Functional optical coherence tomography of pigmented lesions

Background Cutaneous melanomas are diagnosed worldwide in 231 130 patients per year. The sensitivity and specificity of melanoma diagnosis expresses the need for an additional diagnostic method. Optical coherence tomography (OCT) has shown that it allows morphological (qualitative) description of image features and quantitative analysis of pathology related light scattering by means of the attenuation coefficient (μ_oct). Objective We hypothesize that OCT images of nevi will differ qualitatively and quantitatively from melanomas. Methods Forty lesions from 33 consecutive patients were imaged with OCT. After data acquisition, excision was performed. Epidermal layer thickness was measured and values of μ_oct were extracted from 200 OCT images of pigmented lesions. Results Morphologically, absence of the lower border of the lesion was characteristic for melanoma (P = 0.02). Also, the μ_oct was different between benign and malignant lesions (P = 0.02). There were no differences in epidermal layer thickness of benign lesions and melanoma. Conclusion Although this preliminary study comprised a small number of patients, quantitative analysis of OCT images in pigmented skin lesions give valuable additional information about lesions characteristics. When using the attenuation coefficient, it might be possible to distinguish between benign lesions and melanomas.