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. 2025 Jun;52(7):2617-2627.
doi: 10.1007/s00259-025-07072-x. Epub 2025 Jan 24.

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

Xiuting Li #  1 , Valerie Xinhui Teo #  1 , Cheng Yi Kwa  2 , Amalina Binte Ebrahim Attia  3 , Renzhe Bi  1 , Sai Yee Chuah  2 , Melissa Wee Ping Tan  2 , Hui Yi Chia  2 , Sze Hon Chua  2 , Joyce Xiong See Lee  2 , Suzanne Wei Na Cheng  2 , U S Dinish  4 , Steven Tien Guan Thng  5 , Malini Olivo  6
Affiliations

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

Xiuting Li et al. Eur J Nucl Med Mol Imaging. 2025 Jun.

Erratum in

Abstract

Purpose: Basal Cell Carcinoma (BCC), the most common subtype of non-melanoma skin cancers (NMSC), is prevalent worldwide and poses significant challenges due to their increasing incidence and complex treatment considerations. Existing clinical approaches, such as Mohs micrographic surgery, are time-consuming and labour-intensive, requiring meticulous layer-by-layer excision and examination, which can significantly extend the duration of the procedure. Current optical imaging solutions also lack the necessary spatial resolution, penetration depth, and contrast for effective clinical use.

Methods: Here, we introduce photoacoustic imaging, also known as optoacoustic imaging, based Multispectral Optoacoustic Tomography (MSOT) as a promising solution for non-invasive, high-resolution imaging in dermatology, which also measures hemodynamic changes. MSOT offers high isotropic resolution (80 μm), increased tissue penetration, and contrast-enhanced 3D spatial imaging map. For the first time, we integrated an automated level set image segmentation methodology on optoacoustic images to further enhance the precision in delineating tumor boundaries. Through this proof-of-concept study in 30 subjects, we demonstrate that this segmentation allows for precise measurement of tumor width, depth, and volume, aiding in preoperative tumor mapping and surgical planning.

Results: The MSOT measurements, validated against histology, achieved a correlation coefficient of 0.84 and 0.81 for width and depth respectively, ensuring reliable tumor metrics with a low margin of error.

Conclusion: Clinicians can use these tumor metrics to optimize treatment efficacy, while preserving healthy tissue and cosmetic outcomes. This advancement has the potential to revolutionize diagnostics and treatment, significantly improving the patient outcomes in managing NMSC.

Keywords: Basal cell carcinoma; Level set image segmentation; Multispectral optoacoustic tomography; Non-melanoma skin cancer; Photoacoustic imaging.

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Conflict of interest statement

Declarations. Ethics approval: The clinical study was approved by the Domain Specific Review Board (DSRB) of National Health Group, Singapore and the Agency for Science, Technology and Research Institutional Review Board (IRB). DSRB Ref: 2020/00115 and 2022/00347. A*STAR IRB Ref: 2020 − 160 and 2022 − 145. Consent to participate: Informed consent was obtained from all individual participants included in the study. Competing interests: The authors declare no competing interests.

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