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SUMMARY
Optical coherence tomography (OCT) is a novel imaging technology that provides real-time, in vivo, noninvasive imaging of the skin with a micrometer resolution.
The field of OCT has rapidly evolved over the past 15 years with the emergence of newer modalities of OCT that offer notable improvements in resolution and functional capacity over earlier counterparts.
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DON’T FORGET
Compared with other imaging technologies, OCT may offer an optimal balance between imaging resolution and penetration depth for various applications in the diagnosis and management of skin cancer.
OCT has been most widely studied for nonmelanoma skin cancer, where it has been shown to be more accurate than clinical examination and dermoscopy in diagnosing basal cell carcinoma while also reducing unnecessary biopsies.
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CLINICAL PEARLS
Several morphologic criteria have been established in OCT for basal cell carcinoma, actinic keratosis, and squamous cell carcinoma, with a strong correlation to histopathology.
OCT has also proven to be valuable for delineating tumor borders prior to surgery, assessing tumor thickness, and monitoring responses to nonsurgical therapy for nonmelanoma skin cancer.
The potential role of OCT for diagnosing melanoma is less established; however, newer methods of OCT have enabled visualization of cellular and morphologic features that may differentiate melanoma from benign nevi, holding promising diagnostic value for the near future.
The limitations of OCT include the cost of the devices and the requirement of training to interpret images.
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PATIENT EDUCATION POINTS
OCT is an office-based imaging technology that allows visualization of the superficial layers of the skin.
OCT may be used for the diagnosis and management of skin cancer and precancer.
Although OCT has proven to be valuable for this role in dermatology, a skin biopsy is still needed for a definitive diagnosis of skin cancer.
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Optical coherence tomography (OCT) is a noninvasive imaging modality that provides real-time, in vivo imaging of the superficial layers of the skin and other biologic tissues at micrometer resolutions. This novel technology was first introduced in the late 1980s for imaging of the eye, after which its use became widely adopted in ophthalmology.1-4 In the years since, advances in OCT technology have led to its emergence as a promising and valuable tool in several other medical specialties.5-8 In dermatology, OCT has become increasingly utilized for the evaluation and diagnosis of nonmelanoma skin cancer (NMSC).9-16 It has been shown to increase the diagnostic accuracy of a basal cell carcinoma (BCC) diagnosis compared with clinical examination and dermoscopy alone while also reducing unnecessary skin biopsies.17,18 In addition, OCT has shown promise for the delineation of tumor borders in surgical planning, assessment of tumor thickness, and treatment monitoring for NMSC.19-23 With advancements in image analysis and image processing algorithms in recent years, OCT has further expanded its capacity for high-quality imaging, enabling improved visualization of pathologic features in biologic tissues.24-34...