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Kumar P, Rathod S, Pradhan A. Detection of oral mucosal lesions by the fluorescence spectroscopy and classification of cancerous stages by support vector machine. Lasers Med Sci 2024; 39:42. [PMID: 38240832 DOI: 10.1007/s10103-024-03995-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 01/12/2024] [Indexed: 01/23/2024]
Abstract
Detection of oral mucosal lesions has been performed by an in-house developed fluorescence-based portable device in the present study. A laser diode of 405 nm wavelength and a UV-visible spectrometer are utilized in the portable device as excitation and detection sources. At the 405 nm excitation wavelength, the flavin adenine dinucleotide (FAD) band at 500 nm and three porphyrin bands at 634, 676, and 703 nm are observed in the fluorescence spectrum of the oral cavity tissue. We have conducted this clinical study on a total of 189 tissue sites of 36 oral squamous cell carcinoma (OSCC) patients, 18 dysplastic (precancerous) patients, and 34 volunteers. Analysis of the fluorescence data has been performed by using the principal component analysis (PCA) method and support vector machine (SVM) classifier. PCA is applied first in the spectral data to reduce the dimension, and then classification among the three groups has been executed by employing the SVM. The SVM classifier includes linear, radial basis function (RBF), polynomial, and sigmoid kernels, and their classification efficacies are computed. Linear and RBF kernels on the testing data sets differentiated OSCC and dysplasia to normal with an accuracy of 100% and OSCC to dysplasia with an accuracy of 95% and 97%, respectively. Polynomial and sigmoid kernels showed less accuracy values among the groups ranging from 48 to 88% and 51 to 100%, respectively. The result indicates that fluorescence spectroscopy and the SVM classifier can help to identify early oral mucosal lesions with significant high accuracy.
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Affiliation(s)
- Pavan Kumar
- Faculty of Engineering and Technology (FEAT), Datta Meghe Institute of Higher Education and Research (DMIHER), Wardha, 442001, India.
- Department of Physics, Indian Institute of Technology Kanpur (IITK), Kanpur, 208016, India.
| | - Shashikant Rathod
- Faculty of Engineering and Technology (FEAT), Datta Meghe Institute of Higher Education and Research (DMIHER), Wardha, 442001, India
- Department of Instrumentation and Control Engineering, COEP Technological University, Pune, 445001, India
| | - Asima Pradhan
- Department of Physics, Indian Institute of Technology Kanpur (IITK), Kanpur, 208016, India
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Piriou M, Lorenzo C, Raymond-Letron I, Coronas-Dupuis S, Pieruccioni L, Rouquette J, Guissard C, Chaumont J, Casteilla L, Planat-Benard V, Kemoun P, Monsarrat P. A Spectral Principal Component Analysis-Based Framework for Composite Hard/Soft Tissue Fluorescence Image Investigation. Front Physiol 2022; 13:899626. [PMID: 35910575 PMCID: PMC9325997 DOI: 10.3389/fphys.2022.899626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 06/06/2022] [Indexed: 11/25/2022] Open
Abstract
Traditional thin sectioning microscopy of large bone and dental tissue samples using demineralization may disrupt structure morphologies and even damage soft tissues, thus compromising the histopathological investigation. Here, we developed a synergistic and original framework on thick sections based on wide-field multi-fluorescence imaging and spectral Principal Component Analysis (sPCA) as an alternative, fast, versatile, and reliable solution, suitable for highly mineralized tissue structure sustain and visualization. Periodontal 2-mm thick sections were stained with a solution containing five fluorescent dyes chosen for their ability to discriminate close tissues, and acquisitions were performed with a multi-zoom macroscope for blue, green, red, and NIR (near-infrared) emissions. Eigen-images derived from both standard scaler (Std) and Contrast Limited Adaptive Histogram Equalization (Clahe) pre-preprocessing significantly enhanced tissue contrasts, highly suitable for histopathological investigation with an in-depth detail for sub-tissue structure discrimination. Using this method, it is possible to preserve and delineate accurately the different anatomical/morphological features of the periodontium, a complex tooth-supporting multi-tissue. Indeed, we achieve characterization of gingiva, alveolar bone, cementum, and periodontal ligament tissues. The ease and adaptability of this approach make it an effective method for providing high-contrast features that are not usually available in standard staining histology. Beyond periodontal investigations, this first proof of concept of an sPCA solution for optical microscopy of complex structures, especially including mineralized tissues opens new perspectives to deal with other chronic diseases involving complex tissue and organ defects. Overall, such an imaging framework appears to be a novel and convenient strategy for optical microscopy investigation.
