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The Role of Line-Field Confocal Optical Coherence Tomography in Detecting Extramammary Paget Disease Recurrences: A Pilot Diagnostic Study.

Authors :
Diet, Gwendoline
Lenoir, Clément
Fontaine, Margot
Boussingault, Lucas
Orte Cano, Carmen
Mtimet, Lyna
Liénard, Danielle
Sanak, Dilara
Moulart, Florine
Bernardi, Dana
Trepant, Anne-Laure
Perez-Anker, Javiera
Puig, Susana
Malvehy, Josep
Cinotti, Elisa
Tognetti, Linda
Rubegni, Pietro
Perrot, Jean-Luc
Marmol, Véronique Del
Suppa, Mariano
Source :
Diagnostics (2075-4418). Jul2024, Vol. 14 Issue 14, p1562. 12p.
Publication Year :
2024

Abstract

Extramammary Paget disease (EMPD) is an uncommon adenocarcinoma of apocrine gland-rich areas, presenting significant diagnostic challenges due to its nonspecific clinical appearance and frequent misidentification as benign, inflammatory skin conditions. Traditional diagnostic methods such as biopsy are invasive and uncomfortable, often required repeatedly due to high recurrence rates. Dermoscopy and non-invasive imaging techniques have been used but provide limited diagnostic accuracy due to their constraints in depth penetration and resolution. Recent advancements in imaging technologies, such as line-field confocal optical coherence tomography (LC-OCT), show promise in enhancing diagnostic precision while minimizing invasive procedures. LC-OCT merges high-resolution imaging with deep penetration capabilities, capturing detailed horizontal and vertical skin images akin to histopathology. This study evaluated the diagnostic performance of LC-OCT in detecting EMPD and its recurrence in 17 clinically suspicious anogenital regions, belonging to six patients. Data were collected prospectively at the patient's bedside by an LC-OCT expert with poor training for EMPD, and, then, reviewed retrospectively by an independent LC-OCT expert with adequate training for EMPD and no concerns about time. The prospective examination yielded 64.7% accuracy (11 true results out of 17 total cases), 71.4% sensitivity (10 true positives out of 14 actual positives), and 33.3% specificity (1 true negative out of 3 actual negatives). The retrospective analysis achieved 94.1% accuracy (16 true results out of 17 total cases), 100% sensitivity (14 true positives out of 14 actual positives), and 66.7% specificity (2 true positives out of 3 actual positives), with the only false positive case being a difficult-to-diagnose concomitant presentation of a lichen sclerosus et atrophicus. Despite the need for specialized training, our results suggest that LC-OCT represents a valuable tool for accurately identifying EMPD and improving its management by reducing unnecessary biopsies. Further studies are needed to standardize its clinical application. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
20754418
Volume :
14
Issue :
14
Database :
Academic Search Index
Journal :
Diagnostics (2075-4418)
Publication Type :
Academic Journal
Accession number :
178689281
Full Text :
https://doi.org/10.3390/diagnostics14141562