Applications and Future Directions for Optical Coherence Tomography in Dermatology

B. Wan; C. Ganier; X. Du-Harpur; N. Harun; F.M. Watt; R. Patalay; M.D. Lynch

The British Journal of Dermatology. 2021;184(6):1014-1022.

The Development of Optical Coherence Tomography in Dermatology

Dermatology would appear to be an ideal application for OCT imaging as the skin surface is readily accessible and much of skin pathology occurs within the surface of the skin. Initial attempts to develop skin OCT were frustrated by the higher refractive index of skin in comparison with the eye.^[1] This was resolved by a shift from the visible-light wavelengths employed for ophthalmic OCT to infrared wavelengths, which are less attenuated by skin, and all commercially available systems now use the 1300-nm waveband.^[9]

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Abstract and Introduction
Mechanism and Nomenclature
The Development of Optical Coherence Tomography in Dermatology
Optical Coherence Tomography in Normal Skin
Optical Coherence Tomography in the Diagnosis of Keratinocyte Carcinomas
Optical Coherence Tomography Imaging of Melanoma
Optical Coherence Tomography Imaging in Inflammatory Dermatoses
Other Applications of Optical Coherence Tomography Imaging in Dermatology
Discussion
References

Table 1. Features of different optical imaging methods for *in vivo* skin imaging
	Penetration depth (mm)	Lateral resolution (μm)	Axial resolution (μm)	FOV (mm)	Advantages	Disadvantages
RCM (VivaScope 1500)	0·2	< 1·25	< 5·0	0·5 × 0·5 (8 × 8 mosaic)	Cellular resolution	Limited penetration depth (up to papillary dermis layer)
Multiphoton microscopy (MPTflex)	0·2	< 0·5	< 2·0	0·35 × 0·35	Excellent cellular resolution and contrast	Narrow FOV and limited penetration depth (to top of papillary dermis layer)
HFUS (20–100 MHz)	0·35–15	33–250	17–80	8·0–12	Deep penetration depth and good FOV	Unsatisfactory cellular resolution
LC-OCT (Damae Medical)	0·5	1·3	1·1	1·2 × 1·2	Excellent spatial resolution for OCT	Limited penetration depth for OCT
FF-OCM (SkinTell)	1·0	3·0	3·0	1·8 × 1·5	Good resolution for OCT	Long acquisition time
FD-OCT (VivoSight)	1·0	< 7·5	< 5·0	6·0 × 6·0	Good penetration depth to dermis, good imaging speed, excellent FOV	Not cellular resolution

FD-OCT, frequency-domain optical coherence tomography; FF-OCM, full-field optical coherence microscopy; FOV, field of view; HFUS, high-frequency ultrasound; LC-OCT, line-field confocal optical coherence tomography; RCM, reflectance confocal microscopy.