Abstract: 【Abstract】 Objective To investigate the optical coherence tomography （OCT） imaging features of basal cell carcinoma （BCC）, and to evaluate the clinical value of OCT in the diagnosis of BCC. Methods A total of 34 patients with clinically suspected BCC were prospectively collected from the Affiliated Dermatology Hospital of Shandong First Medical University between December 2022 and December 2023. Suspicious lesions were marked and examined using both OCT and histopathological techniques. The correlation between OCT imaging features and histopathological findings was analyzed. Using histopathological results as the gold standard, the diagnostic performance of OCT for BCC was evaluated, including sensitivity, specificity, and other metrics. The chi?square test and Fisher′s exact test were used to analyze the relationship between OCT features and BCC, and the Kappa value was used to evaluate consistency. Results Histopathological results confirmed BCC in 23 patients and non?BCC in 11. All 23 BCC cases exhibited characteristic OCT findings: fracture or blurring of the dermal?epidermal junction indicated epidermal attachment of the tumor, a low?reflectivity band surrounding the tumor corresponded to its palisading border, and cord?like or clustered heterogeneous reflective nests in the dermis corresponded to tumor masses, which were associated with the diagnosis of BCC （all P < 0.05）. OCT demonstrated high sensitivity and specificity for the diagnosis of BCC （observer A: 86.96%, 72.73%; observer B: 91.30%, 72.73%, respectively）, with good interobserver consistency （Kappa = 0.656, 95% CI: 0.382 - 0.683, P < 0.001）. Conclusion The OCT images of BCC showed good agreement with histopathological findings, suggesting the clinical value of OCT as an auxiliary diagnostic tool for BCC.

Key words: Carcinoma, basal cell, Tomography, optical coherence, Histopathological examination, Diagnosis, Consistency