A novel imaging technique may significantly improve the accuracy of the diagnosis of basal cell carcinoma (BCC) compared to clinical and dermoscopic examinations alone, according to new research presented at the 31st European Academy of Dermatology and Venereology (EADV) Congress.
The study found that using a new noninvasive skin imaging technology called line-field confocal optical coherence tomography (LC-OCT), which gives detailed three-dimensional images at cellular level, significantly increased diagnostic accuracy.
For the differentiation of BCC from BCC imitators (such as squamous cell carcinoma, actinic and seborrheic keratosis, dermal nevus, and inflammatory conditions), using LC-OCT significantly increased the diagnostic accuracy by 12% compared to dermoscopic examination alone (from 85% up to 97%).
Importantly, for the differentiation of superficial BCC (a subtype that can be treated ) from other BCC subtypes, using LC-OCT again increased the diagnostic accuracy by 12% compared to dermoscopic examination alone (from 80% to 92%).
The study also produced a diagnostic algorithm that may be useful in guiding diagnosis toward different BCC and BCC imitators’ subtypes. The algorithm is based on the most powerful LC-OCT morphological criteria the comprehensive statistical analysis.
Researchers from the Department of Dermatology at the Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium, analyzed 303 lesions, including 173 BCC and 130 BCC imitators.
“Our findings suggest that, when in front of a BCC equivocal lesion, LC-OCT enables a more accurate diagnosis and, therefore, should be included in the diagnostic process and management of BCC,” stated researcher Mariano Suppa, MD, PhD, a consultant dermatologist from Italy.
Dr. Suppa explained, “LC-OCT has the potential to reduce the number of unnecessary biopsies and excisions in cases of superficial BCC and also in the case of benign lesions that do not require surgery.”
“Diagnosing BCC can be challenging using clinical or dermoscopic assessments alone and it is crucial that the condition is correctly diagnosed in order to treat it properly. We found that the accuracy of diagnosis can be improved by at least 12% using LC-OCT, both in terms of differentiating BCCs from other skin conditions, and of identifying BCC subtypes that do not require surgery,” concluded Dr. Suppa.
