Morphological Evaluation of Facial Pigmented Lesions With Line-Field Confocal Optical Coherence Tomography: Correlation With Reflectance Confocal Microscopy. A Pilot Study
Keywords:
LC-OCT, pigmented lesions, optical coherence tomography, confocal microscopy, non-invasive imagingAbstract
Introduction: Facial pigmented lesions pose significant challenges for diagnosis and treatment planning due to their anatomical topography and complexity. Traditional methods like dermoscopy have limitations, and while reflectance confocal microscopy (RCM) offers in-vivo cellular resolution, it is hindered by shallow penetration. The recently developed line-field confocal optical coherence tomography (LC-OCT) combines the benefits of OCT and RCM, providing deeper penetration and three-dimensional cellular imaging.
Objectives: This study aims to assess the ability of LC-OCT in displaying morphological features correlated and compared with RCM and histopathological findings.
Methods: Over a period of 1 year, various pigmented facial lesions were selected, including solar lentigo, seborrheic keratosis, lichen planus-like keratosis, pigmented actinic keratosis, basal cell carcinoma, compound nevus, lentigo maligna, and invasive melanoma. LC-OCT and RCM were used for imaging, and their morphological features were compared. Lesions, except solar lentigo and compound nevus, were excised for histopathological evaluation. Morphological criteria from imaging were correlated with histopathological findings.
Results: LC-OCT matched RCM in spatial resolution while providing deeper tissue penetration and three-dimensional visualization. This advantage was particularly notable in pigmented actinic keratosis and basal cell carcinoma, where LC-OCT’s vertical imaging offered unique diagnostic insights. It also enhanced the understanding of the architecture of melanocytic lesions.
Conclusion: LC-OCT adds new insight into the imaging and diagnosis of facial pigmented lesions, offering additional morphological features. This pilot study highlights its potential to improve diagnostic accuracy and patient care, with further research needed to assess its broader clinical applications.
References
Goncharova Y, Attia EA, Souid K, Vasilenko IV. Dermoscopic features of facial pigmented skin lesions. ISRN Dermatol. 2013;2013:546813. DOI:10.1155/2013/546813. PMID: 23431466
Costa-Silva M, Calistru A, Barros AM, et al. Dermatoscopy of flat pigmented facial lesions-evolution of lentigo maligna diagnostic criteria. Dermatol Pract Concept. 2018;8(3):198-203. DOI:10.5826/dpc.0803a10. PMID: 30116664.
Wurm E, Pellacani G, Longo C, et al. The value of reflectance confocal microscopy in diagnosis of flat pigmented facial lesions: a prospective study. J Eur Acad Dermatol Venereol. 2017;31(8):1349-54. DOI:10.1111/jdv.14171. PMID: 28214381.
Shahriari N, Grant-Kels JM, Rabinovitz H, Oliviero M, Scope A. Reflectance confocal microscopy: Diagnostic criteria of common benign and malignant neoplasms, dermoscopic and histopathologic correlates of key confocal criteria, and diagnostic algorithms. J Am Acad Dermatol. 2021;84(1):17-31. DOI:10.1016/j.jaad.2020.05.154. PMID: 32565210.
Serban ED, Farnetani F, Pellacani G, Constantin MM. Role of In Vivo Reflectance Confocal Microscopy in the Analysis of Melanocytic Lesions. Acta Dermatovenerol Croat. 2018;26(1):64-7. PMID: 29782304.
Dubois A, Levecq O, Azimani H, et al. Line-field confocal optical coherence tomography for high-resolution noninvasive imaging of skin tumors. J Biomed Opt. 2018;23(10):1-9. DOI:10.1117/1.JBO.23.10.106007. PMID: 37278496.
Monnier J, Tognetti L, Miyamoto M, et al. In vivo characterization of healthy human skin with a novel, non-invasive imaging technique: line-field confocal optical coherence tomography. J Eur Acad Dermatol Venereol. 2020;34(12):2914-21. DOI:10.1111/jdv.16857. PMID: 32786124.
