Optical coherence tomography in the diagnosis of basal cell carcinoma

Since its introduction in dermatology in the late 1990s optical coherence tomography (OCT) has been used to study many skin diseases, in particular non-melanoma skin cancer and it s precursors. Special attention has been paid to superficial basal cell carcinoma (BCC), and a number of smaller observational studies have been published. The diagnostic criteria for BCC of these studies are systematically reviewed. A systemic review of English language studies was performed using PubMed, Google Scholar and Royal Danish Library, to search for primary papers on OCT and BCC. The references of retrieved papers were searched by hand for further relevant papers. A total of 39 papers were identified (search date: 2014-01-15). 22 were excluded because they did not meet the inclusion criteria, leaving 17 papers for analysis. In 100% of the studies, rounded dark structures in the upper dermis surrounded by a hyperreflective halo possibly surrounded by a hyporeflective border and disruption of epidermal layering were described. In 53% of the reports a hyporeflective lateral tumour border was described. A range of other features were mentioned in a minority of the studies. It is suggested that these diagnostic criteria could be characteristic for identifying BCC lesions using OCT.