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Affiliation(s)
- Marie Piriou
- Dental Faculty and Hospital of Toulouse—Toulouse Institute of Oral Medicine and Science, CHU de Toulouse, Toulouse, France
| | - Corinne Lorenzo
- Restore Research Center, Université de Toulouse, INSERM 1301, CNRS 5070, EFS, ENVT, Toulouse, France
| | - Isabelle Raymond-Letron
- Restore Research Center, Université de Toulouse, INSERM 1301, CNRS 5070, EFS, ENVT, Toulouse, France
- LabHPEC, Université de Toulouse, ENVT (Ecole Nationale Vétérinaire de Toulouse), Toulouse, France
| | - Sophie Coronas-Dupuis
- Restore Research Center, Université de Toulouse, INSERM 1301, CNRS 5070, EFS, ENVT, Toulouse, France
- LabHPEC, Université de Toulouse, ENVT (Ecole Nationale Vétérinaire de Toulouse), Toulouse, France
| | - Laetitia Pieruccioni
- Restore Research Center, Université de Toulouse, INSERM 1301, CNRS 5070, EFS, ENVT, Toulouse, France
| | - Jacques Rouquette
- Restore Research Center, Université de Toulouse, INSERM 1301, CNRS 5070, EFS, ENVT, Toulouse, France
| | - Christophe Guissard
- Dental Faculty and Hospital of Toulouse—Toulouse Institute of Oral Medicine and Science, CHU de Toulouse, Toulouse, France
- Restore Research Center, Université de Toulouse, INSERM 1301, CNRS 5070, EFS, ENVT, Toulouse, France
| | - Jade Chaumont
- Dental Faculty and Hospital of Toulouse—Toulouse Institute of Oral Medicine and Science, CHU de Toulouse, Toulouse, France
| | - Louis Casteilla
- Restore Research Center, Université de Toulouse, INSERM 1301, CNRS 5070, EFS, ENVT, Toulouse, France
| | - Valérie Planat-Benard
- Restore Research Center, Université de Toulouse, INSERM 1301, CNRS 5070, EFS, ENVT, Toulouse, France
| | - Philippe Kemoun
- Dental Faculty and Hospital of Toulouse—Toulouse Institute of Oral Medicine and Science, CHU de Toulouse, Toulouse, France
- Restore Research Center, Université de Toulouse, INSERM 1301, CNRS 5070, EFS, ENVT, Toulouse, France
| | - Paul Monsarrat
- Dental Faculty and Hospital of Toulouse—Toulouse Institute of Oral Medicine and Science, CHU de Toulouse, Toulouse, France
- Restore Research Center, Université de Toulouse, INSERM 1301, CNRS 5070, EFS, ENVT, Toulouse, France
- Artificial and Natural Intelligence Toulouse Institute ANITI, Toulouse, France
- *Correspondence: Paul Monsarrat,
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Mendonca P, Sunny SP, Mohan U, Birur N P, Suresh A, Kuriakose MA. Non-invasive imaging of oral potentially malignant and malignant lesions: A systematic review and meta-analysis. Oral Oncol 2022; 130:105877. [PMID: 35617750 DOI: 10.1016/j.oraloncology.2022.105877] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 04/09/2022] [Accepted: 04/18/2022] [Indexed: 12/19/2022]
Abstract
Non-invasive (NI) imaging techniques have been developed to overcome the limitations of invasive biopsy procedures, which is the gold standard in diagnosis of oral dysplasia and Oral Squamous Cell Carcinoma (OSCC). This systematic review and meta- analysis was carried out with an aim to investigate the efficacy of the NI-imaging techniques in the detection of dysplastic oral potentially malignant disorders (OPMDs) and OSCC. Records concerned in the detection of OPMDs, Oral Cancer were identified through search in PubMed, Science direct, Cochrane Library electronic database (January 2000 to October 2020) and additional manual searches. Out of 529 articles evaluated for eligibility, 56 satisfied the pre-determined inclusion criteria, including 13 varying NI-imaging techniques. Meta-analysis consisted 44 articles, wherein majority of the studies reported Autofluorescence (AFI-38.6%) followed by Chemiluminescence (CHEM), Narrow Band Imaging (NBI) (CHEM, NBI-15.9%), Fluorescence Spectroscopy (FS), Diffuse Reflectance Spectroscopy (DRS), (FS, DRS-13.6%) and 5aminolevulinic acid induced protoporphyrin IX fluorescence (5ALA induced PPIX- 6.8%). Higher sensitivities (Sen) and specificities (Spe) were obtained using FS (Sen:74%, Spe:96%, SAUC=0.98), DRS (Sen:79%, Spe:86%, SAUC = 0.91) and 5 ALA induced PPIX (Sen:91%, Spe:78%, SAUC = 0.98) in the detection of dysplastic OPMDs from non-dysplastic lesions(NDLs). AFI, FS, DRS, NBI showed higher sensitivities and SAUC (>90%) in differentiating OSCC from NDLs. Analysed NI-imaging techniques suggests the higher accuracy levels in the diagnosis of OSCC when compared to dysplastic OPMDs. 5 ALA induced PPIX, DRS and FS showed evidence of superior accuracy levels in differentiation of dysplastic OPMDs from NDLs, however results need to be validated in a larger number of studies.
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Affiliation(s)
- Pramila Mendonca
- Department of Head and Neck Surgical Oncology, Mazumdar Shaw Medical Center, NH Health City, Bangalore 99, India; Integrated Head and Neck Oncology Program, Mazumdar Shaw Medical Foundation, Narayana Health City, Bangalore 99, India.
| | - Sumsum P Sunny
- Department of Head and Neck Surgical Oncology, Mazumdar Shaw Medical Center, NH Health City, Bangalore 99, India; Integrated Head and Neck Oncology Program, Mazumdar Shaw Medical Foundation, Narayana Health City, Bangalore 99, India; Manipal Academy of Higher Education, Manipal, Karnataka, India.
| | - Uma Mohan
- Department of Head and Neck Surgical Oncology, Mazumdar Shaw Medical Center, NH Health City, Bangalore 99, India; Integrated Head and Neck Oncology Program, Mazumdar Shaw Medical Foundation, Narayana Health City, Bangalore 99, India.
| | - Praveen Birur N
- KLE Society's Institute of Dental Sciences, #20, Yeshwanthpur Suburb, II Stage, Tumkur Road, Bangalore 22, India.
| | - Amritha Suresh
- Integrated Head and Neck Oncology Program, Mazumdar Shaw Medical Foundation, Narayana Health City, Bangalore 99, India; Manipal Academy of Higher Education, Manipal, Karnataka, India.
| | - Moni A Kuriakose
- Department of Head and Neck Surgical Oncology, Mazumdar Shaw Medical Center, NH Health City, Bangalore 99, India; Integrated Head and Neck Oncology Program, Mazumdar Shaw Medical Foundation, Narayana Health City, Bangalore 99, India.
