Comparison of optical localization techniques for optical coherence tomography of the hand for multi-fraction orthovoltage radiotherapy or photodynamic therapy: white light vs. optical surface imaging (Conference Presentation)

Abstract

Non-melanoma skin cancer (NMSC) is considered the most commonly diagnosed cancer in the United States and Canada. Treatment options include radiotherapy, surgical excision, radiotherapy, topical therapies, electrocautery, and cryotherapy. For patients undergoing fractionated orthovoltage radiation therapy or photodynamic therapy (PDT), the lesions are typically delineated by clinical markup prior to treatment without providing any information about the underlying tissue thus increasing the risk of geographic miss. The development of biomarkers for response in NMSC is imperative considering the current treatment paradigm is based on clinical examination and biopsy confirmation. Therefore, a non-invasive image-based evaluation of skin structure would allow for faster and potentially more comprehensive microscopic evaluation of the treated region at the point of care. To address this, our group is investigating the use of optical coherence tomography (OCT) for pre- and post- treatment evaluation of NMSC lesions during radiation therapy and PDT. Localization of the OCT probe for follow-up is complex, especially in the context of treatment response where the lesion is not present, precluding accurate delineation of the planning treatment area. Further, comparison to standard white light pre-treatment images is limited by the scale of the OCT probe (6 mm X 6 mm) relative to target region. In this study we compare the set-up accuracy of a typical OCT probe to detect a theoretical lesion on a patient’s hand. White light images, optical surface imaging (OSI) and OCT will be obtained at baseline and used for probe set up on subsequent scans. Set-up error will be quantified using advanced image processing techniques.