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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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Hasan MZ, Saha PS, Korfhage MO, Zhu C. Non-contact optical spectroscopy for tumor-sensitive diffuse reflectance and fluorescence measurements on murine subcutaneous tissue models: Monte Carlo modeling and experimental validations. BIOMEDICAL OPTICS EXPRESS 2023; 14:5418-5439. [PMID: 37854556 PMCID: PMC10581788 DOI: 10.1364/boe.502778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 09/12/2023] [Accepted: 09/16/2023] [Indexed: 10/20/2023]
Abstract
Fiber-optic probes are commonly used in biomedical optical spectroscopy platforms for light delivery and collection. At the same time, it was reported that the inconsistent probe-sample contact could induce significant distortions in measured optical signals, which consequently cause large analysis errors. To address this challenge, non-contact optical spectroscopy has been explored for tissue characterizations. However, existing non-contact optical spectroscopy platforms primarily focused on diffuse reflectance measurements and may still use a fiber probe in which the probe was imaged onto the tissue surface using a lens, which serves as a non-contact probe for the measurements. Here, we report a fiber-probe-free, dark-field-based, non-contact optical spectroscopy for both diffuse reflectance and fluorescence measurements on turbid medium and tissues. To optimize the system design, we developed a novel Monte Carlo method to simulate such a non-contact setup for both diffuse reflectance and fluorescence measurements on murine subcutaneous tissue models with a spherical tumor-like target. We performed Monte Carlo simulations to identify the most tumor-sensitive configurations, from which we found that both the depth of the light focal point in tissue and the lens numerical aperture would dramatically affect the system's tumor detection sensitivity. We then conducted tissue-mimicking phantom studies to solidify these findings. Our reported Monte Carlo technique can be a useful computational tool for designing non-contact optical spectroscopy systems. Our non-contact optical setup and experimental findings will potentially offer a new approach for sensitive optical monitoring of tumor physiology in biological models using a non-contact optical spectroscopy platform to advance cancer research.
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Affiliation(s)
- Md Zahid Hasan
- Department of Biomedical Engineering, University of Kentucky, Lexington, KY 40506, USA
| | - Pranto Soumik Saha
- Department of Biomedical Engineering, University of Kentucky, Lexington, KY 40506, USA
| | - Madison O. Korfhage
- Department of Biomedical Engineering, University of Kentucky, Lexington, KY 40506, USA
| | - Caigang Zhu
- Department of Biomedical Engineering, University of Kentucky, Lexington, KY 40506, USA
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In-vivo Testing of Oral Mucosal Lesions with an In-house Developed Portable Imaging Device and Comparison with Spectroscopy Results. J Fluoresc 2023:10.1007/s10895-023-03152-z. [PMID: 36701084 DOI: 10.1007/s10895-023-03152-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 01/19/2023] [Indexed: 01/27/2023]
Abstract
Progression of oral mucosal lesions is generally marked by changes in the concentration of the intrinsic fluorophores such as collagen, nicotinamide adenine dinucleotide (NADH), flavin adenine dinucleotide (FAD) and porphyrin present in the human oral tissue. In this study, we have probed the changes in FAD and porphyrin by exciting with 405 nm laser light on different sites (tongue, buccal mucosa, lip etc.) of the oral cavity. Testing has been done by an in-house developed fluorescence-based portable imaging device on oral squamous cell carcinoma (OSCC) patients, dysplastic patients and control (normal) group. Fluorescence images recorded from OSCC and dysplastic patients have displayed an enhancement in the red band (porphyrin) as compared to those from the normal volunteers. Porphyrin to FAD intensity ratio (IPorphyrin/IFAD), referred to red to green ratio (Ired/Igreen) has been taken as the diagnostic marker for classification among the groups. Receiver operating characteristic (ROC) analysis applied on IPorphyrin/IFAD is able to discriminate OSCC to normal, dysplasia to normal and OSCC to dysplasia with sensitivities of 100%, 81%, 92% and specificities of 100%, 93% and 92% respectively. Fluorescence imaging probe can capture a large area of oral lesions in a single scan and hence would be useful for initial scanning. On comparison with spectroscopy studies performed by our group, it is found that combining both spectroscopy and imaging as a device may be effective for the early detection of oral lesions. This clinical study was registered on the date 13/10/2017 in the clinical trials registry-India (CTRI) with registration number CTRI/2017/10/010102.
