线场共聚焦光学相干断层扫描(LC-OCT)是一种用于皮肤癌诊断的新技术。然而,角质形成细胞癌(KC)的已知图像标记的观察者间协议(IOA),包括基底细胞癌(BCC)和鳞状细胞癌(SCC),以及前体,原位SCC(CIS)和光化性角化病(AK),仍未探索。本研究确定了IOA是否存在KC和前体的10个关键LC-OCT图像标记,在具有不同级别皮肤病学成像经验的LC-OCT新评估者中。其次,报告的图像标记和病变类型之间的频率和关联,已确定。六名评估人员对组织病理学诊断视而不见,评估了75张KC(21SCC;21BCC)的LC-OCT图像,CIS(12),AK(21)对于每个图像,评估人员独立报告了LC-OCT文献综述中描述的KCs和前体的10个预定义关键图像标记的存在或不存在。基于先前的OCT和反射共聚焦显微镜使用,根据经验(3)或新手(3)对评估者进行分层。对所有组进行了IOA测试,使用康格的卡帕系数(κ)。报告的图像标记的频率及其与病变类型的关联,按比例和赔率比(OR)计算,分别。图像标记小叶的总体IOA最高(κ=0.68,95%置信区间(CI)0.57;0.78)和裂口(κ=0.63,CI0.52;0.74),通常见于BCC(94%;OR分别为143.2和158.7,p<0.001),其次是严重的发育不良(κ=0.42,CI0.31;0.53),主要在CIS中观察到(79%;OR7.1,p<0.001)。其余七个图像标记物的IOA较低(κ=0.06-0.32),并且在病变类型中观察到的更均匀。对于明确的(κ=0.07,CI0;0.15)和中断的真皮-表皮连接(DEJ)(κ=0.06,CI-0.002;0.13),IOA最低。与新手相比,经验丰富的评估者中所有图像标记的IOA均较高。这项研究显示了KC的10个关键图像标记的IOA和LC-OCT图像中的前体在新技术的评估者中变化。IOA对小叶的评估最高,裂缝,和严重的发育不良,而对DEJ完整性的评估最低。
Line-field confocal optical coherence tomography (LC-OCT) is a new technology for skin cancer diagnostics. However, the interobserver agreement (IOA) of known image markers of keratinocyte carcinomas (KC), including basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), as well as precursors, SCC in situ (CIS) and actinic keratosis (AK), remains unexplored. This study determined IOA on the presence or absence of 10 key LC-OCT image markers of KC and precursors, among evaluators new to LC-OCT with different levels of dermatologic imaging experience. Secondly, the frequency and association between reported image markers and lesion types, was determined. Six evaluators blinded to histopathologic diagnoses, assessed 75 LC-OCT images of KC (21 SCC; 21 BCC), CIS (12), and AK (21). For each image, evaluators independently reported the presence or absence of 10 predefined key image markers of KCs and precursors described in an LC-OCT literature review. Evaluators were stratified by experience-level as experienced (3) or novices (3) based on previous OCT and reflectance confocal microscopy usage. IOA was tested for all groups, using Conger\'s kappa coefficient (κ). The frequency of reported image marker and their association with lesion-types, were calculated as proportions and odds ratios (OR), respectively. Overall IOA was highest for the image markers lobules (κ = 0.68, 95% confidence interval (CI) 0.57;0.78) and clefting (κ = 0.63, CI 0.52;0.74), typically seen in BCC (94%;OR 143.2 and 158.7, respectively, p < 0.001), followed by severe dysplasia (κ = 0.42, CI 0.31;0.53), observed primarily in CIS (79%;OR 7.1, p < 0.001). The remaining seven image-markers had lower IOA (κ = 0.06-0.32) and were more evenly observed across lesion types. The lowest IOA was noted for a well-defined (κ = 0.07, CI 0;0.15) and interrupted dermal-epidermal junction (DEJ) (κ = 0.06, CI -0.002;0.13). IOA was higher for all image markers among experienced evaluators versus novices. This study shows varying IOA for 10 key image markers of KC and precursors in LC-OCT images among evaluators new to the technology. IOA was highest for the assessments of lobules, clefting, and severe dysplasia while lowest for the assessment of the DEJ integrity.