Presurgical evaluation of basal cell carcinoma using combined reflectance confocal microscopy–optical coherence tomography: A prospective study Journal Article


Authors: Aleissa, S.; Navarrete-Dechent, C.; Cordova, M.; Sahu, A.; Dusza, S. W.; Phillips, W.; Rossi, A.; Lee, E.; Nehal, K. S.
Article Title: Presurgical evaluation of basal cell carcinoma using combined reflectance confocal microscopy–optical coherence tomography: A prospective study
Abstract: Background: Initial biopsy of basal cell carcinoma (BCC) may fail to show aggressive histologic subtypes. Additionality, the clinical evaluation of BCC before surgery can miss subclinical extension. Reflectance confocal microscopy (RCM) and optical coherence tomography (OCT) are emerging tools that can help in the presurgical evaluation of BCCs. Objective: To assess the feasibility of a combined RCM-OCT imaging modality for presurgical evaluation of biopsy-proven BCCs for residual tumor, margin status, and depth. Methods: Thirty-eight BCCs in 35 patients referred to a tertiary cancer center for Mohs micrographic surgery (MMS) were imaged with combined RCM-OCT. Images were correlated to MMS frozen sections. Results: Thirty-eight BCCs were analyzed. The mean age of patients was 67.34 years (range, 36-84 years), and 20 patients were female (57.14%). Twenty four BCCs were located on the head (63.16%), and the mean size was 8.58 mm (range, 3-30 mm). RCM-OCT showed an overall agreement of 91.1% with MMS frozen sections. A sensitivity of 82.6% (95% confidence interval [CI], 69%-92%), specificity of 93.8% (95% CI, 88%-97%), and receiver operating characteristic curve of 0.88 (95% CI, 0.82-0.94) was found. OCT depth was highly correlated with MMS depth (r2 = 0.9). Limitations: Small sample size and difficulty evaluating certain challenging anatomic sites. Conclusions: Combined RCM-OCT may emerge as a useful tool for presurgical evaluation of BCCs. © 2019 American Academy of Dermatology, Inc.
Keywords: adult; clinical article; human tissue; aged; cancer surgery; diagnostic accuracy; prospective study; sensitivity and specificity; reflectance confocal microscopy; basal cell carcinoma; tumor biopsy; biopsy; feasibility study; surgery; frozen section; margins; mohs micrographic surgery; predictive value; optical coherence tomography; mohs; diagnostic test accuracy study; residual; human; male; female; priority journal; article
Journal Title: Journal of the American Academy of Dermatology
Volume: 82
Issue: 4
ISSN: 0190-9622
Publisher: Mosby Elsevier  
Date Published: 2020-04-01
Start Page: 962
End Page: 968
Language: English
DOI: 10.1016/j.jaad.2019.10.028
PUBMED: 31634517
PROVIDER: scopus
PMCID: PMC7513586
DOI/URL:
Notes: Article -- Export Date: 1 April 2020 -- Source: Scopus
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MSK Authors
  1. Kishwer S Nehal
    279 Nehal
  2. Stephen Dusza
    289 Dusza
  3. Erica H Lee
    136 Lee
  4. Anthony Rossi
    235 Rossi
  5. Miguel A Cordova
    88 Cordova
  6. Aditi Kamlesh Sahu
    30 Sahu
  7. Saud Aleissa
    24 Aleissa