An observational study in Basal Cell Carcinoma and Optical Coherence Tomography, sponsored by Maastricht University Medical Center. Not yet recruiting. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2024-10-26.
Sponsored by Maastricht University Medical Center · Observational
The current gold standard for diagnosing basal cell carcinoma (BCC) is the histopathological examination of biopsy specimen. However, non-invasive imaging modalities such as optical coherence tomography (OCT) may replace biopsy if BCC presence and its subtype can be established with high confidence. Subtype differentiation is crucial; while superficial BCCs (sBCC) can be treated topically, nodular (nBCC) and infiltrative BCCs (iBCC) require excision. Dynamic OCT (D-OCT) is a functionality integrated within the OCT device, enabling the visualization of vascular structures through speckle variance.
Descriptive studies have unveiled vascular shapes and patterns associated with BCC and its respective subtypes. These findings suggest that D-OCT could contribute to the accuracy of BCC detection and subtyping. Yet comparative clinical studies between OCT and D-OCT are lacking. In the proposed diagnostic cohort study, we aim to assess whether D-OCT assessment is superior to OCT in terms of accuracy for BCC detection and subtyping.
364 studies on the registry are indexed under Carcinoma, Basal Cell; 66 are open to participants now.
This study's planned enrollment of 424 is above the median of 138 across 92 observational studies indexed under Carcinoma, Basal Cell.
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This diagnostic cohort study will include patients (18+ years) who underwent a biopsy and D-OCT scan for lesions suspect for BCC skin cancer. Patient data was retrieved from a pre-existing registry (METC: 2022-3555). All D-OCT scans were obtained at the outpatient dermatology clinic of Maastricht University Medical Center+ (MUMC+) using a Vivosight Multi-beam Swept-Source Frequency Domain OCT scanner (Michelson Diagnostics Maidstone, Kent, UK; resolution \<7.5 µm lateral, \<5 µm axial; depth of focus 1.0 mm; scan area 6 × 6 mm). All scanned lesions were histopathologically examined by a dermatopathologist blinded to D-OCT scans and D-OCT assessment.
Exclusion Criteria:
This diagnostic cohort study will include patients (18+ years) who underwent a biopsy and D-OCT scan for lesions suspect for BCC skin cancer. Patient data was retrieved from a pre-existing registry (METC: 2022-3555). All D-OCT scans were obtained at the outpatient dermatology clinic of Maastricht University Medical Center+ (MUMC+) using a Vivosight Multi-beam Swept-Source Frequency Domain OCT scanner (Michelson Diagnostics Maidstone, Kent, UK; resolution \<7.5 µm lateral, \<5 µm axial; depth of focus 1.0 mm; scan area 6 × 6 mm). All scanned lesions were histopathologically examined by a dermatopathologist blinded to D-OCT scans and D-OCT assessment.
Device: Vivosight Multi-beam Swept-Source Frequency Domain OCT scanner
Vivosight Multi-beam Swept-Source Frequency Domain OCT scanner (Michelson Diagnostics Maidstone, Kent, UK; resolution \<7.5 µm lateral, \<5 µm axial; depth of focus 1.0 mm; scan area 6 × 6 mm).
Diagnostic accuracy for BCC detection on D-OCT assessment
We will evaluate the ability of OCT assessors to discriminate BCC from non-BCC using OCT without and with dynamic functionality. The diagnostic certainty for BCC detection will be expressed on a five-point confidence scale. A high confidence score (confidence score=4) is considered a positive OCT test results. In these cases, biopsy could effectively be omitted. Lower confidence scores (confidence score≤3) are considered negative OCT test results as in these cases, biopsy remains necessary for a definitive or alternative diagnosis. The primary outcome of interest is the sensitivity of a high confidence BCC diagnosis because we want to evaluate whether the dynamic functionality increases the proportion of correctly classified BCCs.
Time frame: Measured before December 31st 2024
Diagnostic accuracy for BCC subtyping on D-OCT assessment
We will evaluate the ability of OCT assessors to discriminate each individual BCC subtype from the other two subtypes using OCT without and with dynamic functionality. Cases that resulted in a high confidence diagnosis (confidence score=4) will be included in the analyses. Three analyses will be performed to calculate the sensitivity to detect sBCC, nBCC or iBCC and the specificity to identify non-sBCC, non-nBCC or non-iBCC subtypes using histopathology as reference test. In this respect, sensitivity is defined as the proportion of a specific BCC subtype, that is correctly classified as such by the OCT assessor (i.e. sBCC, nBCC or iBCC), whereas specificity is defined as the proportion of the other two subtypes that is correctly classified as such (i.e sBCC/nBCC, sBCC/iBCC or nBCC/iBCC). The primary outcome of interest is the sensitivity. We want to evaluate whether the dynamic functionality increases the proportion of correctly classified subtypes .
Time frame: Measured before December 31st 2024
Diagnostic value of vascular structures and patterns
Diagnostic odds ratios (DORs ) are used to identify subsets of vascular features and patterns that can be used to accurately discriminate BCC subtypes. The histopathological subtype (i.e. sBCC, nBCC, iBCC ) vs. other subtypes (i.e sBCC/nBCC, sBCC/iBCC, nBCC/iBCC) will be used as the dependent variable. A DOR \>1 indicates that the presence of a vascular feature or pattern is indicative for the presence of the respective BCC subtype.
Time frame: Measured before December 31st 2024
No study locations are listed for this record.
Plan to share: Undecided — IPD may be shared with other researchers upon reasonable request. Requests will be evaluated on a case by case manner.
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Maastricht University Medical Center