Diagnostics Using Non-Invasive Technologies in Dermatological Oncology

Abstract

The growing incidence of skin cancer, with its associated mortality and morbidity, has in recent years led to the developing of new non-invasive technologies, which allow an earlier and more accurate diagnosis. Some of these, such as digital photography, 2D and 3D total-body photography and dermoscopy are now widely used and others, such as reflectance confocal microscopy and optical coherence tomography, are limited to a few academic and referral skin cancer centers because of their cost or the long training period required. Health care professionals involved in the treatment of patients with skin cancer need to know the implications and benefits of new non-invasive technologies for dermatological oncology. In this article we review the characteristics and usability of the main diagnostic imaging methods available today.

Line‐field confocal optical coherence tomography and reflectance confocal microscopy of Merkel cell carcinoma

“…It combines the principle of Optical coherence tomography (OCT) interferometry with the spatial filtering of reflectance confocal microscopy (RCM), providing a histological-like vertical, a RCM-like horizontal and a new unique tridimensional (3D) reconstruction of the skin. 1 With an axial resolution of 1.1 μm, a lateral resolution of 1.3 μm and a penetration depth of ~500 μm, LC-OCT appears as an excellent instrument for the diagnosis of skin cancer. [2][3][4] Merkel cell carcinoma (MCC) is a rare neuroendocrine neoplasm with a high rate of metastasis and mortality.…”

Diagnosis and Management of Acral Pigmented Lesions

“…Its utility in melanoma is challenged by limited cellular resolution, despite a penetration depth of up to 2 millimeters. 40 Although no current studies have evaluated the efficacy of OCT in the diagnosis of acral lesions, its increased imaging depth may potentially permit for the identification of melanoma features.…”

Line‐field confocal optical coherence tomography for in vivo visualization of morphological characteristics of squamous cell carcinoma in a murine model

“…5,6 The past decade has seen an increased use of non-invasive techniques to attain a more precise diagnosis as well as margin delineation before surgery. 7 Beyond dermoscopy, the most explored non-invasive imaging techniques for diagnosis and monitoring of KC include reflectance confocal microscopy (RCM), optical coherence tomography (OCT), and line-field confocal OCT (LC-OCT). 8,9 With high resolution, RCM enables visualization of cellular atypia which has proved useful to increase accuracy in diagnosing SCC and BCC.…”

“…10,11 However, its low penetration depth limits detection of deeper lying tumor infiltration in the dermis. 7 On the contrary, OCT cannot visualize cellular morphology but permits evaluation of tumor invasiveness due to its higher penetration depth. 8,9 Recently, LC-OCT has been introduced, which combines high resolution with a medium penetration depth, greater than RCM.…”