Diagnostic Accuracy of Line-Field Confocal Optical Coherence Tomography for the Diagnosis of Skin Carcinomas

January 21, 2023 | Dermatology | Université Libre de Bruxelles, University of Barcelona, University of Siena

Alessandra Cartocci, Elisa Cinotti, Javiera Perez-Anker, Jean-Luc Perrot, Josep Malvehy, Linda Tognetti, Mariano Suppa, Pietro Rubegni, Susanna Puig, Tullio Brunetti

Line-field confocal optical coherence tomography (LC-OCT) is a new, noninvasive imaging technique for the diagnosis of skin cancers. A total of 243 benign (54%) and malignant (46%) skin lesions were consecutively enrolled from 27 August 2020, to 6 October 2021 at the Dermatology Department of the University Hospital of Siena, Italy. Dermoscopic- and LC-OCT-based diagnoses were given by an expert dermatologist and compared with the ground truth. Considering all types of malignant skin tumours (79 basal cell carcinomas (BCCs), 22 squamous cell carcinomas, and 10 melanomas), a statistically significant increase (p = 0.013) in specificity was observed from dermoscopy (0.73, CI 0.64–0.81) to LC-OCT (0.87, CI 0.79–0.93) while sensitivity was the same with the two imaging techniques (0.95 CI 0.89–0.98 for dermoscopy and 0.95 CI 0.90–0.99 for LC-OCT). The increase in specificity was mainly driven by the ability of LC-OCT to differentiate BCCs from other diagnoses. In conclusion, our real-li...

Diagnostics Using Non-Invasive Technologies in Dermatological Oncology

December 11, 2022 | Dermatology

Javiera Perez-Anker, Josep Malvehy, Nelson Lobos Guede, Priscila Giavedoni, Simone Soglia, Susana Puig

The growing incidence of skin cancer, with its associated mortality and morbidity, has in recent years led to the developing of new non-invasive technologies, which allow an earlier and more accurate diagnosis. Some of these, such as digital photography, 2D and 3D total-body photography and dermoscopy are now widely used and others, such as reflectance confocal microscopy and optical coherence tomography, are limited to a few academic and referral skin cancer centers because of their cost or the long training period required. Health care professionals involved in the treatment of patients with skin cancer need to know the implications and benefits of new non-invasive technologies for dermatological oncology. In this article we review the characteristics and usability of the main diagnostic imaging methods available today. ( Read Full Article )

Morphologic evaluation of melanocytic lesions with three-dimensional line-field confocal optical coherence tomography: correlation with histopathology and reflectance confocal microscopy. A pilot study

August 21, 2022 | Dermatology

Adriana García, Beatriz Alejo, Carmen Orte Cano, Clément Lenoir, Elisa Cinotti, Javiera Perez-Anker, Jean L. Perrot, Jilliana Monnier, Josep Malvehy, Linda Tognetti, Llucia Alos, Mariano Suppa, Natalia Machuca, Paola Castillo, Pau Rosés Gibert, Pietro Rubegni, Susana Puig, Véronique Del Marmol

Background Line-field confocal optical coherence tomography (LC-OCT) is a new in vivo emerging technique which provides cellular resolution, imaging depth (400 μm) and produces real-time images in both the horizontal and vertical plane and in 3 dimensions (3D). No previous description of different subtypes of melanocytic lesions and their correlation with histopathology and reflectance confocal microscopy has been reported. Objectives We aimed to describe the features of melanocytic lesions by LC-OCT and their correlation with histopathology and reflectance confocal microscopy (RCM). Methods Selected melanocytic benign lesions and melanomas were imaged in vivo with RCM and LC-OCT at the Hospital Clinic of Barcelona. A minimum area of 4mm x 4mm (block image) at 4 depths (stratum granulosum, suprabasal, dermoepidermal-junction and upper dermis) were acquired with RCM and a minimum of 3 cubes with LC-OCT. Horizontal, vertical sections and 3D cubes of LC-OCT were matched with RCM Viv...

Non-invasive scoring of cellular atypia in keratinocyte cancers in 3D LC-OCT images using Deep Learning

January 13, 2022 | Dermatology

Angelo Di Naro, Arnaud Dubois, Elisa Cinotti, Javiera Perez-Anker, Jean-Luc Perrot, Jilliana Monnier, Josep Malvehy, Linda Tognetti, Mariano Suppa, Pietro Rubegni, Sébastien Fischman, Susana Puig, Théo Viel, Véronique Del Marmol

Diagnosis based on histopathology for skin cancer detection is today's gold standard and relies on the presence or absence of biomarkers and cellular atypia. However it suffers drawbacks: it requires a strong expertise and is time-consuming. Moreover the notion of atypia or dysplasia of the visible cells used for diagnosis is very subjective, with poor inter-rater agreement reported in the literature. Lastly, histology requires a biopsy which is an invasive procedure and only captures a small sample of the lesion, which is insufficient in the context of large fields of cancerization. Here we demonstrate that the notion of cellular atypia can be objectively defined and quantified with a non-invasive in-vivo approach in three dimensions (3D). A Deep Learning (DL) algorithm is trained to segment keratinocyte (KC) nuclei from Line-field Confocal Optical Coherence Tomography (LC-OCT) 3D images. Based on these segmentations, a series of quantitative, reproducible and biologically relevant...

