Application of Cellular Resolution Full-Field Optical Coherence Tomography in vivo for the Diagnosis of Skin Tumours and Inflammatory Skin Diseases: A Pilot Study

Abstract

<b><i>Background:</i></b> Optical coherence tomography (OCT) has been shown to provide non-invasive diagnosis of common skin neoplasms, especially basal cell carcinoma. OCT produces a cross-sectional view of the tissue, similar to a traditionally sectioned histopathological view, but the resolution of conventional OCT is low and thus limits clinical application. <b><i>Objectives:</i></b> This study aimed to investigate the application ability of a full-field (FF)OCT system which was newly developed to scan the skin at the cellular level. <b><i>Methods:</i></b> Patients with skin tumours or inflammatory lesions warranting biopsy were consecutively enrolled. All lesions underwent clinical, dermoscopic, and OCT assessment, followed by routine biopsy. The adjacent normal skin was scanned for comparison. OCT images were interpreted (blinded to the biopsy results) and then compared with the histopathological diagnosis. <b><i>Results:</i></b> A total of 111 patients with 115 lesions completed the protocol, including 80 skin tumours, 28 inflammatory diseases, and 7 other diseases. Of the OCT images, 43.5% were of good quality and show expected features. Identifiable features of actinic keratosis, Bowen’s disease, basal cell carcinoma, extramammary Paget’s disease, seborrheic keratosis, large cell acanthoma, bullous pemphigoid, interface dermatitis, lichenoid tissue reaction, and psoriasis were demonstrated. Lesions are located deeply, and so some features were out of the field of view, accounting for 40.0% (46/115). <b><i>Conclusions:</i></b> This study expanded the ability of FFOCT for the clinical diagnosis of various skin conditions. This new optical technique can clearly visualise skin lesions located in the epidermis and upper dermis. It provided an effective way to perform digital skin biopsy in superficial skin diseases.

Computer-Aided Detection (CADe) System with Optical Coherent Tomography for Melanin Morphology Quantification in Melasma Patients

“…Imaging modalities aid the diagnosis, monitoring, and treatment response for many conditions, especially precancer lesions and skin cancers [6,31,32]. These techniques have further expanded the field of cosmetic dermatology in detecting clinically undetectable cell changes of the skin, affording new insights into the mechanisms and kinetics of pigmentary disorders [3,10,33,34].…”

“…The compartment of melanin taken up by keratinocytes from melanocytes was recently given the name melanokerasome [7,8,[24][25][26][27]. Our previous study comparing hematoxylin and eosin (H&E) stain slice and OCT images revealed melanin appears as hyper-reflective cells with a relatively strong intensity compared with the surrounding tissues [6]. To replace the manual marking of melanin, a series of image processing steps based on signal brightness and shape are proposed as follows.…”

“…The deposit of melanin in keratinocytes is readily seen on hematoxylin and eosin stain (H&E stain), while melanocytes must be identified by special staining. With the emerging non-invasive techniques, melanin in the epidermis can be easily visualized because of its brightness by dermatofluoroscopy [4], reflectance confocal microscopy (RCM) [3], multiphoton microscopy [5], and optical coherence tomography (OCT) [6]. Studies suggested melanocytes rapidly transfer the produced melanin to keratinocytes rather than accumulating it [7].…”

“…Non-invasive techniques including RCM and multiphoton microscopy already detect pigmentary changes after treatment with the picosecond alexandrite laser and Q-switched Nd: YAG laser [3,5,10,11]. We recently demonstrated the cellular resolution full-field optical coherence tomography (FF-OCT) system allows real-time, non-invasive imaging of superficial skin diseases [6]. Although these imaging techniques allow observation of in vivo melanolysis and qualitative pigmentary changes, studies with quantitative measurements of the amount and intensity of melanin remain scarce [4,12,13].…”

Methods and applications of full-filed optical coherence tomography: a review

“…As shown in Figs. 11(a) – 11(d) , the reported applications include, but are not limited to, the discrimination of benign and malignant tissues of skin cancer, 35 , 103 , 105 breast invasive ductal cancer, 102 , 106 head and neck cancer, 104 as well as optical biopsy of intestinal tissues, 107 , 108 detection of esophageal mucosa, liver, and gastric mucosa. 86 , 102 , 106 , 109 – 113 Besides, FF-OCT incorporating artificial intelligence can benefit deep mining of the abundant image data, which can reduce the difficulty of human eye recognition, improve the accuracy of information recognition, and promote the efficiency of FF-OCT histological diagnosis.…”