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Amirchaghmaghi M, Mohtasham N, Delavarian Z, Shakeri MT, Taghizadeh A, Khazaeni K, Hatami M. Analyzing the relationship between tissue color observed in VELscope examination and histopathological factors in OSCC patients. Photodiagnosis Photodyn Ther 2022; 41:103248. [PMID: 36565733 DOI: 10.1016/j.pdpdt.2022.103248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 11/27/2022] [Accepted: 12/16/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Early detection of OSCC is a crucial step towards improving OSCC prognosis. In recent years, novel diagnostic aids such as light-based detection systems have been introduced for early diagnosis. VELscope is one such light-based device which is used to examine tissue fluorescence. Based on different studies, VELscope has a sensitivity of 90% in the diagnosis of oral premalignant and malignant lesions. Tumor depth of invasion and invasive front have recently been proposed as influential factors in OSCC prognosis. Therefore, the aim of this study was to assess the relationship between tissue color seen through this device and tumor depth of invasion. METHODS & MATERIALS 20 histopathologically approved OSCCs were included in this study. Conventional oral examination was carried out followed by an assessment of the lesion using VELscope. The H&E slides prepared following the final OSCC surgeries were then examined by an oral pathologist to assess tumor depth of invasion (interpreted as low-risk/high-risk), invasivefront (low-risk/high-risk) and perivascular and perineural invasions. Data was transferred to SPSS 16 software. The association between color changes and histopathological factors was analyzed using the fisher's exact and chi-square tests. RESULTS The mean age of the patients was 51/5+/-16/74, 60% of which were men. Most lesions were exophytic and the most common color seen during VELscope examination was red. 55% and 50% of the OSCCs showed high-risk tumor depths and high-risk invasive fronts respectively. Perivascular and perineural invasion was seen in 55% and 35% of the samples respectively. Statistical analysis showed that 72/2% of the lesions with high tumor depths and 70% with high-risk invasive fronts were seen as red, although these associations were not significant (P>0/05). Tumor depth was significantly correlated with invasive front (P<0/05). CONCLUSION There was no significant relationship between the type of color seen through VELscope and tumor depth of invasion, however most cases with high-risk depth of invasions were red.
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Affiliation(s)
- Maryam Amirchaghmaghi
- Oral & Maxillofacial Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Nooshin Mohtasham
- Oral & Maxillofacial Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Zahra Delavarian
- Oral & Maxillofacial Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammad Taghi Shakeri
- Social Determinants of Health Research Center, Mashhad University o Medical Sciences, Mashhad, Iran
| | - Ava Taghizadeh
- Department of Oral Medicine, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran.
| | - Kamran Khazaeni
- Department of Otorhinolaryngology, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Masoud Hatami
- Assistant professor of oral and maxillofacial medicine, department of oral and maxillofacial medicine, school of dentistry, Kermanshah university of medical sciences, Kermanshah, Iran
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Fernandes JR, Dos Santos LCF, Lamers ML. Applicability of autofluorescence and fluorescent probes in the trans-surgical of oral carcinomas: A systematic review. Photodiagnosis Photodyn Ther 2022; 41:103238. [PMID: 36509404 DOI: 10.1016/j.pdpdt.2022.103238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 11/07/2022] [Accepted: 12/08/2022] [Indexed: 12/13/2022]
Abstract
Oral cancer represents an important health problem, as it is the sixth most common type of cancer in the world and is associated with high rates of morbidity and mortality. The treatment considered the gold standard for this type of tumor is surgical resection with negative margins, with a distance of at least 5 mm from the tumor. This procedure is strongly associated with local control and disease-specific survival, however, in many cases, large amounts of healthy tissue are removed, resulting in surgical defects, compromising various functions and directly affecting the individual's quality of life. From this perspective, this systematic review aimed to evaluate the use of autofluorescence and fluorescent probes as potential adjuvant techniques to facilitate the delineation of surgical margins for oral cancers. A comprehensive search was performed in Pubmed, Scopus, Web of Science, LIVIVO, Embase, ProQuest Open Access Dissertations & Theses, Open Access Theses and Dissertations, and DART Europe databases, where 1948 articles were found. After the different stages of critical evaluation, 15 articles were selected, eligible for the inclusion criteria. Of these, 7 articles used autofluorescence, 7 used fluorescent probes and 1 article used both methods. As for autofluorescence, the most used device was the VELScope, and indocyanine green was the most used probe. Compared to histopathology, autofluorescence did not obtain significant and/or superiors results. In contrast to fluorescent probes that, most articles showed a good performance of margins during surgical resection, making them a promising alternative. However, it is still necessary to carry out the analysis of more articles, with more significant samples and sensitivity and specificity data to qualify the results.
