Abstract
High-definition optical coherence tomography (HD-OCT) is a non-invasive in vivo imaging technique with cellular resolution based on the principle of conventional optical coherence tomography. The objective of this study was to evaluate HD-OCT for its ability to identify architectural patterns and cytologic features of melanocytic lesions. All lesions were examined by one observer clinically and using dermoscopy. Cross-sectional HD-OCT images were compared with histopathology. En face HD-OCT images were compared with reflectance confocal microscopy (RCM). Twenty-six melanocytic lesions of 26 patients were imaged. Identification of architectural patterns in cross-sectional mode and cytologic features of pigmented cells in the epidermis, dermo-epidermal junction, papillary dermis, and superficial reticular dermis in the en face mode was possible by HD-OCT. HD-OCT provides morphological imaging with sufficient resolution and penetration depth to discriminate architectural patterns and cytologic features of pigmented cells in epidermis and dermis. The method appears to offer the possibility of additional three-dimensional structural information complementary to that of RCM, albeit at a slightly lower lateral resolution. The diagnostic potential of HD-OCT regarding malignant melanoma is not high enough for ruling out a diagnosis of malignant melanoma.
Highlights
One of the challenging problems in clinical dermatology is the early detection of malignant melanoma
The features and definition of the structures seen in dermoscopy, reflectance confocal microscopy (RCM) and histopathology are those described by Rajadhyasksha et al and Scope et al [25,26,27]
This study indicates that High-definition optical coherence tomography (HD-OCT) potentially allows the identification of the architectural patterns and cytologic features of pigmented cells in the epidermis, dermo-epidermal junction, and dermis up to the superficial reticular dermis
Summary
One of the challenging problems in clinical dermatology is the early detection of malignant melanoma. New methods for diagnosis of melanoma are continuously being developed [1] Most prominent among these is reflectance confocal microscopy (RCM) [9, 16, 20, 23, 25, 27]. RCM enables the non-invasive imaging of the skin in horizontal plane, but does this at a quasihistologic resolution. Superficial structures such as the epidermis and papillary dermis can be visualized with high contrast to a theoretical depth of 250 lm [26]. In spite of this limited penetration, a recently published retrospective study suggests that RCM can be used to diagnose nodular lesions except in fully ulcerated lesions or when pronounced hyperkeratosis [19]
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