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.

Summary

In 30 subjects with pigmented BCC, MSOT combined with automated level set segmentation produced tumor width and depth measurements that correlated strongly with histology (r=0.84 and 0.81). The method enables non-invasive 3D mapping for preoperative planning, potentially reducing tissue sacrifice and improving cosmetic outcomes.

Key Findings

• Automated level set segmentation on MSOT enabled precise delineation of pigmented BCC and measurement of width, depth, and volume.
• MSOT-derived width and depth correlated strongly with histology (r=0.84 and r=0.81).
• High isotropic resolution (80 μm) and enhanced penetration allowed contrast-rich 3D mapping suitable for surgical planning.

Clinical Implications

MSOT-based preoperative mapping could reduce Mohs stages or re-excisions, shorten operative time, and preserve healthy tissue, especially in cosmetically sensitive areas.

Limitations

• Small sample size (n=30) and single proof-of-concept setting
• Focused on pigmented BCC and Asian skin; generalizability to other subtypes and populations requires study

Future Directions

Conduct larger, multicenter diagnostic accuracy studies and evaluate clinical utility endpoints (e.g., reduced Mohs stages, operative time, margin status) and cost-effectiveness.