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Affiliation(s)
- Julia Rodrigues Fernandes
- Department of Oral Pathology, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | | | - Marcelo Lazzaron Lamers
- Department of Morphological Sciences, Institute of Basic Health Sciences, Federal University of Rio Grande do Sul, Rua Ramiro Barcelos 2600, Porto Alegre, RS CEP 90035-003, Brazil.
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Lim SY, Jang JI, Yoon H, Kim HM. Spectroscopic Study of Time-Varying Optical Redox Ratio in NADH/FAD Solution. J Phys Chem B 2022; 126:9840-9849. [PMID: 36399328 DOI: 10.1021/acs.jpcb.2c05292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Autofluorescence imaging has been widely applied as advanced noninvasive diagnostics for in vivo and ex vivo tissues. The optical redox ratio (ORR), which is defined as the fluorescence intensity ratio between reduced nicotine adenine dinucleotide (NADH) and oxidized flavin adenine dinucleotide (FAD), has been used as a diagnostic parameter strongly, because NADH and FAD play an important role in energetic and respiratory metabolism as coenzymes. The ORR method has provided successful assessment in cancer diagnosis including breast, cervical, and oral cancer; few studies have been reported about optical and chemical interference between two molecules resulting in a change in ORR values. In this study, we investigated the variations in ORR values of NADH/FAD mixtures dissolved in tris(hydroxymethyl)aminomethane, phosphate buffer, and deionized water environments. In vitro solutions were prepared in various concentration ratios and the experimental and theoretical ORR values were obtained from fluorescence and absorption spectra in time series. Based on the spectroscopic analysis, we concluded that the inner filter effect causes an instant decrease in FAD fluorescence just after dissolution and that the oxidation-reduction coupled with oxygenation reaction results in time-varying decreases in NADH fluorescence and FAD emission.
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Affiliation(s)
- Soo Yeong Lim
- Department of Chemistry, Kookmin University, 77, Jeongneung-ro, Seongbuk-gu, Seoul02707, Republic of Korea
| | - Jin Il Jang
- Department of Chemistry, Kookmin University, 77, Jeongneung-ro, Seongbuk-gu, Seoul02707, Republic of Korea
| | - Hongman Yoon
- Division of Convergence Technology, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do10408, Republic of Korea
| | - Hyung Min Kim
- Department of Chemistry, Kookmin University, 77, Jeongneung-ro, Seongbuk-gu, Seoul02707, Republic of Korea
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Wu Y, Wu H, Lu X, Chen Y, Zhang X, Ju J, Zhang D, Zhu B, Huang S. Development and Evaluation of Targeted Optical Imaging Probes for Image‐Guided Surgery in Head and Neck Cancer. ADVANCED THERAPEUTICS 2022. [DOI: 10.1002/adtp.202100196] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Yue Wu
- Department of Oral and Maxillofacial Surgery Shandong Provincial Hospital Cheeloo College of Medicine Shandong University Jinan Shandong 250021 China
| | - Haiwei Wu
- Department of Oral and Maxillofacial Surgery Shandong Provincial Hospital Cheeloo College of Medicine Shandong University Jinan Shandong 250021 China
| | - Xiaoya Lu
- Department of Oral and Maxillofacial Surgery Shandong Provincial Hospital Cheeloo College of Medicine Shandong University Jinan Shandong 250021 China
| | - Yi Chen
- Department of Oral and Maxillofacial Surgery Shandong Provincial Hospital Cheeloo College of Medicine Shandong University Jinan Shandong 250021 China
| | - Xue Zhang
- University of Jinan Jinan Shandong 250021 China
| | - Jiandong Ju
- Department of Oral and Maxillofacial Surgery Shandong Provincial Hospital Cheeloo College of Medicine Shandong University Jinan Shandong 250021 China
| | - Dongsheng Zhang
- Department of Oral and Maxillofacial Surgery Shandong Provincial Hospital Cheeloo College of Medicine Shandong University Jinan Shandong 250021 China
| | - Baocun Zhu
- University of Jinan Jinan Shandong 250021 China
| | - Shengyun Huang
