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Optical coherence tomography for diagnosing recurrent or residual basal cell carcinoma after topical treatment: A diagnostic cohort study - 16/09/23

Doi : 10.1016/j.jaad.2023.06.033 
Tom Wolswijk, MD, MSc a, b, , Fieke Adan, MD, PhD a, b, Patricia Joan Nelemans, MD, PhD c, Aniek Defauwes, MD d, Klara Mosterd, MD, PhD a, b
a Department of Dermatology, Maastricht University Medical Center, Maastricht, the Netherlands 
b GROW Research Institute for Oncology and Reproduction, Maastricht University, Maastricht, the Netherlands 
c Department of Epidemiology, Maastricht University, Maastricht, the Netherlands 
d Maastricht University, Faculty of Health Medicine and Life Sciences, Maastricht, the Netherlands 

Correspondence to: Tom Wolswijk, MD, MSc, Department of Dermatology, Maastricht University Medical Center, P. Debyelaan 25, P.O. Box 5800, 6202 AZ Maastricht, the Netherlands.Department of DermatologyMaastricht University Medical CenterP. Debyelaan 25P.O. Box 5800Maastricht6202 AZthe Netherlands

Abstract

Background

Recurrent/residual basal cell carcinoma (BCC) after topical treatment may not be visible during clinical and dermatoscopic examination (CDE). Optical coherence tomography (OCT) may detect these subclinical recurrences or residues.

Objective

To compare the diagnostic accuracy of CDE with that of CDE combined with OCT (CDE-OCT) for detecting recurrent/residual BCC after topical treatment of superficial BCC.

Methods

In this diagnostic cohort study, the suspicion level for recurrence or residue was recorded on a 5-point confidence scale. All patients with high suspicion of recurrence or residue based on CDE and/or CDE-OCT were referred for punch biopsy. Patients with a low suspicion on CDE and CDE-OCT were asked to (voluntarily) undergo a control biopsy. Histopathologic results of the biopsy were used for verification of CDE and CDE-OCT diagnoses (gold standard).

Results

This study included 100 patients. A histopathologic recurrent/residual BCC was found in 20 patients. For recurrence or residue detection, sensitivity was 100% (20 of 20) for CDE-OCT and 60% (12 of 20) for CDE (P = .005) and specificity was 95% for CDE-OCT and 96.3% for CDE (P = .317). The area under the curve for CDE-OCT (0.98) was significantly higher than that for CDE (0.77) (P = .001).

Limitations

Results are based on 2 OCT assessors.

Conclusion

Compared with CDE alone, CDE-OCT results in a significantly higher ability to detect recurrent/residual BCCs after topical treatment.

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Key words : basal cell carcinoma, follow-up, imaging, optical coherence tomography, recurrence, residue, topical treatment

Abbreviations used : AUC, BCC, CDE, NPV, OCT, sBCC


Mappa


 Funding sources: None.
 IRB approval status: Reviewed and approved (Medisch-ethische toetsingscommissie azM/UM: NL74245.068.20/METC20-046).


© 2023  American Academy of Dermatology, Inc.. Pubblicato da Elsevier Masson SAS. Tutti i diritti riservati.
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Vol 89 - N° 4

P. 728-733 - ottobre 2023 Ritorno al numero
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