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      Optical coherence tomography-based optimization of mohs micrographic surgery of Basal cell carcinoma: a pilot study.

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          Abstract

          Optical coherence tomography (OCT) is a noninvasive imaging technique that uses a low-power infrared laser to image up to 2 mm beneath the skin's surface.

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          Most cited references19

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          Guidelines for the management of basal cell carcinoma.

          This article represents a planned regular updating of the previous British Association of Dermatologists guidelines for the management of basal cell carcinoma. These guidelines present evidence-based guidance for treatment, with identification of the strength of evidence available at the time of preparation of the guidelines, and a brief overview of epidemiological aspects, diagnosis and investigation.
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            Optical coherence tomography: a review of clinical development from bench to bedside.

            Since its introduction, optical coherence tomography (OCT) technology has advanced from the laboratory bench to the clinic and back again. Arising from the fields of low coherence interferometry and optical time- and frequency-domain reflectometry, OCT was initially demonstrated for retinal imaging and followed a unique path to commercialization for clinical use. Concurrently, significant technological advances were brought about from within the research community, including improved laser sources, beam delivery instruments, and detection schemes. While many of these technologies improved retinal imaging, they also allowed for the application of OCT to many new clinical areas. As a result, OCT has been clinically demonstrated in a diverse set of medical and surgical specialties, including gastroenterology, dermatology, cardiology, and oncology, among others. The lessons learned in the clinic are currently spurring a new set of advances in the laboratory that will again expand the clinical use of OCT by adding molecular sensitivity, improving image quality, and increasing acquisition speeds. This continuous cycle of laboratory development and clinical application has allowed the OCT technology to grow at a rapid rate and represents a unique model for the translation of biomedical optics to the patient bedside. This work presents a brief history of OCT development, reviews current clinical applications, discusses some clinical translation challenges, and reviews laboratory developments poised for future clinical application.
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              Characterization of benign and malignant melanocytic skin lesions using optical coherence tomography in vivo.

              Although optical coherence tomography (OCT) is a promising noninvasive imaging technique for the micromorphology of the skin, OCT has not been studied systematically in skin cancer such as malignant melanoma (MM). We sought to visualize and characterize melanocytic skin lesions (MSL) by using OCT in vivo, compare OCT features of benign nevi (BN) and MM, and histologically validate the OCT findings. In all, 75 patients with 92 MSL, including 52 BN and 40 MM, were included in this study. MSL were investigated by OCT in vivo and consecutive histology. We compared the OCT images with the corresponding histologic slices of BN and MM. To ascertain accuracy of correlation between OCT images and histologic sections, the excised lesions were tattooed according to the level of OCT scanning. For every MSL, serial histologic slices were prepared. MM often showed a marked architectural disarray (P = .036) and rarely displayed a clear dermoepidermal border (P = .0031) when compared with BN. OCT of MM infrequently demonstrated a dermoepidermal junction zone with finger-shaped elongated rete ridges as typically seen in BN (P = .011). Compared with BN, the papillary and superficial reticular dermis in MM frequently displayed a more diffuse or patchy reflectivity with loss of the typical bright horizontal linear structures (P = .022). However, more or less large vertical, icicle-shaped structures were the most striking OCT feature of MM, which were not observed in BN (P < .001). The diagnostic performance of OCT in the diagnosis of MSL could not be fully determined. Sensitivity and specificity studies also including other skin tumors have not been performed. In this study, distinct OCT features of MSL could be correlated to histopathologic findings. With regard to the micromorphologic features visualized by OCT, we detected significant differences between BN and MM. These OCT features might serve as useful discriminating parameters of MSL.
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                Author and article information

                Journal
                Dermatol Surg
                Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.]
                Wiley
                1524-4725
                1076-0512
                Apr 2013
                : 39
                : 4
                Affiliations
                [1 ] Long Island Skin Cancer and Dermatologic Surgery, Smithtown, New York; Michelson Diagnostics Ltd, Kent, UK.
                Article
                10.1111/dsu.12093
                23293854
                470f2f9e-6fa3-4296-8ba6-2129cf23ee2d
                History

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