Ex vivo full‐field cellular‐resolution optical coherence tomography of basal cell carcinomas: A pilot study of quality and feasibility of images and diagnostic accuracy in subtypes

Abstract

Background Studies have reported the application of conventional optical coherence tomography (OCT) in the diagnosis of basal cell carcinoma (BCC). The new OCT provides cellular details similar to those in pathology slides and may reduce user learning time. This study aimed to demonstrate the quality of ex vivo full‐field cellular‐resolution OCT images and compare the diagnostic accuracy between physicians with varying pathology experience. Materials and Methods Sixty histologically confirmed BCCs were selected. Tissue samples were sectioned and scanned using OCT, and their features were compared with those of hematoxylin and eosin (H&E)‐stained sections. Thirty images were selected for the test administered to dermatology residents, dermatopathology fellows, and board‐certified general pathologists without any OCT experience. The pretest learning included a 3‐min instruction and 10‐min self‐study of four BCC variants. Results Histopathological BCC and normal histological features were clearly recognizable on the OCT images. The pathological BCC features observed in the OCT images correlated with those found in the H&E‐stained sections. Seven participants completed the test. The correct answer rates of the residents, fellows, and pathologists were 71%, 68%, and 83% for BCC and 44%, 57%, and 57% for the BCC subtypes, respectively. Conclusion All the participants identified BCC in >70% cases with a learning time of only 13 minutes. The results indicated that cellular‐resolution OCT provided high‐quality images similar to the conventional pathology slides. Pathology experience did reflect the diagnostic accuracy. However, a longer training time is still needed at all levels to recognize the BCC subtypes correctly.

High‐resolution full‐field optical coherence tomography microscope for the evaluation of freshly excised skin specimens during Mohs surgery: A feasibility study

“…A drop of mineral oil was added to the lens and the cassette was then inserted into the imaging well of the device for scanning. The technological details of the device have been previously described 14 . Once the scanning process was completed, the entire plane of 10 to 30 microns below the cut surface of the specimen was visualized as one mosaic composed of multiple small elds of view (FOV; 800 µm x 600 µm).…”

“…Once the scanning process was completed, the entire plane of 10 to 30 microns below the cut surface of the specimen was visualized as one mosaic composed of multiple small elds of view (FOV; 800 µm x 600 µm). The scanned images were stored on a connected computer for analysis 14 .…”

“…Wang et al demonstrated that even a novice (without OCT experience) can read these images with 93-100% sensitivity and 21-54% speci city. However, this study was performed on para n-embedded thick tissue sections, which doesn't equate to the evaluation of freshly excised tissues 14 .…”

High resolution full-field optical coherence tomography for the evaluation of freshly excised skin specimens during Mohs surgery: A feasibility study

“…Wang et al demonstrated that even a novice (without OCT experience) can read these images with 93% to 100% sensitivity and 21% to 54% specificity. However, this study was performed on paraffin-embedded thick tissue sections, which doesn't equate to the evaluation of freshly excised tissues 14 .…”

Biomedical optical imaging technology and applications: From basic research toward clinical diagnosis

“…OCT has found clinical and preclinical applications in various medical fields such as ophthalmology, 30–37 cardiology, 38–40 neurology, 41–43 gynecology, 44,45 dermatology, 46–48 dentistry, 49,50 developmental biology, 51 urology, 52–54 gastroenterology, 55–57 etc. OCT has been used to measure the oxygen saturation in blood vessels by extracting the spectral information in the interference signals.…”