Can fluorescence and autofluorescence imaging be useful in diagnosis of basal cell cancer? Proposition of algorithms

Sebastian Kwiatek; Aleksandra Kawczyk-Krupka; Ewa Mańka; Grzegorz Cieślar; Aleksander Sieroń; Agata Stanek

doi:10.1016/j.pdpdt.2020.101697

Can fluorescence and autofluorescence imaging be useful in diagnosis of basal cell cancer? Proposition of algorithms

Photodiagnosis Photodyn Ther. 2020 Jun:30:101697. doi: 10.1016/j.pdpdt.2020.101697. Epub 2020 Feb 25.

Authors

Sebastian Kwiatek¹, Aleksandra Kawczyk-Krupka², Ewa Mańka³, Grzegorz Cieślar², Aleksander Sieroń⁴, Agata Stanek⁵

Affiliations

¹ Specialist Hospital No2, Department of Internal Diseases, Angiology and Physical Medicine, Center for Laser Diagnosis and Therapy, Batorego Street 15, 41-902 Bytom, Poland.
² Faculty of Medical Sciences in Zabrze, Department of Internal Medicine, Angiology and Physical Medicine, Center for Laser Diagnosis and Therapy, Medical University of Silesia, Batorego Street 15, 41-902 Bytom, Poland.
³ Students Research Group, Department of Internal Medicine, Angiology and Physical Medicine, Center for Laser Diagnosis and Therapy, Batorego Street 15, 41-902 Bytom, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Poland.
⁴ Specialist Hospital No2, Department of Internal Diseases, Angiology and Physical Medicine, Center for Laser Diagnosis and Therapy, Batorego Street 15, 41-902 Bytom, Poland; Faculty of Health Sciences, Jan Dlugosz University in Czestochowa, Armii Krajowej Avenue 13/15, 42-200 Czestochowa, Poland.
⁵ Faculty of Medical Sciences in Zabrze, Department of Internal Medicine, Angiology and Physical Medicine, Center for Laser Diagnosis and Therapy, Medical University of Silesia, Batorego Street 15, 41-902 Bytom, Poland. Electronic address: astanek@tlen.pl.

PMID: 32109617
DOI: 10.1016/j.pdpdt.2020.101697

Abstract

Background: The most common non-melanoma skin carcinomas (NMSC) are basal cell carcinomas (BCC). Autofluorescence study may allow a non-invasive distinction of neoplastic lesions from benign lesions, whereas fluorescence spectroscopy enables qualification of the patient for possible photodynamic or surgical treatment. The aim of the study is to assess the suitability of autofluorescence and fluorescence imaging in the diagnosis of the stage of advancement, and the morphological type of changes in basal cell carcinoma of the skin.

Methods: A group of 382 patients with 430 skin lesions of basal cell carcinoma were subjected to an autofluorescence study and a spectral imaging using a spectral camera. The acquired spectra and fluorescence images were analyzed using the Image Pro-Plus 5.0.2 software. An analysis of fluorescence intensity profiles in the long and short axis of the studied changes was carried out.

Results: The fluorescence emission observed in BCC lesions with an area of up to 3 cm² showed a statistically significantly higher level of intensity in comparison to changes in lesions exceeding 3 cm² (#p < 0.05, ## p < 0.01). In the autofluorescence evaluation, we observed significant differences in the mean values of the Numerical Colour Value (NCV) depending on the size of the area of skin occupied by skin lesions. Based on the spatial and profile assessment of the types of BCC lesions a proposed algorithm for identifying changes was developed. Analysis of green fluorescence intensity profiles, analogous to fluorescence profiles analysis, allowed to propose an algorithm of autofluorescence evaluation in the diagnosis of BCC.

Conclusions: Autofluorescence and fluorescence imaging allow assessment of the extent of neoplastic infiltration and distinguish types of skin lesions with BCC. The determined diagnostic algorithms may be an effective diagnostic solution in the diagnosis of skin lesions of this nature.

Keywords: Autofluorescence; Basal cell cancer; Fluorescence spectroscopy; Non-melanoma skin cancer; Photodynamic diagnosis.

MeSH terms

Algorithms
Carcinoma, Basal Cell* / diagnostic imaging
Humans
Optical Imaging
Photochemotherapy* / methods
Photosensitizing Agents
Skin Neoplasms* / diagnostic imaging

Substances

Photosensitizing Agents