Kosmet Med 2014. 34(6): 266 – 271

New aspects in the use of optical coherence tomography (OCT) in dermatology through high-resolution en-face-view (EFV)-OCT:
Fast three dimensional display of skin vessels for diagnosis and Planning of the therapy

Neue Aspekte zur Anwendung der Optischen-Kohärenz-Tomografie (OCT) in der Dermatologie durch high-resolution En-Face-View (EFV)-OCT:
Schnelle dreidimensionale Darstellung von Gefäßen der Haut zur Diagnostik und Planung der Therapie

Martin Nguyen1, Marcella Kollmann-Hemmerich1, 2, Beata Trautner3, Gerald Messer1, 2

1 Praxis für Dermatologie, Sendlinger-Tor-Platz 9, D-80336 München
2 Praxis für Dermatologie und Allergologie, Bauseweinallee 2, D-81247 München
3 Praxis für Dermatologie und Phlebologie, Sendlinger-Tor-Platz 9, D-80336 München

Key words: Vessels, en face view, 3D, high-resolution Oct, multibeam Oct, varicosis, angioma, diagnosis, infrared, optical coherence tomography

Summary:
Optical coherence tomography (OCT) is now evaluated in a routinely clinical setting in Dermatology. Oct-imaging is based on computeraided black and white tomograms, obtained by infrared laser light. These are taken in vivo and in real time and can be depicted in addition as transversal en face view (EFV)-Oct. Promising results have been obtained in the detection of actinic keratoses, spinocellular carcinomas and basal cell carcinomas (BCC). Moreover, a hallmark is the localization of vessels, e.g. small teleangiectatic, in Bcc. We here report on the fast and reliable imaging of small vessels of the skin using Oct in 3D for diagnosis, planning of surgical and other therapeutic procedures. In this study, the vivosight-OCT, Michelson Diagnostics, Orpington, UK, was applied for tomograms, EFV-Oct and 3D-modelling. In the first patient with a suspicious lesion for Bcc at the right forehead, the temporal vein could be depicted. thus, the intraoperative risk for bleeding could be deminuished. In the second patient, a pigmented lesion of the lip could be excluded by the non-invasive imaging of the vasculature, leading to the diagnosis of an angioma, as venous lake. here, surgical removal of the lesion could be avoided. In addition, smaller vascular lesions in a patient with varicosis, like teleagiectases and venous ectases, can be measured (0,1-2 mm) and depicted in 3D. this can help to define the caliber and thus can help the therapeutic decision prior to lasEr- or sclerosing therapy. Three dimensional Oct can be used as a rapid and precise approach to discriminate characteristic lesions by their pattern of the vasculature, like basal cell carcinomas, angiomas, vascular nevi, spider nevi, teleangiectases, venous lakes and hematomas.