Line-Field Confocal Optical Coherence Tomography: Is One Hour of Training Sufficient for Diagnosing Basal Cell Carcinoma?

Basal cell carcinoma (BCC) is the most common malignancy, characterised by local invasiveness and the potential for tissue destruction. Diagnosing BCC can be challenging, particularly for less experienced dermatologists. Line-field confocal optical coherence tomography (LC-OCT), a new noninvasive optical technique, has become increasingly useful in clinical practice, allowing in vivo imaging at cellular resolution. This study aimed to evaluate the impact of a 1 h structured training session on the ability of dermatology residents to diagnose BCC using LC-OCT. Eight dermatology residents with different levels of LC-OCT experience (no experienced and low experience in LC-OCT) participated alongside an expert dermatologist as a benchmark. Overall, participants evaluated 40 histopathologically confirmed lesions (20 BCC, 20 non-BCC) before and after training, with and without the inclusion of dermoscopic images. We observed a significant improvement in diagnostic accuracy post-training, especially among inexperienced users, with a 20% reduction in false negatives and a 35% reduction in false positives. When the dermoscopic images were included, further improvements were noted, with the accuracy increasing by an additional 5%. The overall diagnostic rate for inexperienced readers increased from 48% to 76% after training and to 81% with the addition of dermoscopic images in the course. Our study highlights the effectiveness of short, targeted training in enhancing the diagnostic utility of LC-OCT, emphasising its potential for broader clinical adoption to improve BCC detection.