Hyperspectral Imaging for Lateral Tumour Demarcation of High-risk Basal Cell Carcinomas during Mohs Micrographic Surgery

Authors

  • Hannah Ceder Department of Dermatology and Venereology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Region Västra Götaland, Sahlgrenska University Hospital, Department of Dermatology and Venereology, Gothenburg, Sweden
  • Mari Salmivuori Department of Dermatology and Venereology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Region Västra Götaland, Sahlgrenska University Hospital, Department of Dermatology and Venereology, Gothenburg, Sweden; Department of Dermatology, Allergology and Venereology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
  • Ilkka Pölönen Faculty of Information Technology, University of Jyväskylä, Jyväskylä, Finland
  • John Paoli Department of Dermatology and Venereology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Region Västra Götaland, Sahlgrenska University Hospital, Department of Dermatology and Venereology, Gothenburg, Sweden
  • Noora Neittaanmäki Department of Laboratory Medicine, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Pathology, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden

DOI:

https://doi.org/10.2340/actadv.v105.43614

Keywords:

high-risk basal cell carcinoma, Mohs micrographic surgery, tumour demarcation, hyperspectral imaging

Abstract

Hyperspectral imaging is a non-invasive imaging modality showing potential in delineating tumour margins preoperatively. This pilot study evaluated the feasibility of using hyperspectral imaging to demarcate lateral margins of high-risk facial basal cell carcinomas (BCC) prior to Mohs micrographic surgery. Thirty patients with high-risk BCCs were recruited from the Department of Dermatology, Sahlgrenska University Hospital, Sweden. Lesions were initially demarcated using dermoscopy, followed by hyperspectral imaging scans. During the first stage, a superficial vertical incision was performed along the demarcation line before adding a 3-mm clinical margin for the bowl-shaped excision of the tumour. Hyperspectral imaging-based tumour margins were compared with histopathologically verified borders, serving as ground truth. The data analysis used supervised learning; 2 complementary validation strategies were employed: a half-split approach where the left half of each annotated image was used for training and the right half for testing, and a leave-one-out cross-validation at the image level. A pixel-wise classification approach was used, treating each pixel as an independent sample. Hyperspectral imaging achieved a pixel-wise classification accuracy of 0.76, sensitivity of 0.75, specificity of 0.78, and an area under the receiver operating characteristic curve of 0.84. Hyperspectral imaging demonstrated potential for tumour demarcation, providing a basis for future research.

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Published

2025-12-02

How to Cite

Ceder, H., Salmivuori, M., Pölönen, I., Paoli, J., & Neittaanmäki, N. (2025). Hyperspectral Imaging for Lateral Tumour Demarcation of High-risk Basal Cell Carcinomas during Mohs Micrographic Surgery. Acta Dermato-Venereologica, 105, adv43614. https://doi.org/10.2340/actadv.v105.43614

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