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Nazeer SS, Sreedevi TP, Jayasree RS. Autofluorescence spectroscopy and multivariate analysis for predicting the induced damages to other organs due to liver fibrosis. SPECTROCHIMICA ACTA. PART A, MOLECULAR AND BIOMOLECULAR SPECTROSCOPY 2021; 257:119741. [PMID: 33872953 DOI: 10.1016/j.saa.2021.119741] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 03/17/2021] [Accepted: 03/19/2021] [Indexed: 06/12/2023]
Abstract
When our liver does not work well, it can induce damage to other organs causing their dysfunction. With this background, we aim to study the effect of liver fibrosis on other organs such as heart, lungs, kidney and spleen by assessing the variations in the inherent emission property of the tissue, using fluorescence spectroscopy. Fluorescence emission spectra from excised organs of liver fibrosis induced rats were collected at excitation wavelengths 320 and 410 nm. Optical redox ratio derived from the spectral data supported by multivariate statistical analysis, principal component analysis followed by linear discriminant analysis (PCA-LDA) distinguished between control and fibrosis induced groups. The two different excitation wavelength provided variations in the endogenous flurophores collagen, nicotinamide adenine dinucleotide (NADH), flavin adenine dinucleotide (FAD), lipopigments and porphyrins. Additionally, evaluation of redox ratio provided variations in tissue metabolic activity of different organs. The PCA-LDA modelling yielded a sensitivity of 85 to 97% and specificity of 80 to 96% on 320 nm excitation and a sensitivity of 72 to 100% and specificity of 59 to 100% on 410 nm excitation. Fluorescence emission spectral study along with multivariate analysis paved way to identify the biochemical alterations caused to other organs due to the development of liver fibrosis, which could lead to their damage and dysfunction.
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Affiliation(s)
- Shaiju S Nazeer
- Department of Chemistry, Indian Institute of Space Sciences and Technology, Thiruvananthapuram, Kerala, India; Division of Biophotonics and Imaging, Biomedical Technology Wing, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India
| | - T P Sreedevi
- Department of Optoelectronics and Communication, Thangal Kunju Musaliar Institute of Technology, Kollam, Kerala, India
| | - Ramapurath S Jayasree
- Division of Biophotonics and Imaging, Biomedical Technology Wing, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India.
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Ramesh S, Nazeer SS, Thomas S, Vivek V, Jayasree RS. Optical diagnosis of oral lichen planus: A clinical study on the use of autofluorescence spectroscopy combined with multivariate analysis. SPECTROCHIMICA ACTA. PART A, MOLECULAR AND BIOMOLECULAR SPECTROSCOPY 2021; 248:119240. [PMID: 33310275 DOI: 10.1016/j.saa.2020.119240] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 11/03/2020] [Accepted: 11/14/2020] [Indexed: 06/12/2023]
Abstract
Oral lichen planus (OLP) is a chronic mucocutaneous inflammatory condition of stratified squamous epithelia. OLP is a potentially malignant condition in oral mucosa. Patients with OLP have an increased risk of developing squamous cell carcinoma. Therefore an early and accurate diagnosis is necessary to avoid further damage to the oral mucosa. Biopsy followed by histopathological examination is the gold standard for the diagnosis of oral mucosal lesions including OLP. But this invasive procedure is traumatic and time consuming with limited statistical confidence level. Autofluorescence spectroscopy (AFS) has recently emerged as a potential tool to evaluate the biochemical changes associated with oral cavity disorders. In this study, we used AFS to differentiate the oral cavity tissue of 20 OLP patients from that of 16 normal volunteers. Spectra from oral mucosa were acquired at 280, 320 and 410 nm excitation wavelengths which correspond to the excitation energy of major endogenous fluorophores. Normalized spectral data at 320 nm excitation showed significant increase in the intensity of collagen peak for OLP. Optical redox ratio and total hemoglobin concentration estimated from the spectral data revealed significant increase and decrease respectively in OLP and normal patients. Principal component analysis followed by linear discriminant analysis (PCA-LDA) provided sensitivity and specificity of 71 and 80%, 80 and 90%, and 72 and 75% respectively for 280, 320 and 410 nm excited spectral datasets. Meanwhile, partial least square discriminant analysis (PLS-DA) provided sensitivity and specificity of 69 and 77%, 78 and 91% and 73 and 78.13% respectively for 280, 320 and 410 nm excited spectral datasets. From the results, it is concluded that AFS is an efficient tool for the non invasive diagnosis of OLP, with 320 nm light identified as the best wavelength for excitation.
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Affiliation(s)
- S Ramesh
- Department of Oral Medicine and Radiology, PMS College of Dental Sciences and Research, Trivandrum, Kerala, India; Department of Oral Medicine and Radiology, Government Dental College, Trivandrum, Kerala, India
| | - Shaiju S Nazeer
- Department of Chemistry, Indian Institute of Space Sciences and Technology, Trivandrum, Kerala, India; Division of Biophotonics and Imaging, Biomedical Technology Wing, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Kerala, India
| | - Sunila Thomas
- Department of Oral Medicine and Radiology, PMS College of Dental Sciences and Research, Trivandrum, Kerala, India
| | - V Vivek
- Department of Oral Medicine and Radiology, PMS College of Dental Sciences and Research, Trivandrum, Kerala, India
| | - Ramapurath S Jayasree
- Division of Biophotonics and Imaging, Biomedical Technology Wing, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Kerala, India.
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6
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Diagnostic accuracy of clinical visualization and light-based tests in precancerous and cancerous lesions of the oral cavity and oropharynx: a systematic review and meta-analysis. Clin Oral Investig 2021; 25:4145-4159. [PMID: 33392809 DOI: 10.1007/s00784-020-03746-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 12/15/2020] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Evaluate and compare the performance of autofluorescence, chemiluminescence, and clinical visual examination in the detection of oral potentially malignant disorders (OPMD), oral cancer (OC), and oropharyngeal cancer (OPC). MATERIALS AND METHODS A systematic review with meta-analysis based on diagnostic test studies. A literature search was carried out in the MEDLINE and EMBASE databases through August 30, 2020. For this review, the quality assessment tool of diagnostic precision studies (QUADAS-2) was used. Hierarchical regression models were used to estimate pooled diagnostic precision values in a random effects model. RESULTS A total of 40 studies were identified for this review according to each test evaluated: 5.562 samples for autofluorescence, 1.353 samples for chemiluminescence, and 1.892 samples for clinical examination. The summary measures sensitivity and specificity of the clinical examination were 63% and 78%, respectively, AUC = 0.78 95% CI (0.74-0.81). In the autofluorescence test, these were 86% and 72%, respectively, AUC = 0.86 95% CI (0.83-0.89); and the chemiluminescent test were 67% and 48%, respectively, AUC = 0.59 95% CI (0.54-0.63) CONCLUSIONS: Autofluorescence devices displayed superior accuracy levels in the identification of premalignant lesions and early neoplastic changes compared to clinical examination and chemiluminescent test. Overall, biopsy remains the gold standard for the definitive diagnosis of OPMD, OC, and OPC. CLINICAL RELEVANCE Light-based clinical methods such as autofluorescence and chemiluminescence techniques have been used in clinical diagnosis for the differentiation of OPMD and malignant and benign lesions; although detailed visual examination appears to be effective in identifying, previous systematic reviews have not evaluated a relevant number of studies and they did not evaluate the accuracy of the clinical examination.
