Histopathological correlates of basal cell carcinoma in the slice and en face imaging modes of high-definition optical coherence tomography

Background High-definition optical coherence tomography (HD-OCT) scanners have recently been developed, providing significantly higher resolution than conventional OCT. Objectives To assess the relationship between recently defined histopathological HD-OCT correlates of basal cell carcinomas (BCC) and possible predictors for the most common tumour subtypes. Methods For HD-OCT imaging, we used the Skintell (R) device. Twenty-five BCCs were histopathologically confirmed (including both vertical and horizontal haematoxylin and eosin and Alcian blue sectioning) and correlated with HD-OCT images. Results In the en face mode, lobulated nodules were seen in 21/25 BCCs (84%), peripheral rimming in 18/25 (72%), epidermal disarray in 18/25 (72%) and variably refractile stroma in 22/25 (88%). In the slice imaging mode, we observed destruction of layering in 19/25 (76%) BCCs. In both the slice and en face modes a significant correlation was observed between peritumoral rimming and grey/dark oval structures and lobulated nodules. Alcian blue stains showed peritumoral mucin deposits correlating with peripheral rimming around the tumour nodules. In a logistic regression model, we did not observe significant independent micromorphological HD-OCT predictors for either the solid or superficial BCC subtypes. Conclusions In agreement with recent studies we have demonstrated that HD-OCT using the slice and en face imaging modes can visualize histopathological correlates of BCC, and potentially aid noninvasive diagnostics. However, using HD-OCT correlation it was not possible to predict the superficial or solid BCC subtypes. For the first time we have shown that peripheral rimming in HD-OCT correlates with peritumoral mucin deposition.