1006P - Optical coherence tomography in vulvar intraepithelial neoplasia

Date 29 September 2012
Event ESMO Congress 2012
Session Poster presentation I
Topics Vulvar and Vaginal Cancers
Imaging, Diagnosis and Staging
Presenter Ronni Wessels
Authors R. Wessels1, D.M. De Bruin2, D.J. Faber2, H.H. van Boven3, A.D. Vincent4, T.G. van Leeuwen2, M. van Beurden5, T. Ruers6
  • 1Surgical Oncology, Antoni van Leeuwenhoek Hospital, 1066CX - Amsterdam/NL
  • 2Biomedical Engineering And Physics, Academic Medical Center, Amsterdam/NL
  • 3Pathology, Antoni van Leeuwenhoek Hospital, Amsterdam/NL
  • 4Biometrics, Antoni van Leeuwenhoek Hospital, Amsterdam/NL
  • 5Gynecology, Antoni van Leeuwenhoek Hospital, Amsterdam/NL
  • 6Nanobiophysics Group, Mira Institute, University Twente, Amsterdam/NL

Abstract

Background

Vulvar squamous cell carcinoma (VSCC) is the fourth most common gynaecological type of cancer with an incidence of approximately 2-3 per 100,000 women. VSCC arises from premalignant lesions called vulvar intraepithelial neoplasia (VIN). VIN is diagnosed through a punch biopsy, which can be painful. Optical coherence tomography (OCT) measures backscattered light like ultrasound measures backscattered sound waves. The backscattered light versus the depth is described by the attenuation coefficient (µoct). The µoct may vary along different histological types of tissue. We hypothesize thickness of the epidermal layer of the skin, measured in the OCT-images, will be different in normal tissue and VIN. Furthermore, we hypothesize that quantitative measurements of µoct by using OCT can differentiate between VIN and normal vulvar tissue.

Material and methods

All OCT- images were conducted in vivo in the outpatient clinic or in the operation room. Directly after imaging, punch or incisional biopsy was performed. Measurements of the epidermal thickness were performed in cross-sectonial OCT-images. Analysis of the attenuation coefficient measurements were made based on the difference in µoct between normal and VIN tissue within individual patients.

Results

Twenty suspicious lesions from sixteen patients were imaged with OCT and the epidermal thickness and the attenuation coefficient were determined. Paired Mann-Whitney-test showed a statistically significant difference between epidermal layer thickness in VIN lesions and normal tissue within individual patients (p < 0.0001). The attenuation coefficient of these tissues was significantly different (P < 0.0001) as well. Epidermal layer thickness and attenuation coefficient were not related to each other.

Conclusion

This study shows that the epidermal thickness and the attenuation coefficient of vulvar epithelial tissue containing VIN is different from normal vulvar tissue. Therefore, OCT seems to be a promising tool to discriminate between normal and VIN tissue.

Disclosure

All authors have declared no conflicts of interest.