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Nair RV, Nair LV, Govindachar DM, Santhakumar H, Nazeer SS, Rekha CR, Shenoy SJ, Periyasamy G, Jayasree RS. Luminescent Gold Nanorods To Enhance the Near‐Infrared Emission of a Photosensitizer for Targeted Cancer Imaging and Dual Therapy: Experimental and Theoretical Approach. Chemistry 2020; 26:2826-2836. [DOI: 10.1002/chem.201904952] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Indexed: 11/11/2022]
Affiliation(s)
- Resmi V. Nair
- Sree Chitra Tirunal Institute for Medical Sciences and Technology Thiruvananthapuram 695012 India
| | - Lakshmi V. Nair
- Sree Chitra Tirunal Institute for Medical Sciences and Technology Thiruvananthapuram 695012 India
- Present Address: School of Materials Science & Engineering National Institute of Technology Calicut, Kozhikode 673601 Kerala India
| | | | - Hema Santhakumar
- Sree Chitra Tirunal Institute for Medical Sciences and Technology Thiruvananthapuram 695012 India
| | - Shaiju S. Nazeer
- Sree Chitra Tirunal Institute for Medical Sciences and Technology Thiruvananthapuram 695012 India
- Present Address: Department of Chemistry University of Alabama at Birmingham Birmingham AL 35205 USA
| | | | - Sachin J. Shenoy
- Sree Chitra Tirunal Institute for Medical Sciences and Technology Thiruvananthapuram 695012 India
| | - Ganga Periyasamy
- Department of Chemistry Bangalore University Bangalore 560 056 India
| | - Ramapurath S. Jayasree
- Sree Chitra Tirunal Institute for Medical Sciences and Technology Thiruvananthapuram 695012 India
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Abstract
The spatiotemporal determination of molecular events and cells is important for understanding disease processes, especially in oncology, and thus for the development of novel treatments. Equally important is the knowledge of the biodistribution, localization, and targeted accumulation of novel therapies as well as monitoring of tumor growth and therapeutic response. Optical imaging provides an ideal versatile platform for imaging of all these problems and questions.
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Borse V, Konwar AN, Buragohain P. Oral cancer diagnosis and perspectives in India. SENSORS INTERNATIONAL 2020; 1:100046. [PMID: 34766046 PMCID: PMC7515567 DOI: 10.1016/j.sintl.2020.100046] [Citation(s) in RCA: 119] [Impact Index Per Article: 29.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 09/19/2020] [Accepted: 09/19/2020] [Indexed: 01/05/2023] Open
Abstract
Globally, oral cancer is the sixth most common type of cancer with India contributing to almost one-third of the total burden and the second country having the highest number of oral cancer cases. Oral squamous cell carcinoma (OSCC) dominates all the oral cancer cases with potentially malignant disorders, which is also recognized as a detectable pre-clinical phase of oral cancer. Tobacco consumption including smokeless tobacco, betel-quid chewing, excessive alcohol consumption, unhygienic oral condition, and sustained viral infections that include the human papillomavirus are some of the risk aspects for the incidence of oral cancer. Lack of knowledge, variations in exposure to the environment, and behavioral risk factors indicate a wide variation in the global incidence and increases the mortality rate. This review describes various risk factors related to the occurrence of oral cancer, the statistics of the distribution of oral cancer in India by various virtues, and the socio-economic positions. The various conventional diagnostic techniques used routinely for detection of the oral cancer are discussed along with advanced techniques. This review also focusses on the novel techniques developed by Indian researchers that have huge potential for application in oral cancer diagnosis.
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Affiliation(s)
- Vivek Borse
- NanoBioSens Lab, Centre for Nanotechnology, Indian Institute of Technology Guwahati, Guwahati, 781 039, Assam, India
| | - Aditya Narayan Konwar
- NanoBioSens Lab, Centre for Nanotechnology, Indian Institute of Technology Guwahati, Guwahati, 781 039, Assam, India
| | - Pronamika Buragohain
- NanoBioSens Lab, Centre for Nanotechnology, Indian Institute of Technology Guwahati, Guwahati, 781 039, Assam, India
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Giovannacci I, Magnoni C, Vescovi P, Painelli A, Tarentini E, Meleti M. Which are the main fluorophores in skin and oral mucosa? A review with emphasis on clinical applications of tissue autofluorescence. Arch Oral Biol 2019; 105:89-98. [PMID: 31299549 DOI: 10.1016/j.archoralbio.2019.07.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 07/01/2019] [Accepted: 07/02/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVES The present review provides information about which molecules appear to be the main fluorophores in skin and oral mucosa, together with their clinical applications. DESIGN The MEDLINE database was searched, using "oral mucosa AND fluorophores", "skin AND fluorophores", "epidermal AND fluorophores", "dermal AND fluorophores" and "cutaneous AND fluorophores" as entry terms. We searched the literature following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The level of evidence in the studies was assessed using the Classification of the Oxford Centre for Evidence-based Medicine (CEBM) Levels for Diagnosis. RESULTS Five papers and 17 were primarily focused on description of fluorophores in oral mucosa and skin Evidence exists that fluorophores of oral mucosa and skin are mainly proteins such as collagen, elastin, keratin and tryptophan. Other possible fluorophores identified are: porphyrins, advanced glycation end products, flavins, lipopigment, nicotinamide adenine dinucleotide, flavin adenine dinucleotide, pheomelanin, eumelanin and components of lipofuscin. Clinical applications of oral mucosal autofluorescence (AF) are related to management of malignant and potentially malignant lesions. In the skin, AF has been used for acne assessment, diagnosis of sweat-gland pathologies, glycemic control and management of malignant lesions and as a marker for skin aging. CONCLUSION Fluorophores stimulated through AF devices are implied in different physiologic and pathologic processes. AF seems to be useful for several clinical applications, especially in skin department. Because most of the studies show a low level of evidence, further studies are necessary in such a promising and fascinating field.
