Diagnostic Concordance between Optical Coherence Tomography and Histological Investigations for Immune-Mediated Desquamative Gingivitis: Observational Study

Abstract

Desquamative gingivitis (DG) denotes a heterogeneous immune-mediated disease for which early diagnosis represents a great challenge. The main aim of this study is to validate diagnostic concordance between specific Optical Coherence Tomography (OTC) patterns for DG related to oral Lichen Planus (OLP), Pemphigus Vulgaris (PV), and Mucous Membrane Pemphigoid (MMP) and definitive histological diagnosis. Forty-three patients with suspected immune-mediated DGs, were progressively recruited. Before biopsy, an OCT preliminary evaluation was performed using specific pre-determined OCT diagnostic patterns (i.e., morphology and localization of blisters, status of the basal membrane, epithelial thickness, presence/absence of acantholytic cells into blister and/or inflammatory infiltrate) related to OLP, PV and MMP. After histological confirmation, OCT and histological diagnoses were compared. Using pre-determined patterns, OCT diagnoses of DGs were: 22 (51%) OLP, of which 11 (26%) were with the bullous variant, 4 (9%) PV and 6 (14%) MMP. The same diagnoses were found by histological investigations (with the main OCT discriminatory potential for the bullous variant of OLP). The concordance between the two diagnostic methods was confirmed by the Fisher exact test (p-value < 0.01). These specific OCT patterns show a diagnostic reliability in 100% of the cases investigated, suggesting their accuracy to support the complex diagnosis and management of immune-mediated DGs.

Personalized Medicine in Oral Oncology: Imaging Methods and Biological Markers to Support Diagnosis of Oral Squamous Cell Carcinoma (OSCC): A Narrative Literature Review

“…Briefly, confocal microscopy (CM) and optical coherence tomography (OCT) are based on an incident harmless laser source penetrating the epithelial layers. Then, an associated detector collects the backscattered co-planar or coherent light, respectively, thus allowing the digital rebuilding of virtual horizontal (in CM) or transversal (in OCT) sections of the tissue at a microscopic resolution [ 82 , 84 , 85 , 86 ].…”

Characteristics of Clinically Classified Oral Lichen Planus in Optical Coherence Tomography: A Descriptive Case-Series Study

“…These include EP integrity, EP thickness [ 29 , 46 ], the identifiability of the BM and the vascular network within the connective tissue [ 29 ], as well as the reflectivity of the EP and the LP, and the associated differentiability of the near-surface mucosal layers. Comparable morphographic patterns with fewer features have recently been proposed for erosive and bullous OLP in a study of OLP-related immune-mediated gingivitis [ 47 ]. By means of the results presented here, it becomes apparent that with the visualization of the intact or degenerated layered structure of the oral mucosa, the type as well as the progression of OLP can be specified more accurately in combination with the clinical appearance.…”

Site-Coded Oral Squamous Cell Carcinoma Evaluation by Optical Coherence Tomography (OCT): A Descriptive Pilot Study

“…The axial optical resolution in tissues is <10 μm and the lateral resolution is <7.5 μm, with a maximum scan width of 6 mm × 6 mm to a focal depth of ≈2 mm. For the OCT evaluation the same protocol (and limitations) detailed in our previous study [ 22 ] was applied. OCT evaluation was performed for each lesion and the most representative OCT images were archived.…”