Noninvasive imaging of oral neoplasia with a high‐resolution fiber‐optic microendoscope

Abstract

BackgroundThe purpose of this study was to evaluate the ability of high-resolution microendoscopy to image and quantify changes in cellular and architectural features seen in early oral neoplasia in vivo.MethodsA high-resolution microendoscope (HRME) was used to image intact, resected oral squamous carcinoma specimens. HRME images were reviewed and classified as non-neoplastic or neoplastic by expert clinicians. An algorithm based on quantitative morphologic features was also used to classify each image. Results were compared to the histopathologic diagnosis.ResultsHRME images were obtained from 141 sites in resected specimens from 13 patients. Subjective image interpretation yielded sensitivity and specificity of 85% to 90% and 80% to 85%, respectively, whereas the objective classification algorithm achieved sensitivity and specificity of 81% and 77%, respectively.ConclusionHigh-resolution microendoscopy of intact oral mucosa can provide images with sufficient detail to classify oral lesions by both subjective image interpretation and objective image analysis. © 2011 Wiley Periodicals, Inc. Head Neck, 2011

Axial response of high-resolution microendoscopy in scattering media

“…Thus it would appear that the effects of defocus shown here, in addition to the biodistribution of contrast agent, both enable HRME to effectively resolve cell nuclei within only the most superficial layers of the epithelium with minimal effect from out of focus light. Previous and future studies which quantify nuclear morphology for tissue classification [16,[26][27][28], should not be adversely affected by fluorescence from nuclei located deeper within the epithelium.…”

“…The simplicity, low cost, and real-time imaging performance of the HRME system have led to its use by several research groups in laboratory studies [11][12][13][14][15][16][17][18][19][20][21][22][23][24] and in vivo clinical investigations [25][26][27][28]. However, the imaging properties of the HRME system have not been fully characterized; in particular, the axial imaging range and sensitivity to out-of-focus light have to the best of our knowledge, not been quantitatively studied.…”

How Close Are We to Real Time Optical Margin Control in Head and Neck Oncologic Surgery?

“…This device has been utilized in gastroenterology applications to evaluate and screen for lesion of the esophagus [66,68] . Previously reported data has validated this device for the detection of head and neck squamous cell carcinoma (HNSCC) ex vivo, with a sensitivity and specificity of 98% and 92% respectively [69] .…”

Differential structured illumination microendoscopy for in vivo imaging of molecular contrast agents

“…When used in conjunction with contrast agents, high resolution microendoscopy (HRME) has shown promise to improve early detection of precancerous lesions based on changes in nuclear size, shape, and density (9)(10)(11)(12)(13)(14)(15). However, the coherent fiber optic bundles used in microendoscopes lack inherent optical sectioning capabilities (8); out-of-focus light generated in highly scattering tissues can result in poor image contrast that obscures cellular detail (16,17), which is particularly problematic in tissues with glandular epithelium, such as the breast, where microendoscopic images do not show sufficient contrast to differentiate between normal and neoplastic tissue (18).…”