Noninvasive imaging to improve diagnostic accuracy: A case report
Abstract
Optical coherence tomography (OCT) is a noninvasive imaging modality that enables acquisition of 2-dimensional cross-sectional in vivo images of the skin.1 The images are created by the backscatter of light and provide the reader with a real-time view of the anatomic microstructure of the skin.2, 3 Although it lacks cell-level resolution, OCT permits visualization of the architecture of the stratum corneum, epidermis, and papillary dermis, as well as the skin's vasculature. This, in turn, has provided a convenient in vivo means to evaluate both inflammatory cutaneous conditions and neoplasms of the skin.4
Basal cell carcinoma (BCC) is particularly amenable to OCT visualization, and OCT is, in fact, being used to assist in the diagnosis and management of this skin cancer.5, 6 At the time of publication, histology and more recently reflectance confocal microscopy (RCM) are considered gold standard for BCC diagnosis, and both have Current Procedural Terminology Category 1 code options. OCT currently has a category 3 code, which is used to track the utilization of emerging technology, and the device has demonstrated a sensitivity of 87% and a specificity of 80% for diagnosing BCC.7 In addition, OCT can assist in determining the extent and depth of BCC tumors.
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