New imaging technique improves accuracy of diagnosis for the most common skin cancer

A novel imaging technique significantly improves the accuracy of the diagnosis of basal cell carcinoma (BCC) – the most frequent skin cancer – compared to clinical and dermoscopic examinations alone

New research being presented at the 31st European Academy of Dermatology and Venereology (EADV) Congress

The study found that using a new, non-invasive skin imaging technology called line-field confocal optical coherence tomography (LC-OCT), which gives detailed 3D images at cellular level, significantly increased diagnostic accuracy.

For the differentiation of BCC from BCC-imitators (such as squamous cell carcinoma, actinic and seborrheic keratosis, dermal nevus, and inflammatory conditions), using LC-OCT significantly increased the diagnostic accuracy by 12% compared to dermoscopic examination alone (from 85% up to 97%), the most commonly used skin cancer diagnostic techniques.

Importantly, for the differentiation of superficial BCC (a subtype that can be treated non-surgically) from other BCC subtypes, using LC-OCT again increased the diagnostic accuracy by 12% compared to dermoscopic examination alone (from 80% to 92%).

The study also produced a diagnostic algorithm useful to guide the clinician’s diagnosis towards different BCC and BCC-imitators’ subtypes. The algorithm is based on the most powerful LC-OCT morphological criteria that came out from their comprehensive statistical analysis.

Researchers from the Department of Dermatology at the Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium, analysed 303 lesions, including 173 BCC and 130 BCC-imitators in the study.

“Our findings suggest that, when in front of an BCC equivocal lesion, LC-OCT enables a more accurate diagnosis and, therefore, should be included in the diagnostic process and management of BCC”, states Professor Mariano Suppa, a lead researcher and consultant dermatologist from Italy..

Prof. Suppa explains: “LC-OCT has the potential to reduce the number of unnecessary biopsies and excisions in cases of superficial BCC and also in the case of benign lesions that do not require surgery”.

BCC is a type of skin cancer, mainly caused by sun exposure, or use of tanning beds. While it grows slowly and rarely spreads, it is the most common form of cancer worldwide and incidence has doubled in the past 20 years.2 In Europe, the incidence is between 50 and 80 new patients per 100 persons, per year.3

Prof. Suppa said: “Diagnosing basal cell carcinoma can be challenging using clinical or dermoscopic assessments alone and it is crucial that the condition is correctly diagnosed in order to treat it properly. We found that the accuracy of diagnosis can be improved by at least 12% using LC-OCT, both in terms of differentiating BCCs from other skin conditions, and of identifying BCC subtypes that do not require surgery.”


  1. Line-Field Confocal Optical Coherence Tomography For Basal Cell Carcinoma: A Retrospective Study On Diagnostic Performance, presented at EADV Congress 2022
  2. Insight into the number of patients diagnosed with basal cell carcinoma in the Netherlands and an estimation of future numbers. Schreuder et al. British Journal of Dermatology/ Volume 186 Issue 3/p476-484. British Journal of Dermatology: Vol 186, No 3 (
  3. Basal Cell Carcinoma, European Skin Cancer Foundation. 
  4. http://www.escf-

About Prof Mariano Suppa:

Mariano Suppa is an Associate Professor of Dermatology at the Université Libre de Bruxelles in Brussels, Belgium, and currently serves as vice-president of the non-invasive skin imaging group of the Société Française de Dermatologie (GICNI-SFD); member of the Communication Committee of the European Academy of Dermatology and Venereology (EADV); member of the EUROMELANOMA Prevention Campaign Organizing Committee; and member of the “Hidradenitis Suppurativa Global Alliance” Expert Group. After his medical studies in Italy, France, and UK, he subsequently got his PhD at the Université Libre de Bruxelles (Brussels, Belgium). His main clinical/research interests are non-invasive skin imaging, dermato-oncology, skin cancer prevention, hidradenitis suppurativa, epidemiology and biostatistics.

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