A proof-of-concept study for precise mapping of pigmented basal cell carcinoma in asian skin using multispectral optoacoustic tomography imaging with level set segmentation

Abstract

Purpose

Basal Cell Carcinoma (BCC), the most common subtype of non-melanoma skin cancers (NMSC), is prevalent worldwide and poses significant challenges due to their increasing incidence and complex treatment considerations. Existing clinical approaches, such as Mohs micrographic surgery, are time-consuming and labour-intensive, requiring meticulous layer-by-layer excision and examination, which can significantly extend the duration of the procedure. Current optical imaging solutions also lack the necessary spatial resolution, penetration depth, and contrast for effective clinical use.

Methods

Here, we introduce photoacoustic imaging, also known as optoacoustic imaging, based Multispectral Optoacoustic Tomography (MSOT) as a promising solution for non-invasive, high-resolution imaging in dermatology, which also measures hemodynamic changes. MSOT offers high isotropic resolution (80 μm), increased tissue penetration, and contrast-enhanced 3D spatial imaging map. For the first time, we integrated an automated level set image segmentation methodology on optoacoustic images to further enhance the precision in delineating tumor boundaries. Through this proof-of-concept study in 30 subjects, we demonstrate that this segmentation allows for precise measurement of tumor width, depth, and volume, aiding in preoperative tumor mapping and surgical planning.

Results

The MSOT measurements, validated against histology, achieved a correlation coefficient of 0.84 and 0.81 for width and depth respectively, ensuring reliable tumor metrics with a low margin of error.

Conclusion

Clinicians can use these tumor metrics to optimize treatment efficacy, while preserving healthy tissue and cosmetic outcomes. This advancement has the potential to revolutionize diagnostics and treatment, significantly improving the patient outcomes in managing NMSC.