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Affiliation(s)
- I Giovannacci
- Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy.
| | - C Magnoni
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - P Vescovi
- Centro Universitario di Odontoiatria, Department of Medicine and Surgery, Oral Medicine and Laser Surgery Unit, University of Parma, Parma, Italy
| | - A Painelli
- Department of Chemistry, Life Science and Environmental Sustainability, University of Parma, Parma, Italy
| | - E Tarentini
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - M Meleti
- Centro Universitario di Odontoiatria, Department of Medicine and Surgery, Oral Medicine and Laser Surgery Unit, University of Parma, Parma, Italy
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In vivo detection of oral precancer using a fluorescence-based, in-house-fabricated device: a Mahalanobis distance-based classification. Lasers Med Sci 2019; 34:1243-1251. [PMID: 30659473 DOI: 10.1007/s10103-019-02720-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Accepted: 01/10/2019] [Indexed: 02/04/2023]
Abstract
In vivo detection of oral precancer has been carried out by a fluorescence-based, in-house-developed handheld probe on three groups: oral squamous cell carcinoma (OSCC), dysplastic (precancer), and control (normal). Measurements have been performed on a total of 141 patients and volunteers of different age groups. Excitation wavelength of 405 nm was used and fluorescence emission spectra were recorded in the scan range of 450.14 to 763.41 nm at very low incident power (122 μW) from different oral sites buccal mucosa (BM), lateral boarder of tongue (LBT), and dorsal surface of tongue (DST). Spectral profiles are found to vary among the three groups as well as among the different oral sites. Major and minor bands of flavin adenine dinucleotide (FAD) and porphyrins near 500, 634, 676, 689, and 703 nm have been obtained. Porphyrin contribution is found to be more dominant than the FAD in OSCC and dysplastic groups as compared to the control group. A better classification has been observed using the entire spectral range rather than restricting to individual bands, by application of principal component analysis (PCA), Mahalanobis distance model, and receiver operating characteristic analysis (ROC). ROC on Mahalanobis distance differentiates OSCC to normal, dysplastic to normal, and OSCC to dysplastic with sensitivities from 71% to 98%, 92% to 94% and 81% to 93% and specificities 91% to 100%, 86% to 100% and 79% to 97% for oral sites BM, LBT and DST. LBT and DST appear to be more sensitive to dysplasia detection as compared to BM.
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Swami MK, Gupta PK. Optical Spectroscopy for Biomedical Diagnosis. PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES INDIA SECTION A-PHYSICAL SCIENCES 2018. [DOI: 10.1007/s40010-018-0519-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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13
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Nazeer SS, Saraswathy A, Shenoy SJ, Jayasree RS. Fluorescence spectroscopy as an efficient tool for staging the degree of liver fibrosis: an in vivo comparison with MRI. Sci Rep 2018; 8:10967. [PMID: 30030510 PMCID: PMC6054616 DOI: 10.1038/s41598-018-29370-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Accepted: 07/06/2018] [Indexed: 12/20/2022] Open
Abstract
The study utilizes autofluorescence spectroscopy (AFS) along with multivariate spectral analysis for differentiating various stages of hepatic fibrosis. AFS has recently emerged as an efficient tool for evaluating the variations in different endogenous flurophores. In this study, the potential of AFS for differentiating the stages of liver fibrosis is assessed and compared with the results of enzyme evaluation, histopathology and the most advanced diagnostic tool, MRI. Using a fiber optic probe, the emission profile of the flurophores such as flavin adenine dinucleotide (FAD), lipofuscin-like lipopigments (lipopigments), porphyrins and the variation in the total hemoglobin concentration are evaluated in vivo on liver fibrosis induced animal models adopting a minimally invasive technique. Significant difference (p < 0.05) in the level of these biomarkers was observed between different stages of liver fibrosis. Normal hepatic tissue could be distinguished from mild and moderate hepatic fibrosis with a sensitivity of 95 to 100% and specificity of 90 to 100% using multivariate spectral analysis. The results are favourable to consider this technique as a potential tool for diagnosing liver fibrosis at an early stage, which is monumental as it otherwise can lead to cirrhosis and liver failure.
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Affiliation(s)
- Shaiju S Nazeer
- Division of Biophotonics and Imaging, Biomedical Technology Wing Sree Chitra Tirunal Institute for Medical Sciences & Technology, Poojappura, Thiruvananthapuram, 695 012, Kerala, India.,Department of Pathology, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Ariya Saraswathy
- Division of Biophotonics and Imaging, Biomedical Technology Wing Sree Chitra Tirunal Institute for Medical Sciences & Technology, Poojappura, Thiruvananthapuram, 695 012, Kerala, India.,Department of Physics, NSS College, Pandalam, Kerala, India
| | - Sachin J Shenoy
- Division of In Vivo Models and Testing, Biomedical Technology Wing Sree Chitra Tirunal Institute for Medical Sciences & Technology, Poojappura, Thiruvananthapuram, 695 012, Kerala, India
| | - Ramapurath S Jayasree
- Division of Biophotonics and Imaging, Biomedical Technology Wing Sree Chitra Tirunal Institute for Medical Sciences & Technology, Poojappura, Thiruvananthapuram, 695 012, Kerala, India.
