Toward real-time virtual biopsy of oral lesions using confocal laser endomicroscopy interfaced with embedded computing

Abstract

Abstract. Oral lesions are conventionally diagnosed using white light endoscopy and histopathology. This can pose a challenge because the lesions may be difficult to visualise under white light illumination. Confocal laser endomicroscopy can be used for confocal fluorescence imaging of surface and subsurface cellular and tissue structures. To move toward real-time "virtual" biopsy of oral lesions, we interfaced an embedded computing system to a confocal laser endomicroscope to achieve a prototype three-dimensional (3-D) fluorescence imaging system. A field-programmable gated array computing platform was programmed to enable synchronization of cross-sectional image grabbing and Z-depth scanning, automate the acquisition of confocal image stacks and perform volume rendering. Fluorescence imaging of the human and murine oral cavities was carried out using the fluorescent dyes fluorescein sodium and hypericin. Volume rendering of cellular and tissue structures from the oral cavity demonstrate the potential of the system for 3-D fluorescence visualization of the oral cavity in real-time. We aim toward achieving a real-time virtual biopsy technique that can complement current diagnostic techniques and aid in targeted biopsy for better clinical outcomes.

Review of diverse optical fibers used in biomedical research and clinical practice

“…The use of optical fibers also enables a wide range of optical power levels at different wavelengths to be delivered to specific viewing or treatment areas in an oral cavity. [141][142][143][144][145][146] Conventional optical fibers can be used for procedures such as early dental caries detection, oral cavity and caries imaging, and discrimination of periodontitis and gingivitis from healthy gingiva. PCFs and conventional hollow-core fibers are commonly used for delivery of optical power from 1.06-μm Nd: YAG, 2.94-μm Er:YAG, and 10.6-μm CO 2 lasers for ablation of hard dental tissues.…”

Automated analysis of confocal laser endomicroscopy images to detect head and neck cancer

“…Similar to high‐resolution microendoscopy, CLE has problems with keratinizing areas . Here, it would probably help to improve the CLE technique or make an improvement by combining CLE with other optical imaging techniques that have deeper resolution . It was necessary to select appropriate CLE images offline for the automated analysis.…”

“…12,39 Here, it would probably help to improve the CLE technique or make an improvement by combining CLE with other optical imaging techniques that have deeper resolution. 34,40 It was necessary to select appropriate CLE images offline for the automated analysis. For application within the operating theater, the algorithm must be further developed to perform this selection fast and online.…”

Demons registration for in vivo and deformable laser scanning confocal endomicroscopy

“…Minimally invasive in vivo imaging of living tissue and cells can be achieved with the laser scanning confocal endomicroscope (LSCEM). 1 Since its advent, the LSCEM has been used in a wide range of applications to substitute for painful biopsy procedures. [2][3][4][5] Its confocal properties enable deep-sectional microscopic imaging achieved by capturing light signals that penetrate through the tissue surface to obtain a three-dimensional (3-D) dataset.…”