Ogien J, Daures A, Cazalas M, Perrot JL, Dubois A. Line-field confocal optical coherence tomography for three-dimensional skin imaging. Front Optoelectron. 2020;13(4):381-92. DOI:10.1007/s12200-020-1096-x. PMID: 36641566.
Ogien J, Levecq O, Azimani H, Dubois A. Dual-mode line-field confocal optical coherence tomography for ultrahigh-resolution vertical and horizontal section imaging of human skin in vivo. Biomed Opt Express. 2020;11(3):1327-35. DOI:10.1364/BOE.385303. PMID: 32206413.
Ogien J, Tavernier C, Fischman S, Dubois A. Line-field confocal optical coherence tomography (LC-OCT): principles and practical use. Ital J Dermatol Venerol. 2023;158(3):171-9. DOI:10.23736/S2784-8671.23.07613-2. PMID: 37278495.
Ruini C, Schuh S, Sattler E, Welzel J. Line-field confocal optical coherence tomography-Practical applications in dermatology and comparison with established imaging methods. Skin Res Technol. 2021;27(3):340-52. DOI:10.1111/srt.12949. PMID: 33085784.
Suppa M, Palmisano G, Tognetti L, et al. Line-field confocal optical coherence tomography in melanocytic and non-melanocytic skin tumors. Ital J Dermatol Venerol. 2023;158(3):180-9. DOI:10.23736/S2784-8671.23.07639-9. PMID: 37278496.
Suppa M, Fontaine M, Dejonckheere G, et al. Line-field confocal optical coherence tomography of basal cell carcinoma: a descriptive study. J Eur Acad Dermatol Venereol. 2021;35(5):1099-110. DOI:10.1111/jdv.17078. PMID: 33398911.
Cinotti E, Tognetti L, Cartocci A, et al. Line-field confocal optical coherence tomography for actinic keratosis and squamous cell carcinoma: a descriptive study. Clin Exp Dermatol. 2021;46(8):1530-41. DOI:10.1111/ced.14801. PMID: 34115900.
Perez-Anker J, Puig S, Alos L, et al. Morphological evaluation of melanocytic lesions with three-dimensional line-field confocal optical coherence tomography: correlation with histopathology and reflectance confocal microscopy. A pilot study. Clin Exp Dermatol. 2022;47(12):2222-33. DOI:10.1111/ced.15383. PMID: 35988042.
Lenoir C, Cinotti E, Tognetti L, et al. Line-field confocal optical coherence tomography of actinic keratosis: a case series. J Eur Acad Dermatol Venereol. 2021;35(12):e900-e2. DOI:10.1111/jdv.17548. PMID: 34310768.
Lenoir C, Perez-Anker J, Tognetti L, et al. Line-field confocal optical coherence tomography of seborrheic keratosis: A case series. J Eur Acad Dermatol Venereol. 2023. DOI:10.1111/jdv.19075. PMID: 36974591.
Lenoir C, Perez-Anker J, Diet G, et al. Line-field confocal optical coherence tomography of benign dermal melanocytic proliferations: a case series. J Eur Acad Dermatol Venereol. 2021;35(6):e399-e401. DOI:10.1111/jdv.17180. PMID: 33594684.
Soglia S, Perez-Anker J, Fraghi A, et al. Line-field confocal optical coherence tomography and reflectance confocal microscopy of Merkel cell carcinoma. J Eur Acad Dermatol Venereol. 2023. DOI:10.1111/jdv.19211. PMID: 37191203.
Farnetani F, Pedroni G, Lippolis N, et al. Facial seborrheic keratosis with unusual dermoscopic patterns can be differentiated from other skin malignancies by in vivo reflectance confocal microscopy. J Eur Acad Dermatol Venereol. 2021;35(11):e784-e7. DOI:10.1111/jdv.17470. PMID: 34161654.
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Copyright (c) 2025 Clément Lenoir, Mariano Suppa, Simone Soglia, Susana Puig, Linda Tognetti, Elisa Cinotti, Carmen Orte Cano, Gwendoline Diet, Pietro Rubegni, Jean-Luc Perrot, Veronique del Marmol, Josep Malvehy, Javiera Pérez-Anker
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