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Basal Cell Carcinoma (BCC)

VivoSight is a valuable research tool in the visualization of BCC and monitoring of treatment effects

In vivo differentiation of common basal cell carcinoma subtypes by microvascular and structural imaging using dynamic optical coherence tomography. Experimental Dermatology. 2018 Feb;27(2):156-65. Themstrup - Roskilde Hospital
VivoSight OCT Dx Image of Basal Cell Carcinoma.
Structural, cross-sectional OCT image (image size: 6 mm x 2 mm; imaging depth: 800 μm) of the nBCC lesion. The white asterisks mark hyporeflective ovoid structures corresponding to tumour nests; thin arrows mark dark peripheral borders at the margin of a hyporeflective ovoid structure; the thick white arrows mark the dermoepidermal junction; the black asterisk marks focal thinning of epidermis; the thick black arrow marks a hair casting a shadow. Image courtesy of Themstrup [4]

Dermatoscope and VivoSight Dx images of nodular BCC

  • Nodular BCC on the back shows sharply outlined ovoid hyporeflective structure (thin white arrows) with a bright surrounding stroma and a thinner epidermis above the lesion (thick white arrow).
  • Serpiginous vessels in branching shape forming an outlined figure can be seen in D-OCT en-face view. Images courtesy of Welzel, Schuh [1]
Dermatoscope and VivoSight Dx images of nodular BCC

VivoSight can aid in the identification of suspicious lesions

Evaluation of optical coherence tomography as a means of identifying earlier stage basal cell carcinomas while reducing the use of diagnostic biopsy. The Journal of clinical and aesthetic dermatology. 2015 Oct;8(10):14. Dr Orit Markowitz - Mount Sinai Hospital
Comparison of Diagnostic Performance between clinical assessment demoscapy and VivoSight OCT for diagnosis of basal cell carcinoma
Sensitivity, specificity, positive predictive value and negative predictive value for three examination techniques [3] Note: OCT is not a substitute for biopsy. Individual results vary and depend on user experience

VivoSight Monitoring and Measurement of BCC Treatment Effect

Topical Treatment

VivoSight Dx OCT image of a BCC treated with Imiquimod at baseline
Before imiquimod therapy (visit 1)
VivoSight Dx OCT image of a BCC treated with Imiquimod at 1 week of treatment
Same patient at 1 week with imiquimod therapy (visit 2)
VivoSight Dx OCT image of a BCC treated with Imiquimod at 1 month of treatment
Patient treated 1 month with imiquimod (visit 3)
VivoSight Dx OCT image of a BCC treated with Imiquimod at 4 weeks after treatment ended
Patient 4 weeks after ended imiquimod therapy (visit 4). Epidermoid cysts (confirmed histopathologically), represented by the hyperreflective ovoid structures with hyporeflective cores have replaced the BCCislands

Lazer Treatment

VivoSight scans of BCC before and after laser treatment, showing a marked reduction in vascular supply to the tumor.

  • Top: structural views of BCC before (left) and immediately after (right) laser treatment
  • Bottom: en-face views at 150 micrometers depth of BCC before (left) and immediately after (right) Nd:YAG laser treatment

VivoSight quantifies changes in the superficial vascular plexus and VivoTools calculates vessel density by depth. Images courtesy of Ahluwalia, Ortiz [5].

VivoSight scans of BCC before and after laser treatment, showing a marked reduction in vascular supply to the tumor.

Photodynamic Therapy

Monitoring of PhotoDynamic Therapy (PDT) treatment of Basal Cell Carcinoma

  • Measure the effects of treatment on number, appearance, depth, thickness and lateral extent of lesions
  • Final outcome three month after second treatment
VivoSight Dx OCT Images of a Basal Cell Carcinoma undergoing treatment with PDT (Photodynamic therapy). Pretreatment image shows nodular BCC with cystic core. Measure the effects of treatment on number, appearance, depth, thickness and lateral extent of lesions OCT monitoring of PhotoDynamic Therapy (PDT): clearance three months after second treatment
References:

1. Schuh S., Welzel J. (2020) OCT-Guided Laser Treatment and Surgery. In: Bard R. (eds) Image Guided Dermatologic Treatments. Springer, Cham

2. Ulrich M, Braunmuehl T, Kurzen H, Dirschka T, Kellner C, Sattler EC, Berking C, Welzel J, Reinhold U. The sensitivity and specificity of optical coherence tomography for the assisted diagnosis of nonpigmented basal cell carcinoma: an observational study. Br J Dermatol. 2015;173(2):428–35.

3. Markowitz O, Schwartz M, Feldman E, Bienenfeld A, Bieber AK, Ellis J, Alapati U, Lebwohl MG, Siegel DM. Evaluation of optical coherence tomography as a means of identifying earlier stage basal cell carcinomas while reducing the use of diagnostic biopsy. J Clin Aesthet Dermatol. 2015;8(10):14–20.

4. Themstrup L, De Carvalho N, Nielsen SM, Olsen J, Ciardo S, Schuh S, Nørnberg BM, Welzel J, Ulrich M, Pellacani G, Jemec GBE. In vivo differentiation of common basal cell carcinoma subtypes by microvascular and structural imaging using dynamic optical coherence tomography. Exp Dermatol. 2018;27(2):156–65.

5. Ahluwalia J, Avram MM, Ortiz AE. Outcomes of Long-Pulsed 1064 nm Nd:YAG Laser Treatment of Basal Cell Carcinoma: A Retrospective Review. Lasers Surg Med. 2019 Jan;51(1):34-39

6. Ahluwalia J, Avram MM, Ortiz AE. The Evolving Story of Laser Therapeutics for Basal Cell Carcinoma. Dermatol Surg. 2020 Feb 11

7. Markowitz O, Psomadakis CE. Patient-driven management using same-day noninvasive diagnosis and complete laser treatment of basal cell carcinomas: a pilot study. Cutis. 2019 Dec;104(6):345-348;350;351

8. Markowitz O, Tongdee E, Levine A. Optimal cosmetic outcomes for basal cell carcinoma: a retrospective study of nonablative laser management. Cutis. 2019 May;103(5):292-297;E1;E2;E3.

9. C. A. Banzhaf, L. Themstrup, H. C. Ring, M. Mogensen and G. B. E. Jemec. Optical coherence tomography imaging of non-melanoma skin cancer undergoing imiquimod therapy. Skin Research and Technology 2013; 0: 1–7

Applications

Explore the research and clinical applications for VivoSight

Advance Your Research and Development Programs

VivoSight Dx in combination with VivoTools image analysis software visualizes and quantifies treatment effects.

See the Whole Picture to Improve Outcomes

VivoSight Dx produces high resolution imaging of skin sub-structures and vascular networks to aid in patient care