Multispectral fluorescence imaging of human ovarian and fallopian tube tissue for early-stage cancer detection

Abstract

With early detection, 5-year survival rates for ovarian cancer exceed 90%, yet no effective early screening method exists. Emerging consensus suggests over 50% of the most lethal form of the disease originates in the fallopian tube. Twenty-eight women undergoing oophorectomy or debulking surgery provided informed consent for the use of surgical discard tissue samples for multispectral fluorescence imaging. Using multiple ultraviolet and visible excitation wavelengths and emissions bands, 12 fluorescence and 6 reflectance images of 47 ovarian and 31 fallopian tube tissue samples were recorded. After imaging, each sample was fixed, sectioned, and stained for pathological evaluation. Univariate logistic regression showed cancerous tissue samples had significantly lower intensity than noncancerous tissue for 17 image types. The predictive power of multiple image types was evaluated using multivariate logistic regression (MLR) and quadratic discriminant analysis (QDA). Two MLR models each using two image types had receiver operating characteristic curves with area under the curve exceeding 0.9. QDA determined 56 image type combinations with perfect resubstituting using as few as five image types. Adaption of the system for future in vivo fallopian tube and ovary endoscopic imaging is possible, which may enable sensitive detection of ovarian cancer with no exogenous contrast agents.

Ultraminiature optical design for multispectral fluorescence imaging endoscopes

“…[19][20][21][22][23][24][25] Laser sources are used for the endoscope prototype and are similar in central wavelength to those provided by a filtered xenon arc lamp in our previous MFI imaging study on ex vivo ovarian and fallopian tube tissue. 25 The ultraviolet and blue wavelengths efficiently excite the endogenous fluorophores. Sampling the blood absorption curve in reflectance mode with 375, 406, and 515 nm can also provide diagnostic utility.…”

“…Endogenous fluorescence differences among normal, benign, and cancerous ovarian tissues have been characterized both in vivo and ex vivo by investigators and others using fiber-optic probes [19][20][21][22] and widefield autofluorescence imaging. [23][24][25] Mutispectral fluorescence imaging (MFI) can image in both reflectance and fluorescence mode to either measure optical absorption or fluorescence emission, both of which can be an indicator of molecular changes (changes in concentration of hemoglobin or fluorophores) or to combine multiple reflectance images for pseudo-white-light imaging.…”

Bimodal reflectance and fluorescence multispectral endoscopy based on spectrally resolving detector arrays

“…Methods with a finer sampling of the spectral response, such as multi-or hyperspectral imaging (MSI/HSI) systems (≈10 and 100 spectral color channels, respectively), 12,13 may enable quantitative assessment of functional tissue properties and more detailed statistical classification of the spectral changes that occur during disease. The use of reflectance-based MSI/HSI systems in biomedical applications has, for example, been shown to increase contrast in vascular conditions, 14 wound healing, [15][16][17] ophthalmology, 15,18,19 cancer diagnostics, 12,[20][21][22][23] and for the determination of tumor resection margins. 24 The application of a targeted fluorescent contrast agent is often referred to as optical molecular imaging (OMI) and has shown promise for endoscopic cancer detection in the GI tract.…”

Optical coherence tomography in gynecology: a narrative review

“…26 It was shown that fluorescence imaging of human ovarian and fallopian tube tissue is promising for early cancer detection. 27 A combination of fluorescence-based techniques and OCT seems to provide additional benefits. [28][29][30] An endoscopic probe for the conjugation of OCT with wide-field falloposcopy 31 , as well as multimodal imaging of ovarian tissue using OCT and second-harmonic generation microscopy, was also reported.…”