Assessment of the sensitivity and specificity of tissue-specific-based and anatomical-based optical biomarkers for rapid detection of human head and neck squamous cell carcinoma

Abstract

SUMMARY Objectives We propose the use of morphological optical biomarkers for rapid detection of human head and neck squamous cell carcinoma (HNSCC) by leveraging the underlying tissue characteristics in aerodigestive tracts. Materials and Methods Diffuse reflectance spectra were obtained from malignant and contra-lateral normal tissues of 57 patients undergoing panendoscopy and biopsy. Oxygen saturation, total hemoglobin concentration, and the reduced scattering coefficient were extracted. Differences in malignant and normal tissues were examined based on two different groupings: anatomical site and morphological tissue type. Results and Conclusions Measurements were acquired from 252 sites, of which 51 were pathologically classified as SCC. Optical biomarkers exhibited statistical differences between malignant and normal samples. Contrast was enhanced when parsing tissues by morphological classification rather than anatomical subtype for unpaired comparisons. Corresponding linear discriminant models using multiple optical biomarkers showed improved predictive ability when accounting for morphological classification, particularly in node-positive lesions. The false-positive rate was retrospectively found to decrease by 34.2% in morphologically- vs. anatomically-derived predictive models. In glottic tissue, the surgeon exhibited a false-positive rate of 45.7% while the device showed a lower false-positive rate of 12.4%. Additionally, comparisons of optical parameters were made to further understand the physiology of tumor staging and potential causes of high surgeon false-positive rates. Optical spectroscopy is a user-friendly, non-invasive tool capable of providing quantitative information to discriminate malignant from normal head and neck tissues. Predictive models demonstrated promising results for real-time diagnostics. Furthermore, the strategy described appears to be well suited to reduce the clinical false-positive rate.

Bimodal multispectral imaging system with cloud-based machine learning algorithm for real-time screening and detection of oral potentially malignant lesions and biopsy guidance

“…19 The diagnostic ability of the algorithm specific to buccal mucosa was steadfastly higher for discriminating benign, dysplastic, and malignant lesions. In a similar study, Hu et al 39 reported an increase in PPV and NPV when using tissue-specific classification algorithms, which resulted in the false-positive rates declining by 34%. The results from the present study indicate that site-specific algorithms implemented for the detection of lesions in the oral cavity increase diagnostic accuracy, which in turn reduces the number of false-negative rates.…”

“… 37 , 38 Improvements in the tissue classification parameters such as PPV and NPV were observed when site-specific classification was used to discriminate head and neck SCC. 39 To test this hypothesis on existing patient data, we collated data of patients with buccal mucosal abnormalities. We also recorded the DR ratio (R610/R545) from the left and right buccal mucosa of healthy volunteers with no history of alcohol, smoking, or tobacco usage.…”

A Clinical Study to Assess Diffuse Reflectance Spectroscopy with an Auto-Calibrated, Pressure-Sensing Optical Probe in Head and Neck Cancer

“…Having established an appropriate, non-perturbative measurement device and technique, we sought to investigate HSNCC optical properties and identify potential diagnostic biomarkers. Significant differences in tissue hemoglobin saturation exist between cancerous and non-cancerous tissues; this has been seen in breast [ 26 ], rectum/anus [ 27 ] and head and neck cancer [ 28 ]. It is well-accepted that most solid tumors are both chronically and cyclically hypoxic due to the increase in oxygen demand and deficiencies in tumor vasculature [ 20 ].…”

Dark field optical imaging reveals vascular changes in an inducible hamster cheek pouch model during carcinogenesis

“…Future studies include incorporating optical filters for spectral imaging to estimate tumor hypoxia, a crucial cause for tumor angiogenesis [37], during the carcinogenesis. Measuring tumor hypoxia has shown promise for cancer detection [38][39][40]. Therefore, the addition of physiological endpoints to the currently available vascular features could potentially enhance the contrast between malignant and normal tissues.…”