A novel imaging approach to periocular basal cell carcinoma: In vivo optical coherence tomography and histological correlates

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Optical coherence tomography (OCT) is a non-invasive imaging method widely used in ophthalmology. Recent developments have produced OCT devices for imaging the skin. The purpose of this study was to assess preoperative OCT of periocular basal cell carcinoma (BCC) and to correlate optical biopsies with histological features.


Consecutive patients with periocular BCC were prospectively investigated with VivoSight OCT (Michelson Ltd) prior to surgical excision. OCT images were correlated to haematoxylin and eosin stained histology sections with regard to: epidermal changes, intralesional and perilesional features.


A total of 15 patients with periocular BCC were recruited. Epidermal changes over BCC lesions represented important landmarks for topographic correlation and consisted in epidermal thinning and hyper-reflective signals from surface ulceration and crusting. Intralesional OCT features of BCC included: hyporeflective lobular patterns corresponding to BCC nests with high cellularity, hyporeflective cystic spaces of liquefactive necrosis and hyper-reflective margins corresponding to collagen compression. Perilesional OCT features of BCC included: hyporeflective spaces corresponding to fluid clefts, hyper-reflective bands of perilesional granulomatous inflammation secondary to tissue biopsy and hyporeflective lumens of blood vessels and hair follicles


This study demonstrated a high correlation between OCT images and histological features. Further studies are necessary to investigate novel potential applications of in vivo OCT for BCC such as non-invasive diagnosis, intraoperative OCT-guided tumour excision and postoperative detection of recurrences.

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