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Hyperspectral imaging system in the delineation of Ill-defined basal cell carcinomas: a pilot study

Journal article
Authors M. Salmivuori
Noora Neittaanmäki
I. Polonen
L. Jeskanen
E. Snellman
M. Gronroos
Published in Journal of the European Academy of Dermatology and Venereology
Volume 33
Issue 1
Pages 71-78
ISSN 0926-9959
Publication year 2019
Published at Institute of Clinical Sciences, Department of Dermatology and Venereology
Institute of Biomedicine
Pages 71-78
Language en
Keywords mohs micrographic surgery, confocal microscopy, punch biopsy, epidemiology, histology, excision, subtype, margin
Subject categories Dermatology and Venereal Diseases


Background Basal cell carcinoma (BCC) is the most common skin cancer in the Caucasian population. Eighty per cent of BCCs are located on the head and neck area. Clinically ill-defined BCCs often represent histologically aggressive subtypes, and they can have subtle subclinical extensions leading to recurrence and the need for re-excisions. Objectives The aim of this pilot study was to test the feasibility of a hyperspectral imaging system (HIS) in vivo in delineating the preoperatively lateral margins of ill-defined BCCs on the head and neck area. Methods Ill-defined BCCs were assessed clinically with a dermatoscope, photographed and imaged with HIS. This was followed by surgical procedures where the BCCs were excised at the clinical border and the marginal strip separately. HIS, with a 12-cm(2) field of view and fast data processing, records a hyperspectral graph for every pixel in the imaged area, thus creating a data cube. With automated computational modelling, the spectral data are converted into localization maps showing the tumour borders. Interpretation of these maps was compared to the histologically verified tumour borders. Results Sixteen BCCs were included. Of these cases, 10 of 16 were the aggressive subtype of BCC and 6 of 16 were nodular, superficial or a mixed type. HIS delineated the lesions more accurately in 12 of 16 of the BCCs compared to the clinical evaluation (4 of 16 wider and 8 of 16 smaller by HIS). In 2 of 16 cases, the HIS-delineated lesion was wider without histopathological confirmation. In 2 of 16 cases, HIS did not detect the histopathologically confirmed subclinical extension. Conclusions HIS has the potential to be an easy and fast aid in the preoperative delineation of ill-defined BCCs, but further adjustment and larger studies are warranted for an optimal outcome.

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