Optical coherence tomography improves basal cell carcinoma detection after topicals

Key takeaways:

• CDE plus OCT exhibited 100% sensitivity while the sensitivity of CDE alone was 60%.
• Specificity remained comparable between CDE plus OCT (95%) and CDE alone (96.3%).

When used in tandem with clinical and dermoscopic examination, optical coherence tomography significantly improved the ability to detect recurrent or residual basal cell carcinomas after topical treatment, according to a study.

While recurrent or residual basal cell carcinoma (BCC) after topical treatment may not be visible during clinical and dermoscopic examination (CDE), it may be detectable using optical coherence tomography (OCT).

“In recent years, OCT has become available for noninvasive diagnosis of BCC,” Tom Wolswijk, MD, MSc, of the department of dermatology and GROW School for Oncology and Reproduction at Maastricht University, and colleagues wrote. “It generates real-time in-vivo cross-sectional images with a depth of approximately 1.5 mm. These images resemble histopathological sections and morphological features that are characteristic for BCC [and] can be used for diagnosis of BCC.”

In this diagnostic cohort study, researchers compared the diagnostic accuracy of CDE with that of CDE combined with OCT for detecting recurrent or residual BCC after topical treatment of superficial BCC.

Results showed that 20 of the 100 patients included in the study had a histopathological recurrent/residual BCC. When the researchers used CDE plus OCT to detect these BCCs, sensitivity was 100% while the sensitivity of CDE alone was 60% (P = .005).

Specificity was comparable between CDE plus OCT and CDE alone (95% vs. 96.3%, respectively).

Results also showed that the negative predictive values for CDE alone were 90.6% but increased to 100% for CDE plus OCT (P = .005). Ultimately, the area under the curve for CDE plus OCT was significantly higher compared with CDE alone (0.98 vs. 0.77; P = .001).

The authors determined that the incorporation of OCT into clinical practices significantly improves the sensitivity of CDE for detecting recurrent or residual BCC after topical treatment without compromising specificity.