Multimodality approach to optical early detection and  mapping of oral neoplasia

Abstract

Abstract. Early detection of cancer remains the best way to ensure patient survival and quality of life. Squamous cell carcinoma is usually preceded by dysplasia presenting as white, red, or mixed red and white epithelial lesions on the oral mucosa (leukoplakia, erythroplakia). Dysplastic lesions in the form of erythroplakia can carry a risk for malignant conversion of 90%. A noninvasive diagnostic modality would enable monitoring of these lesions at regular intervals and detection of treatment needs at a very early, relatively harmless stage. The specific aim of this work was to test a multimodality approach [three-dimensional optical coherence tomography (OCT) and polarimetry] to noninvasive diagnosis of oral premalignancy and malignancy using the hamster cheek pouch model (nine hamsters). The results were compared to tissue histopathology. During carcinogenesis, epithelial down grow, eventual loss of basement membrane integrity, and subepithelial invasion were clearly visible with OCT. Polarimetry techniques identified a four to five times increased retardance in sites with squamous cell carcinoma, and two to three times greater retardance in dysplastic sites than in normal tissues. These techniques were particularly useful for mapping areas of field cancerization with multiple lesions, as well as lesion margins.C 2011 Society of Photo-Optical Instrumentation Engineers (SPIE).

Fluorescence lifetime imaging and reflectance confocal microscopy for multiscale imaging of oral precancer

“…12,20 The combination of large FOV imaging for macroscopic surveillance with high resolution imaging or point measurement techniques has the potential to improve diagnosis and diagnostic yield by guiding the effective point sampling technique to the site with the most advanced state of disease within a lesion or the oral cavity. 11,[21][22][23] Wide-field autofluorescence imaging instruments are commercially available for clinical oral cancer detection; of interest in epithelial precancer progression are collagen crosslinks in the stroma and metabolic cofactors nicotinamide adenine dinucleotide (NADH) and flavin adenine dinucleotide (FAD) in epithelial cells. Increased cellular metabolism in epithelial dysplasia results in an increase in NADH and FAD fluorescence signal; conversely, in inflammation, the epithelial cell fluorescence decreases slightly.…”

Open questions and novel concepts in oral cancer surgery

“…In the same direction, optical coherence tomography (OCT) [135][136][137] exploits light waves rather than sound with high resolution in the range of 2-10 lm. This advice provides high-resolution real-time three-dimensional visualization of tissue structure in a minimally invasive manner and seems effective in detecting mucosal abnormalities leading to OSCC.…”

A novel multimodal optical imaging system for early detection of oral cancer

“…A number of optical imaging modalities have been proposed to noninvasively differentiate between normal, premalignant and malignant lesions within the oral cavity [3-8]. Autofluorescence imaging has emerged as one of such techniques and it has shown promise and is used clinically [9-11].…”