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14
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Jing Y, Wang Y, Wang X, Song C, Ma J, Xie Y, Fei Y, Zhang Q, Mi L. Label-free imaging and spectroscopy for early detection of cervical cancer. JOURNAL OF BIOPHOTONICS 2018; 11:e201700245. [PMID: 29205885 DOI: 10.1002/jbio.201700245] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Accepted: 11/28/2017] [Indexed: 05/20/2023]
Abstract
The label-free imaging and spectroscopy method was studied on cervical unstained tissue sections obtained from 36 patients. The native fluorescence spectra of tissues are analyzed by the optical redox ratio (ORR), which is defined as fluorescence intensity ratio between NADH and FAD, and indicates the metabolism change with the cancer development. The ORRs of normal tissues are consistently higher than those of precancer or cancerous tissues. A criterion line of ORR at 5.0 can be used to discriminate cervical precancer/cancer from normal tissues. The sensitivity and specificity of the native fluorescence spectroscopy method for cervical cancer diagnosis are determined as 100% and 91%. Moreover, the native fluorescence spectroscopy study is much more sensitive on the healthy region of cervical precancer/cancer patients compared with the traditional clinical staining method. The results suggest label-free imaging and spectroscopy is a fast, highly sensitive and specific method on the detection of cervical cancer.
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Affiliation(s)
- Yueyue Jing
- Department of Optical Science and Engineering, Key Laboratory of Micro and Nano Photonic Structures (Ministry of Education), Shanghai Engineering Research Center of Ultra-Precision Optical Manufacturing, Green Photoelectron Platform, Fudan University, Shanghai, China
| | - Yulan Wang
- Department of Gynecology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Xinyi Wang
- Department of Optical Science and Engineering, Key Laboratory of Micro and Nano Photonic Structures (Ministry of Education), Shanghai Engineering Research Center of Ultra-Precision Optical Manufacturing, Green Photoelectron Platform, Fudan University, Shanghai, China
| | - Chuan Song
- Department of Optical Science and Engineering, Key Laboratory of Micro and Nano Photonic Structures (Ministry of Education), Shanghai Engineering Research Center of Ultra-Precision Optical Manufacturing, Green Photoelectron Platform, Fudan University, Shanghai, China
| | - Jiong Ma
- Department of Optical Science and Engineering, Key Laboratory of Micro and Nano Photonic Structures (Ministry of Education), Shanghai Engineering Research Center of Ultra-Precision Optical Manufacturing, Green Photoelectron Platform, Fudan University, Shanghai, China
| | - Yonghui Xie
- Department of Pathology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yiyan Fei
- Department of Optical Science and Engineering, Key Laboratory of Micro and Nano Photonic Structures (Ministry of Education), Shanghai Engineering Research Center of Ultra-Precision Optical Manufacturing, Green Photoelectron Platform, Fudan University, Shanghai, China
| | - Qinghua Zhang
- Department of Gynecology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Lan Mi
- Department of Optical Science and Engineering, Key Laboratory of Micro and Nano Photonic Structures (Ministry of Education), Shanghai Engineering Research Center of Ultra-Precision Optical Manufacturing, Green Photoelectron Platform, Fudan University, Shanghai, China
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15
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Maciel VH, Correr WR, Kurachi C, Bagnato VS, da Silva Souza C. Fluorescence spectroscopy as a tool to in vivo discrimination of distinctive skin disorders. Photodiagnosis Photodyn Ther 2017; 19:45-50. [DOI: 10.1016/j.pdpdt.2017.03.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Revised: 02/19/2017] [Accepted: 03/26/2017] [Indexed: 10/19/2022]
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16
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Shaikh R, Prabitha VG, Dora TK, Chopra S, Maheshwari A, Deodhar K, Rekhi B, Sukumar N, Krishna CM, Subhash N. A comparative evaluation of diffuse reflectance and Raman spectroscopy in the detection of cervical cancer. JOURNAL OF BIOPHOTONICS 2017; 10:242-252. [PMID: 26929106 DOI: 10.1002/jbio.201500248] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2015] [Revised: 01/13/2016] [Accepted: 01/25/2016] [Indexed: 05/09/2023]
Abstract
Optical spectroscopic techniques show improved diagnostic accuracy for non-invasive detection of cervical cancers. In this study, sensitivity and specificity of two in vivo modalities, i.e diffuse reflectance spectroscopy (DRS) and Raman spectroscopy (RS), were compared by utilizing spectra recorded from the same sites (67 tumor (T), 22 normal cervix (C), and 57 normal vagina (V)). Data was analysed using principal component - linear discriminant analysis (PC-LDA), and validated using leave-one-out-cross-validation (LOOCV). Sensitivity, specificity, positive predictive value and negative predictive value for classification between normal (N) and tumor (T) sites were 91%, 96%, 95% and 93%, respectively for RS and 85%, 95%, 93% and 88%, respectively for DRS. Even though DRS revealed slightly lower diagnostic accuracies, owing to its lower cost and portability, it was found to be more suited for cervical cancer screening in low resource settings. On the other hand, RS based devices could be ideal for screening patients with centralised facilities in developing countries.
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Affiliation(s)
- Rubina Shaikh
- Chilakapati Laboratory, ACTREC, Kharghar, Navi Mumbai, 410210, India
| | - Vasumathi G Prabitha
- Biophotonics Laboratory, National Centre for Earth Science Studies, Akkulam, Thiruvananthapuram, 695 031, Kerala, India
| | - Tapas Kumar Dora
- Tata Memorial Center, Radiation Oncology, ACTREC, Kharghar, Navi Mumbai, 410210, India
| | - Supriya Chopra
- Tata Memorial Center, Radiation Oncology, ACTREC, Kharghar, Navi Mumbai, 410210, India
| | - Amita Maheshwari
- Tata Memorial Hospital, Gynecology Oncology, Parel, Mumbai, 400012, India
| | - Kedar Deodhar
- Tata Memorial Hospital, Surgical Pathology, Cytopathology, Parel, Mumbai, 400012, India
| | - Bharat Rekhi
- Tata Memorial Hospital, Surgical Pathology, Cytopathology, Parel, Mumbai, 400012, India
| | - Nita Sukumar
- Biophotonics Laboratory, National Centre for Earth Science Studies, Akkulam, Thiruvananthapuram, 695 031, Kerala, India
| | - C Murali Krishna
- Chilakapati Laboratory, ACTREC, Kharghar, Navi Mumbai, 410210, India
| | - Narayanan Subhash
- Sascan Meditech Pvt Ltd, Centre for Innovation in Medical Electronics, BMS College of Engineering, Basavanagudi, Bangalore, 560019, India
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17
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Ebenezar J, Aruna PR, Ganesan S. Native fluorescence spectroscopic characterization of DMBA induced carcinogenesis in mice skin for the early detection of tissue transformation. Analyst 2015; 140:4170-81. [DOI: 10.1039/c4an00650j] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The objective of the study is to characterize the endogenous porphyrin fluorescence in a dimethylbenz(a)anthracene (DMBA) induced mouse skin tumor model using native fluorescence emission and excitation spectroscopy.
