Volume 31, Issue 1 (3-2024)
RJMS 2024, 31(1): 1-8 |
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Research code: 01
Ethics code: IR.IAU.SARI.REC.1403.350
Clinical trials code: 01
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Eftekhari M A, Eftekhari Y. Using Optical Imaging Techniques (HD-OCT) for Early Detection of Skin Cancer. RJMS 2024; 31 (1) :1-8
URL: http://rjms.iums.ac.ir/article-1-8977-en.html
URL: http://rjms.iums.ac.ir/article-1-8977-en.html
Rajaie Cardiovascular Medical and Research Institute, Iran University of Medical Sciences, Tehran, Iran , Eftekhari.Yahya.2020@gmail.com
Abstract: (311 Views)
Background & Aims: High-Resolution Optical Coherence Tomography (HD-OCT) is an advanced, non-invasive, in vivo imaging technique that offers cellular resolution images of skin lesions, particularly those with melanocytic characteristics. This study aimed to evaluate the ability of HD-OCT in identifying architectural patterns and cytological features of melanocytic lesions, with a focus on early detection of skin cancer. HD-OCT presents a unique opportunity for enhancing diagnostic accuracy and may serve as a complementary tool in the early diagnosis of skin cancers such as melanoma, especially in cases where clinical examination and dermoscopy are not conclusive.
Methods: This prospective study involved the examination of 26 melanocytic lesions from 26 patients. Each lesion was assessed clinically, using dermoscopy by a trained observer, followed by imaging with HD-OCT. The HD-OCT images were captured in both cross-sectional and en-face modes to ensure comprehensive imaging coverage. The obtained images were then compared with histopathological findings obtained from biopsy specimens of the lesions. The primary aim was to evaluate the HD-OCT’s capacity to identify and differentiate specific features such as cellular architecture, pigmentation patterns, and dermal involvement, which could assist in distinguishing benign from malignant melanocytic lesions. The comparison between the imaging modalities was made to assess the diagnostic performance of HD-OCT relative to the gold standard of histopathology.
Results: The results indicated that HD-OCT was able to detect distinct architectural patterns in both the cross-sectional and en-face modes of imaging. Notably, the technology could provide clear visualization of the cellular features of pigmented cells within various skin layers, including the epidermis and dermis. The technique demonstrated adequate resolution and suitable depth of penetration, allowing for the acquisition of detailed three-dimensional structural data of the melanocytic lesions. However, the lateral resolution of HD-OCT was found to be slightly inferior when compared to confocal reflectance microscopy (RCM), which remains the gold standard for non-invasive skin imaging with cellular resolution. Despite this, HD-OCT was still able to detect significant cytological features that could potentially differentiate benign from malignant lesions. It was noted, however, that while HD-OCT showed promise in identifying malignant melanoma, it was not definitive enough to exclude melanoma as a diagnosis solely based on imaging. This indicates that while the technology can provide valuable insights, it cannot replace histopathology or serve as a standalone diagnostic tool. HD-OCT represents a significant advancement in non-invasive imaging for the early detection of melanocytic skin lesions. The technique’s ability to provide high-resolution, in vivo images of skin lesions at the cellular level allows for the detection of subtle architectural and cytological features that may not be visible through conventional clinical examination or dermoscopy. The ability to capture cross-sectional and en-face images is an added advantage, as it allows for a more comprehensive evaluation of the lesion's depth, structure, and pigmentation, which is essential for differentiating malignant melanoma from benign melanocytic lesions. However, while HD-OCT shows significant potential, it also has limitations. The lateral resolution, while adequate, is still inferior to that of confocal microscopy, which may affect its diagnostic accuracy in certain cases. Additionally, the technology’s diagnostic potential in terms of melanoma detection remains limited. Although HD-OCT can detect patterns suggestive of malignancy, its sensitivity and specificity for ruling out melanoma are not yet sufficient to rely on it exclusively for diagnosis. As such, further refinement of the technology is needed to enhance its diagnostic accuracy. This study demonstrates that HD-OCT can be used as a complementary tool alongside traditional methods such as dermoscopy for the diagnosis of melanocytic lesions. The ability of HD-OCT to visualize cellular and architectural features of skin lesions could be particularly useful in cases where dermoscopy alone is inconclusive, thus potentially reducing the need for unnecessary biopsies. By providing detailed three-dimensional images, HD-OCT can also aid clinicians in monitoring the progression of lesions over time, especially in high-risk patients with a history of skin cancer. However, it is crucial to note that while HD-OCT holds promise, it should not be used as a replacement for histopathological examination, which remains the gold standard for diagnosing melanoma and other skin cancers. HD-OCT should be viewed as a complementary diagnostic tool, enhancing clinical decision-making but not replacing the need for biopsy and histopathological confirmation.
Conclusion: Overall, High-Resolution Optical Coherence Tomography (HD-OCT) presents a significant advancement in the field of non-invasive imaging of melanocytic skin lesions. It provides clinicians with the ability to visualize cellular architecture and cytological features in a non-invasive manner, offering valuable insights into the nature of skin lesions. While HD-OCT is not yet definitive enough to replace histopathology, it holds substantial promise as a complementary tool in the early diagnosis and management of skin cancers, especially melanoma. Further research and development are required to enhance the sensitivity and specificity of HD-OCT and to establish standardized imaging protocols for its clinical use. With these improvements, HD-OCT could become an invaluable tool in dermatology, assisting clinicians in providing better outcomes for patients with melanocytic lesions.
Type of Study: Research |
Subject:
Clinical Psychiatry
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