Line-field confocal optical coherence tomography as a tool for three-dimensional in vivo quantification of healthy epidermis: a pilot study

October 8, 2021 | Dermatology

Antoine Sanchez, Arnaud Dubois, Carmen Orte Cano, Clément Lenoir, E. Cinotti, Gabriel Cazorla, J. L. Perrot, Javiera Perez-Anker, Jilliana Monnier, Joseph Malvehy, Julie Chauvel-Picard, Linda Tognetti, M. Suppa, Margot Fontaine, Mélanie Pedrazzani, Pietro Rubegni, Randa Jdid, Sandra Forestier, Sébastien Fischman, Susana Puig, Véronique Del Marmol, Vincent Bérot

Epidermal three-dimensional (3D) topography/quantification have not been completely characterized yet. The recently developed line-field confocal optical coherence tomography (LC-OCT) provides real-time, high-resolution, in-vivo 3D imaging of the skin. This pilot study aimed at quantifying epidermal metrics [epidermal thicknesses, dermal-epidermal junction (DEJ) undulation and keratinocyte number/shape/size] using 3D LC-OCT. For each study participant (8 female, skin-type-II, younger/older volunteers), seven body sites were imaged with LC-OCT. Epidermal metrics were calculated by segmentations and measurements assisted by artificial intelligence (AI) when appropriate. Thicknesses of epidermis/SC, DEJ undulation and keratinocyte nuclei volume varied across body sites. Evidence of keratinocyte maturation was observed in vivo: keratinocyte nuclei being small/spherical near the DEJ and flatter/elliptical near the skin surface. Skin microanatomy can be quantified by combining LC-OCT and ...

Line-field confocal optical coherence tomography: a case on the importance of full-lesion examination for basal cell carcinoma

October 2, 2021 | Dermatology

Elisa Cinotti, Guillaume Dejonckheere, Javiera Perez-Anker, Jean L. Perrot, Josep Malvehy, Ketty Peris, Linda Tognetti, Mariano Suppa, Nancy Hajjar, Pietro Rubegni, Simone Cappilli, Susana Puig, Véronique Del Marmol

Correspondence   ( Read Full Article )

Line-field confocal optical coherence tomography of actinic keratosis: a case series

July 27, 2021 | Dermatology

Anne-Laure Trépant, Carmen Orte Cano, Clément Lenoir, Elisa Cinotti, Gwendoline Diet, Javiera Perez-Anker, Jean-Luc Perrot, Josep Malvehy, Laureen Rocq, Linda Tognetti, Makiko Miyamoto, Mariano Suppa, Pietro Rubegni, Susana Puig, Véronique Del Marmol

Line-field confocal optical coherence tomography (LC-OCT) is a non-invasive imaging technique that was recently developed, combining high penetration depth (up to 500-µm, approaching that of conventional OCT) with high isotropic resolution [lateral: 1.3 µm; axial: 1.1 µm - similar to that of reflectance confocal microscopy (RCM)]. 1 . ( Read Full Article )

Line-field confocal optical coherence tomography of sebaceous hyperplasia: a case series

April 1, 2021 | Dermatology

Anne-Laure Trépant, Carmen Orte Cano, Clément Lenoir, Elisa Cinotti, Gwendoline Diet, Javiera Perez-Anker, Jean-Luc Perrot, Jilliana Monnier, Josep Malvehy, Laureen Rocq, Linda Tognetti, Mariano Suppa, Pietro Rubegni, Susana Puig, Véronique Del Marmol

Line-field confocal optical coherence tomography (LC-OCT) is a newly developed non-invasive imaging technique that combines high penetration depth (500 µm, similar to conventional OCT) with high isotropic resolution (lateral 1.3 µm, axial 1.1 µm, similar to reflectance confocal microscopy [RCM]). 1 Moreover, with its ability to produce images in both vertical and horizontal planes, it enables a tridimensional (3D) analysis of the skin, which can prove very useful for assessing physiological 2 as well as pathological skin. ( Read Full Article )