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18
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Nazeer SS, Sandhyamani S, Jayasree RS. Optical diagnosis of the progression and reversal of CCl4-induced liver injury in rodent model using minimally invasive autofluorescence spectroscopy. Analyst 2015; 140:3773-80. [DOI: 10.1039/c4an01507j] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Schematic representation of the degree of intoxicant-induced liver injury and regeneration and the minimally invasive analysis using autofluorescence spectral features.
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Affiliation(s)
- Shaiju S. Nazeer
- Biophotonics and Imaging Lab
- Biomedical Technology Wing
- Sree Chitra Tirunal Institute for Medical Sciences & Technology
- Thiruvananthapuram - 695 012
- India
| | - S. Sandhyamani
- Department of Pathology
- Sree Chitra Tirunal Institute for Medical Sciences & Technology
- Thiruvananthapuram - 695 011
- India
| | - Ramapurath S. Jayasree
- Biophotonics and Imaging Lab
- Biomedical Technology Wing
- Sree Chitra Tirunal Institute for Medical Sciences & Technology
- Thiruvananthapuram - 695 012
- India
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19
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K G, Nazeer SS, M G, Jayasree RS, Nirmal R M, N K. Endogenous porphyrin fluorescence as a biomarker for monitoring the anti-angiogenic effect in antitumor response to hesperetin loaded nanoparticles in experimental oral carcinogenesis. RSC Adv 2014. [DOI: 10.1039/c4ra06140c] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
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20
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Hu F, Vishwanath K, Beumer HW, Puscas L, Afshari HR, Esclamado RM, Scher R, Fisher S, Lo J, Mulvey C, Ramanujam N, Lee WT. Assessment of the sensitivity and specificity of tissue-specific-based and anatomical-based optical biomarkers for rapid detection of human head and neck squamous cell carcinoma. Oral Oncol 2014; 50:848-856. [PMID: 25037162 DOI: 10.1016/j.oraloncology.2014.06.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2013] [Revised: 05/22/2014] [Accepted: 06/19/2014] [Indexed: 11/29/2022]
Abstract
OBJECTIVES We propose the use of morphological optical biomarkers for rapid detection of human head and neck squamous cell carcinoma (HNSCC) by leveraging the underlying tissue characteristics in aerodigestive tracts. MATERIALS AND METHODS Diffuse reflectance spectra were obtained from malignant and contra-lateral normal tissues of 57 patients undergoing panendoscopy and biopsy. Oxygen saturation, total hemoglobin concentration, and the reduced scattering coefficient were extracted. Differences in malignant and normal tissues were examined based on two different groupings: anatomical site and morphological tissue type. RESULTS AND CONCLUSIONS Measurements were acquired from 252 sites, of which 51 were pathologically classified as SCC. Optical biomarkers exhibited statistical differences between malignant and normal samples. Contrast was enhanced when parsing tissues by morphological classification rather than anatomical subtype for unpaired comparisons. Corresponding linear discriminant models using multiple optical biomarkers showed improved predictive ability when accounting for morphological classification, particularly in node-positive lesions. The false-positive rate was retrospectively found to decrease by 34.2% in morphologically- vs. anatomically-derived predictive models. In glottic tissue, the surgeon exhibited a false-positive rate of 45.7% while the device showed a lower false-positive rate of 12.4%. Additionally, comparisons of optical parameters were made to further understand the physiology of tumor staging and potential causes of high surgeon false-positive rates. Optical spectroscopy is a user-friendly, non-invasive tool capable of providing quantitative information to discriminate malignant from normal head and neck tissues. Predictive models demonstrated promising results for real-time diagnostics. Furthermore, the strategy described appears to be well suited to reduce the clinical false-positive rate.
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Affiliation(s)
- Fangyao Hu
- Duke University, Biomedical Engineering Department, Durham, NC, USA
| | | | - H Wolfgang Beumer
- Division of Otolaryngology - Head and Neck Surgery, Duke University Medical Center, Durham, NC, USA
| | - Liana Puscas
- Division of Otolaryngology - Head and Neck Surgery, Duke University Medical Center, Durham, NC, USA.,Section of Otolaryngology - Head and Neck Surgery, Durham Veterans Administration Medical Center, Durham, NC, USA
| | - Hamid R Afshari
- Dental Service, Durham Veterans Administration Medical Center, Durham, NC, USA
| | - Ramon M Esclamado
- Division of Otolaryngology - Head and Neck Surgery, Duke University Medical Center, Durham, NC, USA
| | - Richard Scher
- Division of Otolaryngology - Head and Neck Surgery, Duke University Medical Center, Durham, NC, USA
| | - Samuel Fisher
- Division of Otolaryngology - Head and Neck Surgery, Duke University Medical Center, Durham, NC, USA
| | - Justin Lo
- Duke University, Biomedical Engineering Department, Durham, NC, USA
| | - Christine Mulvey
- Duke University, Biomedical Engineering Department, Durham, NC, USA
| | | | - Walter T Lee
- Division of Otolaryngology - Head and Neck Surgery, Duke University Medical Center, Durham, NC, USA.,Section of Otolaryngology - Head and Neck Surgery, Durham Veterans Administration Medical Center, Durham, NC, USA
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21
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Fuller C, Camilon R, Nguyen S, Jennings J, Day T, Gillespie MB. Adjunctive diagnostic techniques for oral lesions of unknown malignant potential: Systematic review with meta-analysis. Head Neck 2014; 37:755-62. [PMID: 24596227 DOI: 10.1002/hed.23667] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2013] [Revised: 02/12/2014] [Accepted: 03/01/2014] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND The purpose of this study was to critically review the published evidence concerning adjunctive diagnostic techniques in the diagnosis of oral lesions of unknown malignant potential. METHODS We conducted a systematic literature review with meta-analysis using PubMed to search for articles published from June 1993 through June 2013 to identify prospective studies evaluating any diagnostic method, with tissue biopsy confirmation, in clinically evident oral lesions of unknown malignant potential. Aggregate weighted totals and SEs for true, false-positive, false-negative, and inadequate results were calculated and compared among subgroups. RESULTS Forty-eight articles satisfying inclusion criteria were identified. Twenty-five were included in quantitative synthesis. CONCLUSION Oral cytology holds higher diagnostic value than specialist's oral examination, which holds higher value than in vivo toluidine blue staining. This study does not support the use of computer-aided or liquid-based cytology. Future studies should be designed to test multiple methods in the same patient population to allow direct comparison among various techniques.
