PhD Scientific Days 2024

Pathological and Oncological Sciences II.

Emerging Imaging Modalities for Basal Cell Carcinoma Margin Assessment: A Systematic Scoping Review

Text of the abstract

Introduction: Mohs micrographic surgery (MMS) is a precise technique utilized for the removal of basal cell carcinomas (BCCs) subsequent to clinical evaluation, with margins immediately confirmed via frozen section histopathology. Renowned for its unparalleled margin assessment accuracy and superior cure rates compared to existing treatment modalities, MMS ensures meticulous eradication of BCCs. Emerging noninvasive imaging modalities such as dermoscopy, high-frequency ultrasound (HFUS), optical coherence tomography (OCT), line-field optical coherence tomography (LC-OCT), and reflectance confocal microscopy (RCM) present potential alternatives to conventional clinical assessment in delineating presurgical margins.

Aims: This systematic scoping review aims to evaluate the current understanding regarding the efficacy of these innovative imaging techniques in identifying BCC margins, with a specific focus on modalities sanctioned for clinical application by either the United States Food and Drug Administration (FDA) or the European Medicines Agency (EMA).

Method: A systematic search encompassing EMBASE, Scopus, PubMed, and the Cochrane Public Library databases was conducted.

Result: The systematic search strategy yielded 2123 records, culminating in the identification of 11 pertinent studies comprising 644 lesions across five imaging modalities.

Conclusion: The reviewed imaging techniques, including dermoscopy, HFUS, OCT, LC-OCT, and RCM, exhibit promise in discerning BCC margins, potentially optimizing the workflow of MMS. Moreover, these modalities offer insights into anticipated defect dimensions and reconstructive requirements, thereby potentially mitigating procedural expenses. A comprehensive analysis of the advantages and limitations of these techniques is provided to facilitate dermatologists' comprehension of their potential impact on BCC management.

Funding: This research was funded by Semmelweis Excellence 250+ Scholarship (M.B.), ÚNKP-23-4-II-SE-8 (N.K.), New National Excellence Program of the Ministry for Innovation and Technology and Roswell Park Alliance Foundation.