High-Definition Optical Coherence Tomography in the Diagnosis of Basal Cell Carcinoma Evaluated by an Experienced Versus Inexperienced Investigator

Abstract

Background: Histopathology is the gold standard in the diagnosis of basal cell carcinoma (BCC) but biopsies are invasive and often not the preferred diagnostic method for patients. In this context, non-invasive diagnostic imaging tools such as high definition optical coherence tomography (HD-OCT) have shown promising results in diagnosing BCC in real time, atraumatically and repeatedly. Objective: To evaluate the sensitivity and specificity of HD-OCT in the diagnosis of BCC by an experienced versus an inexperienced investigator and describe typical features in common differential diagnosis of BCC. Patients and methods: Forty three patients with clinical suspicion for BCC were included. The HD-OCT images were evaluated in a blinded manner by an experienced and inexperienced investigator. The results were compared to the histopathological diagnosis. Results: Histopathology revealed 22 BCC, 10 fibrous papules of the face, 5 actinic keratoses, 3 intradermal nevi, 2 squamous cell carcinomas and 1 sebaceous hyperplasia. The sensitivity and specificity in diagnosing BCCs correctly by HD-OCT in the experienced investigator was 86.4% and 90.5%, respectively. In the inexperienced investigator the sensitivity and the specificity was 77.3% and 81.0%, respectively. There was a good inter-observer agreement found between experienced and inexperienced investigators. Conclusion: HD-OCT can be used as auxiliary diagnostic tool in the evaluation and treatment of BCC even by inexperienced investigators.