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Does Adding Optical Coherence Tomography Increase Detection of Recurrent, Residual BCC?

Area under curve 0.98 for clinical and dermatoscopic examination combined with OCT and 0.77 for clinical and dermatoscopic examination alone

By Dermsquared Editorial Team | September 27, 2023

WEDNESDAY, Sept. 27, 2023 -- Clinical and dermatoscopic examination combined with optical coherence tomography (CDE-OCT) has higher ability to detect recurrent/residual basal cell carcinoma (BCC) than CDE alone after topical treatment, according to a study published in the October issue of the Journal of the American Academy of Dermatology.

Tom Wolswijk, M.D., from Maastricht University Medical Center in the Netherlands, and colleagues compared the diagnostic accuracy of CDE to that of CDE-OCT for detecting recurrent/residual BCC after topical treatment of superficial BCC in 100 patients. The suspicion level for recurrence or residue was recorded on a 5-point confidence scale. Patients with high suspicion were referred for punch biopsy, while those with low suspicion were asked to undergo a control biopsy. Verification of CDE and CDE-OCT diagnoses was based on histopathological results of the biopsy.

A histopathological recurrent/residual BCC was detected in 20 patients. The researchers found that sensitivity for recurrence or residue detection was 100 and 60 percent, respectively, for CDE-OCT and CDE, and specificity was 95 and 96.3 percent, respectively. The area under the curve was 0.98 and 0.77 for CDE-OCT and CDE, respectively.

"Use of CDE-OCT at the follow-up appointment after topical treatment may result in the detection of subclinical recurrences or residues," the authors write. "Early detection of recurrent or residual BCC may prevent tumor progression and may prevent additional follow-up appointments if no recurrence or residue is seen."


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