Abstract

Nonmelanoma skin cancer (NMSC) remains the most common form of cancer in the United States with the cost of treatment exceeding $8 billion per year [1]. The most effective form of treatment is Mohs Micrographic Surgery, but the process is time consuming and labor intensive. An imaging modality capable of in vivo margin delineation can significantly the time, labor and cost of treatment. Terahertz imaging is non-ionizing and offers intrinsic contrast between normal and cancerous skin, however the resolution is wavelength limited to around 0.5 mm, thus morphological information is not available. Optical polarized light imaging (PLI) offers a rapid wide-field data acquisition with high resolution but does not offer intrinsic contrast. We explore the combination of terahertz and PLI for nonmelanoma skin cancer detection. Fresh, thick excisions of NMSC were imaged using both modalities- an initial study was used to determine a terahertz reflectivity threshold for cancer detection. A fresh set of specimens was then imaged – thresholded terahertz images were compared to histopathology to determine sensitivity and specificity. We then used a combined approach using both PLI and terahertz images and sensitivity and specificity was determined for this technique as well. Our results indicate that a combination of terahertz and PLI is capable of detecting NMSC in thick, fresh excisions with a sensitivity and specificity of 96% and 99% respectively.

© 2018 The Author(s)