Comparison of Noninvasive Methods for Diagnosing Basal Cell Carcinoma: A Network Meta-Analysis

Area of Science:

• Dermatology
• Oncology
• Medical Imaging

Background:

• Basal cell carcinoma (BCC) is the most prevalent skin cancer in the elderly globally.
• This study focuses on evaluating diagnostic methods for BCC.

Purpose of the Study:

• To compare the diagnostic effectiveness of dermatoscopy (DE), high-frequency ultrasound (HFU), optical coherence tomography (OCT), reflectance confocal microscopy (RCM), and histopathological examination (HPE).
• To conduct a network meta-analysis of diagnostic methods for BCC.

Main Methods:

• A systematic literature search across seven databases.
• Network meta-analysis synthesizing direct and indirect evidence.
• Assessment of sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy.
• Calculation of odds ratios (ORs) and surface under the cumulative ranking curve (SUCRA) values.

Main Results:

• Dermoscopy combined with optical coherence tomography (DE-OCT) demonstrated high sensitivity (88.8%), specificity (70.7%), and NPV (84.2%), with the highest SUCRA.
• Dermoscopy combined with high-frequency ultrasound (DE-HFU) showed the highest accuracy (90.1%) and PPV (73.8%).
• Optical coherence tomography (OCT) and reflectance confocal microscopy (RCM) had similar sensitivity and accuracy.

Conclusions:

• DE-OCT and DE-HFU are the most effective methods for BCC diagnosis.
• Further validation in larger studies is recommended.
• This analysis provides initial guidance for selecting clinical diagnostic tools for BCC.