Optical coherence tomography of basal cell carcinoma: density and signal attenuation

Background: Basal cell carcinoma (BCC) is the most prevalent malignancy in Caucasians. Optical coherence tomography (OCT) is a non-invasive optical imaging technology using the principle of interferometry. OCT has shown a great potential in diagnosing, monitoring, and follow-up of BCC. So far most OCT studies on the subject of BCC have had a qualitative focus, i.e. on morphological analysis of the OCT images. The aim of this study was to explore the use of quantitative OCT measurements, density, and attenuation coefficient in BCC lesions as a way to improve the OCT evaluation of BCC. Methods: The study was based on OCT images of 58 histologically verified BCC lesions and the corresponding normal adjacent skin. The study population was divided into two groups based on the OCT morphology of the BCC lesions: the “Disrupt BCC group” and the “Nodular BCC group”. Density and attenuation coefficients were measured in the OCT images by specially designed software and the regions of interests (ROI) were placed directly on (ROI1) and under the visible BCC lesions (ROI2). The results were compared to the OCT images of normal adjacent skin. Results: Disrupt BCC group: The densities of BCC lesions were significant lower (P = 0.002), than the normal skin in ROI1. Attenuation measurements were found to be significantly greater (P = 0.012) in BCC lesions compared to normal skin in ROI1. Nodular BCC group: Attenuation measurements were found to be significantly lower (P = 0.017) in BCC lesions compared to normal skin in ROI1. Conclusions: Our study suggests a quantitative potential of OCT in the context of BCC. This study is exploratory and requires independent verification.