 2023 Feb;29(2):e13271. doi: 10.1111/srt.13271.
The diagnosis of basal cell carcinoma (BCC) is based on clinical and dermoscopical features. In uncertain cases, innovative imaging techniques, such as reflectance confocal microscopy (RCM) and optical coherence tomography (OCT), have been used. The main limitation of these techniques is the inability to study deep margins. HFUS (high-frequency ultrasound) and the most recent UHFUS (ultra-high-frequency ultrasound) have been used in various applications in dermatology, but they are not yet routinely used in the diagnosis of BCC. A key point in clinical practice is to find an imaging technique that can help to reduce post-surgical recurrences with a careful presurgical assessment of the lesional margins. This technique should show high sensitivity, specificity, reproducibility and simplicity of execution. This concept is very important for the optimal management of patients who are often elderly and have many comorbidities. The aim of the paper is to analyse the characteristics of current imaging techniques and the studies in the literature on this topic.
The authors independently searched the MEDLINE, PubMed, Embase, Scopus, ScienceDirect and Cochrane Library databases for studies looking for non-invasive imaging techniques for the presurgical margin assessment of BCC.
Preoperative study of the BCC subtype can help to obtain a complete excision with free margins. Different non-invasive imaging techniques have been studied for in vivo evaluation of tumour margins, comparing the histologic evaluation with a radical surgery. The possibility to study the lateral and deep margins would allow a reduction of recurrences and sparing of healthy tissue.
HFUS and UHFUS represent the most promising, non-invasive techniques for the pre-operative study of BCC facilitating the characterization of vascularization, deep lateral margins and high-risk subtypes, although they are limited by insufficient literature unlike RCM and OCT.
基底细胞癌 (BCC) 的诊断基于临床和皮肤镜特征。在不确定的情况下，已经使用了反射共聚焦显微镜 (RCM) 和光相干断层扫描 (OCT) 等创新的成像技术。这些技术的主要限制是无法研究深部边缘。高频超声 (HFUS) 和最新的超高频超声 (UHFUS) 已在皮肤科的各种应用中使用，但尚未常规用于 BCC 的诊断。临床实践中的一个关键点是找到一种可以帮助减少术后复发的成像技术，通过仔细的术前评估病变边缘。该技术应具有高灵敏度、特异性、可重复性和执行简便性。对于经常患有多种合并症的老年患者，这一概念对于患者的最佳管理非常重要。本文的目的是分析当前成像技术的特点和该主题的文献研究。
作者独立搜索了 MEDLINE、PubMed、Embase、Scopus、ScienceDirect 和 Cochrane Library 数据库，以寻找用于 BCC 术前评估的非侵入性成像技术的研究。
BCC 亚型的术前研究有助于获得无边缘的完全切除。已经研究了不同的非侵入性成像技术，用于肿瘤边缘的体内评估，将组织学评估与根治性手术进行比较。研究侧向和深部边缘的可能性将允许减少复发并保留健康组织。
HFUS 和 UHFUS 是最有前途的 BCC 术前研究的非侵入性技术，有助于对血管化、深部侧缘和高风险亚型进行特征描述，尽管它们的文献有限，不如 RCM 和 OCT。
