Saud Aleissa1, Cristian Navarrete-Dechent2, Miguel Cordova1, Aditi Sahu1, Stephen W Dusza1, William Phillips1, Anthony Rossi1, Erica Lee1, Kishwer S Nehal3. 1. Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York. 2. Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York; Department of Dermatology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile. 3. Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York. Electronic address: nehalk@mskcc.org.
Abstract
BACKGROUND: Initial biopsy of basal cell carcinoma (BCC) may fail to show aggressive histologic subtypes. Additionality, the clinical evaluation of BCC before surgery can miss subclinical extension. Reflectance confocal microscopy (RCM) and optical coherence tomography (OCT) are emerging tools that can help in the presurgical evaluation of BCCs. OBJECTIVE: To assess the feasibility of a combined RCM-OCT imaging modality for presurgical evaluation of biopsy-proven BCCs for residual tumor, margin status, and depth. METHODS: Thirty-eight BCCs in 35 patients referred to a tertiary cancer center for Mohs micrographic surgery (MMS) were imaged with combined RCM-OCT. Images were correlated to MMS frozen sections. RESULTS: Thirty-eight BCCs were analyzed. The mean age of patients was 67.34 years (range, 36-84 years), and 20 patients were female (57.14%). Twenty four BCCs were located on the head (63.16%) , and the mean size was 8.58 mm (range, 3-30 mm). RCM-OCT showed an overall agreement of 91.1% with MMS frozen sections. A sensitivity of 82.6% (95% confidence interval [CI], 69%-92%), specificity of 93.8% (95% CI, 88%-97%), and receiver operating characteristic curve of 0.88 (95% CI, 0.82-0.94) was found. OCT depth was highly correlated with MMS depth (r2 = 0.9). LIMITATIONS: Small sample size and difficulty evaluating certain challenging anatomic sites. CONCLUSIONS: Combined RCM-OCT may emerge as a useful tool for presurgical evaluation of BCCs.
BACKGROUND: Initial biopsy of basal cell carcinoma (BCC) may fail to show aggressive histologic subtypes. Additionality, the clinical evaluation of BCC before surgery can miss subclinical extension. Reflectance confocal microscopy (RCM) and optical coherence tomography (OCT) are emerging tools that can help in the presurgical evaluation of BCCs. OBJECTIVE: To assess the feasibility of a combined RCM-OCT imaging modality for presurgical evaluation of biopsy-proven BCCs for residual tumor, margin status, and depth. METHODS: Thirty-eight BCCs in 35 patients referred to a tertiary cancer center for Mohs micrographic surgery (MMS) were imaged with combined RCM-OCT. Images were correlated to MMS frozen sections. RESULTS: Thirty-eight BCCs were analyzed. The mean age of patients was 67.34 years (range, 36-84 years), and 20 patients were female (57.14%). Twenty four BCCs were located on the head (63.16%) , and the mean size was 8.58 mm (range, 3-30 mm). RCM-OCT showed an overall agreement of 91.1% with MMS frozen sections. A sensitivity of 82.6% (95% confidence interval [CI], 69%-92%), specificity of 93.8% (95% CI, 88%-97%), and receiver operating characteristic curve of 0.88 (95% CI, 0.82-0.94) was found. OCT depth was highly correlated with MMS depth (r2 = 0.9). LIMITATIONS: Small sample size and difficulty evaluating certain challenging anatomic sites. CONCLUSIONS: Combined RCM-OCT may emerge as a useful tool for presurgical evaluation of BCCs.
Authors: Sarah E Sasor; Naveed N Nosrati; Terrence Katona; William A Wooden; Adam Cohen; Imtiaz A Munshi; Sunil S Tholpady Journal: JAMA Surg Date: 2016-03 Impact factor: 14.766
Authors: Cristian Navarrete-Dechent; Miguel Cordova; Saud Aleissa; Konstantinos Liopyris; Stephen W Dusza; William Phillips; Anthony M Rossi; Erica H Lee; Ashfaq A Marghoob; Kishwer S Nehal Journal: J Am Acad Dermatol Date: 2019-06-19 Impact factor: 11.527
Authors: D J Kadouch; M E Schram; M M Leeflang; J Limpens; P I Spuls; M A de Rie Journal: J Eur Acad Dermatol Venereol Date: 2015-08-19 Impact factor: 6.166
Authors: Oriol Yélamos; Miguel Cordova; Nina Blank; Kivanc Kose; Stephen W Dusza; Erica Lee; Milind Rajadhyaksha; Kishwer S Nehal; Anthony M Rossi Journal: JAMA Dermatol Date: 2017-12-01 Impact factor: 10.282
Authors: Cristian Navarrete-Dechent; Saud Aleissa; Miguel Cordova; Konstantinos Liopyris; Aditi Sahu; Anthony M Rossi; Erica H Lee; Kishwer S Nehal Journal: Arch Dermatol Res Date: 2020-02-04 Impact factor: 3.017
Authors: Peter R Jermain; Tyler W Iorizzo; Mary Maloney; Bassel Mahmoud; Anna N Yaroslavsky Journal: Cancers (Basel) Date: 2022-08-22 Impact factor: 6.575