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Affiliation(s)
- Colin Fuller
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina
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22
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Venugopal C, Nazeer SS, Balan A, Jayasree R. Autofluorescence Spectroscopy Augmented by Multivariate Analysis as a Potential Noninvasive Tool for Early Diagnosis of Oral Cavity Disorders. Photomed Laser Surg 2013; 31:605-12. [DOI: 10.1089/pho.2013.3547] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- C. Venugopal
- Department of Oral Medicine and Radiology, Dental College, Trivandrum, Kerala, India
| | - Shaiju S. Nazeer
- Biophotonics and Imaging Laboratory, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Biomedical Technology Wing, Trivandrum, Kerala, India
| | - Anita Balan
- Department of Oral Medicine and Radiology, Dental College, Trivandrum, Kerala, India
| | - R.S. Jayasree
- Biophotonics and Imaging Laboratory, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Biomedical Technology Wing, Trivandrum, Kerala, India
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23
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Tissue discrimination by uncorrected autofluorescence spectra: a proof-of-principle study for tissue-specific laser surgery. SENSORS 2013; 13:13717-31. [PMID: 24152930 PMCID: PMC3859088 DOI: 10.3390/s131013717] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2013] [Accepted: 09/27/2013] [Indexed: 11/21/2022]
Abstract
Laser surgery provides a number of advantages over conventional surgery. However, it implies large risks for sensitive tissue structures due to its characteristic non-tissue-specific ablation. The present study investigates the discrimination of nine different ex vivo tissue types by using uncorrected (raw) autofluorescence spectra for the development of a remote feedback control system for tissue-selective laser surgery. Autofluorescence spectra (excitation wavelength 377 ± 50 nm) were measured from nine different ex vivo tissue types, obtained from 15 domestic pig cadavers. For data analysis, a wavelength range between 450 nm and 650 nm was investigated. Principal Component Analysis (PCA) and Quadratic Discriminant Analysis (QDA) were used to discriminate the tissue types. ROC analysis showed that PCA, followed by QDA, could differentiate all investigated tissue types with AUC results between 1.00 and 0.97. Sensitivity reached values between 93% and 100% and specificity values between 94% and 100%. This ex vivo study shows a high differentiation potential for physiological tissue types when performing autofluorescence spectroscopy followed by PCA and QDA. The uncorrected autofluorescence spectra are suitable for reliable tissue discrimination and have a high potential to meet the challenges necessary for an optical feedback system for tissue-specific laser surgery.
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24
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Stephen MM, Jayanthi JL, Unni NG, Kolady PE, Beena VT, Jeemon P, Subhash N. Diagnostic accuracy of diffuse reflectance imaging for early detection of pre-malignant and malignant changes in the oral cavity: a feasibility study. BMC Cancer 2013; 13:278. [PMID: 23738507 PMCID: PMC3679752 DOI: 10.1186/1471-2407-13-278] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2012] [Accepted: 05/30/2013] [Indexed: 11/27/2022] Open
Abstract
Background Diffusely reflected light is influenced by cytologic and morphologic changes that take place during tissue transformation, such as, nuclear changes, extracellular matrix structure and composition as well as blood flow. Albeit with varying degree of sensitivity and specificity, the properties of diffusely reflected light in discriminating a variety of oral lesions have been demonstrated by our group in multiple studies using point monitoring systems. However, the point monitoring system could not identify the region with the most malignant potential in a single sitting. Methods In order to scan the entire lesion, we developed a multi-spectral imaging camera system that records diffuse reflectance (DR) images of the oral lesion at 545 and 575 nm with white light illumination. The diagnostic accuracy of the system for 2-dimensional DR imaging of pre-malignant and malignant changes in the oral cavity was evaluated through a clinical study in 55 patients and 23 healthy volunteers. The DR imaging data were compared with gold standard tissue biopsy and histopathology results. Results In total 106- normal/clinically healthy sites, 20- pre-malignant and 29- malignant (SCC) sites were compared. While the median pixel value of the R545/R575 image ratio for normal/clinically healthy tissue was 0.87 (IQR = 0.82-0.94), they were 1.35 (IQR = 1.13-1.67) and 2.44 (IQR = 1.78-3.80) for pre-malignant and malignant lesions, respectively. Area under the ROC curve to differentiate malignant from normal/clinically healthy [AUC = 0.99 (95% CI: 0.99-1.00)], pre-malignant from normal/clinically healthy [AUC = 0.94 (95% CI: 0.86-1.00)], malignant from pre-malignant [AUC = 0.84 (95% CI: 0.73-0.95)] and pre-malignant and malignant from normal/clinically healthy [AUC = 0.97 (95% CI: 0.94-1.00)] lesions were desirable. Conclusion We find DR imaging to be very effective as a screening tool in locating the potentially malignant areas of oral lesions with relatively good diagnostic accuracy while comparing it to the gold standard histopathology.
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