Longitudinal Assessment of Vascularity in Actinic Keratosis Using Dynamic Optical Coherence Tomography: Practical Considerations and Theoretical Insights

Longitudinal monitoring of actinic keratosis (AK) is a part of patient management, scientific studies, and the development of new treatment strategies. Dynamic optical coherence tomography (D-OCT), an imaging method that enables noninvasive assessment of microvasculature, in conjunction with automated quantitative analysis, shows promise as an objective and robust method for monitoring AKs. Critical to quantitative longitudinal assessments is a dataset in which good-quality images are available at all time points. Yet, to date, few resources exist to train clinical researchers on how to ensure robust D-OCT data collection. In this study, we identify hallmarks of poor image quality to guide data curation and avoid biasing study results. We highlight strategies for imaging lesions with significant hyperkeratosis. Finally, we discuss characteristic features present in D-OCT images of AK that may complicate quantitative analysis. We hope that this work will facilitate the use of D-OCT in the objective longitudinal assessment of AK.