A procedure for computer analyzing an optical coherence tomography (OCT) image of normal and precancerous oral mucosae is demonstrated to reasonably plot the boundary between epithelium (EP) and lamina propria (LP) layers, determine the EP thickness, and estimate the range of dysplastic cell distribution based on standard deviation (SD) mapping. In this study, 54 normal oral mucosa, 39 oral mild dysplasia, and 44 oral moderate dysplasia OCT images are processed for evaluating the diagnosis statistics. Based on SD mapping in an OCT image, it is found that the laterally average range percentages of 70% SD maximum level in the EP layer is a reasonably good threshold for differentiating moderate dysplasia from mild dysplasia oral lesion based on the OCT image analysis. The sensitivity and specificity in diagnosis statistics can reach 82 and 90%, respectively.
A swept-source optical coherence tomography (SS-OCT) system is used to clinically scan oral lesions in different oral carcinogenesis stages, including normal oral mucosa control, mild dysplasia (MiD), moderate dysplasia (MoD), early-stage squamous cell carcinoma (ES-SCC), and well-developed SCC (WD-SCC), for diagnosis purpose. On the basis of the analyses of the SS-OCT images, the stages of dysplasia (MiD and MoD), and SCC (ES-SCC and WD-SCC) can be differentiated from normal control by evaluating the depth-dependent standard deviation (SD) values of lateral variations. In the dysplasia stage, the boundary between the epithelium (EP) and lamina propria (LP) layers can still be identified and the EP layer becomes significantly thicker than that of normal control. Also, in a certain range of the EP layer above the EP/LP boundary, the SD value becomes larger than a certain percentage of the maximum level, which is observed around the EP/LP boundary. On the other hand, in the ES-SCC and WD-SCC stages, the EP/LP boundary disappears. Because of the higher density of connective tissue papillae in the ES-SCC stage, the SD values of the slowly varying lateral scan profiles in the ES-SCC samples are significantly larger than those in the WD-SCC sample. Also, ES-SCC can be differentiated from WD-SCC by comparing the exponential decay constants of averaged A-mode scan profiles. Because of the higher tissue absorption in the WD-SCC lesion, the decay constants in the WD-SCC samples are significantly higher than those in the ES-SCC samples.
A swept-source optical coherence tomography system is used to clinically scan oral precancer and cancer patients for statistically analyzing the effective indicators of diagnosis. Three indicators are considered, including the standard deviation (SD) of an A-mode scan signal profile, the exponential decay constant (alpha) of an A-mode-scan spatial-frequency spectrum, and the epithelium thickness (T) when the boundary between epithelium and lamina propria can still be identified. Generally, in abnormal mucosa, the standard deviation becomes larger, the decay constant of the spatial-frequency spectrum becomes smaller, and epithelium becomes thicker. The sensitivity and specificity of the three indicators are discussed based on universal and individual relative criteria. It is found that SD and alpha are good diagnosis indicators for moderate dysplasia and squamous cell carcinoma. On the other hand, T is a good diagnosis indicator for epithelia hyperplasia and moderate dysplasia.
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