Imaging of Mohs micrographic surgery sections using full-field optical coherence tomography: a pilot study

Area of Science:

• Dermatology
• Medical Imaging
• Oncology

Background:

• Full-field optical coherence tomography (FF-OCT) is an advanced noninvasive imaging technology.
• FF-OCT provides cellular-level visualization without requiring tissue preparation or contrast agents.

Purpose of the Study:

• To evaluate FF-OCT for imaging Mohs micrographic surgery specimens.
• To assess a dermatopathologist's ability to detect or rule out malignancy using FF-OCT images.

Main Methods:

• Eighteen Mohs sections from 11 patients were scanned using FF-OCT.
• A dermatopathologist, blinded to the diagnosis, interpreted FF-OCT images for malignancy.
• FF-OCT findings were compared with intraoperative hematoxylin and eosin (H&E)-stained frozen sections.

Main Results:

• FF-OCT correctly identified 9 specimens as negative for malignancy, consistent with H&E results.
• Six of the remaining FF-OCT images were accurately interpreted as positive for malignancy.
• Three cases were deferred due to inconclusive FF-OCT findings regarding malignancy.

Conclusions:

• FF-OCT is capable of correctly identifying or excluding malignancy in Mohs surgical specimens.
• While not yet clinically ready, FF-OCT holds promise for future use in Mohs surgery workflows.