High-definition optical coherence tomography imaging of melanocytic lesions: a pilot study

High-definition optical coherence tomography (HD-OCT) is a non-invasive in vivo imaging technique with cellular resolution based on the principle of conventional optical coherence tomography. The objective of this study was to evaluate HD-OCT for its ability to identify architectural patterns and cytologic features of melanocytic lesions. All lesions were examined by one observer clinically and using dermoscopy. Cross-sectional HD-OCT images were compared with histopathology. En face HD-OCT images were compared with reflectance confocal microscopy (RCM). Twenty-six melanocytic lesions of 26 patients were imaged. Identification of architectural patterns in cross-sectional mode and cytologic features of pigmented cells in the epidermis, dermo-epidermal junction, papillary dermis, and superficial reticular dermis in the en face mode was possible by HD-OCT. HD-OCT provides morphological imaging with sufficient resolution and penetration depth to discriminate architectural patterns and cytologic features of pigmented cells in epidermis and dermis. The method appears to offer the possibility of additional three-dimensional structural information complementary to that of RCM, albeit at a slightly lower lateral resolution. The diagnostic potential of HD-OCT regarding malignant melanoma is not high enough for ruling out a diagnosis of malignant melanoma.