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Line-Field Confocal Optical Coherence Tomography: Is One Hour of Training Sufficient for Diagnosing Basal Cell
Elisa Cinotti1, Martina D'Onghia1, Alessandra Cartocci1
1Dermatology Unit, Department of Medical, Surgical and Neurological Sciences, University of Siena, 53100 Siena, Italy.
Cancers
|March 13, 2025
Summary
A brief training session significantly improved dermatology residents' ability to diagnose basal cell carcinoma (BCC) using line-field confocal optical coherence tomography (LC-OCT). This noninvasive technique shows promise for enhancing BCC detection, especially for less experienced clinicians.
Area of Science:
- Dermatology
- Medical Imaging
- Oncology
Background:
- Basal cell carcinoma (BCC) is the most common skin cancer, presenting diagnostic challenges.
- Accurate BCC diagnosis is crucial to prevent local invasiveness and tissue destruction.
- Line-field confocal optical coherence tomography (LC-OCT) offers noninvasive, in vivo cellular resolution imaging.
Purpose of the Study:
- To assess the impact of a 1-hour structured training on dermatology residents' BCC diagnostic accuracy using LC-OCT.
- To evaluate the effectiveness of LC-OCT training for both inexperienced and low-experience residents.
- To determine if incorporating dermoscopic images further enhances diagnostic performance.
Main Methods:
- Eight dermatology residents (varying LC-OCT experience) evaluated 40 histopathologically confirmed lesions (20 BCC, 20 non-BCC).
- Lesion evaluations were conducted before and after a 1-hour LC-OCT training session.
- Performance was assessed with and without the addition of dermoscopic images, compared to an expert dermatologist benchmark.
Main Results:
- Diagnostic accuracy significantly improved post-training, with a 20% reduction in false negatives and 35% in false positives.
- Inexperienced readers' overall diagnostic rate increased from 48% to 76% after training.
- Including dermoscopic images further boosted accuracy to 81% for inexperienced readers.
Conclusions:
- Short, targeted LC-OCT training effectively enhances diagnostic capabilities for BCC detection.
- LC-OCT shows significant potential for improving BCC diagnosis, particularly for less experienced dermatologists.
- The study supports broader clinical adoption of LC-OCT to improve early and accurate BCC detection.