- Department of Oral and Maxillofacial Surgery Shandong Provincial Hospital Cheeloo College of Medicine Shandong University Jinan Shandong 250021 China
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Sarode SC, Sarode GS, Yuwanati M, Gadbail A, Gondivkar S. A brief overview of 100 best-cited papers on oral submucous fibrosis in Oral Oncology. Oral Oncol 2022; 126:105769. [DOI: 10.1016/j.oraloncology.2022.105769] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 02/07/2022] [Indexed: 01/18/2023]
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Validity and Reliability of Intraoral Camera with Fluorescent Aids for Oral Potentially Malignant Disorders Screening in Teledentistry. Int J Dent 2021; 2021:6814027. [PMID: 34745263 PMCID: PMC8570874 DOI: 10.1155/2021/6814027] [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: 09/03/2021] [Revised: 10/08/2021] [Accepted: 10/15/2021] [Indexed: 11/18/2022] Open
Abstract
There is limited documentation of using fluorescence images in oral potentially malignant disorders (OPMDs) and oral cancer screening through the field of teledentistry. This study aims to develop and evaluate the validity and reliability of the intraoral camera with the combination method of autofluorescence and LED white light used for OPMDs and oral cancer screening in teledentistry. The intraoral camera with fluorescent aids, which uses a combined method of both autofluorescence and LED white light, was developed before the device was evaluated for validity and reliability as a OPMDs screening tool for teledentistry. All lesions of thirty-four OPMD patients underwent biopsy for definitive diagnosis and were examined by an oral medicine specialist. Both images under autofluorescent and LED white light mode captured from the device were sent online and interpreted for the initial diagnosis and dysplastic features in addition to being compared to the direct clinical examination and histopathological findings. The combination method was also compared with autofluorescence method alone. The device provided good image quality, which was enough for initial diagnosis. Using the combination method, sensitivity, specificity, PPV, and NPV of the device via teledentistry were 87.5%, 84.6%, 63.6%, and 95.7%, respectively, which were higher than autofluorescence method alone in every parameter. The concordance of dysplastic lesion was 85.29% and 79.41% for category of lesion. The validity and reliability results of the combination method for the screening of dysplasia in OPMDs were higher than autofluorescent method alone. The intraoral camera with fluorescent aids for the OPMDs screening can be utilized for screening via teledentistry.
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Detection of inaccessible head and neck lesions using human saliva and fluorescence spectroscopy. Lasers Med Sci 2021; 37:1821-1827. [PMID: 34637056 PMCID: PMC8506087 DOI: 10.1007/s10103-021-03437-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 10/01/2021] [Indexed: 12/04/2022]
Abstract
Head and neck cancer detection using fluorescence spectroscopy from human saliva is reported here. This study has been conducted on squamous cell carcinoma (SCC), and dysplastic (precancer) and control (normal) groups using an in-house developed compact set-up. Fluorescence set-up consists of a 375-nm laser diode and optical components. Spectral bands of flavin adenine dinucleotide (FAD), porphyrins, and Raman are observed in the spectral range of 400 to 800 nm. Presence of FAD and porphyrin bands in human saliva is confirmed by the liquid phantoms of FAD and porphyrin. Significant differences in fluorescence intensities among all the three groups are observed. Three spectral ranges from 455 to 600, 605 to 770, and 400 to 800 nm are selected for each group and area values under each spectral range are computed. To differentiate among the groups, receiver operating characteristic (ROC) analysis is employed on the area values. ROC differentiates among the groups with accuracies of 98%, 92.85%, and 81.13% respectively in the spectral ranges of 400 to 800 nm. However, in other two spectral ranges (455 to 600 and 605 to 770 nm), low accuracy values are found. Obtained accuracy values indicate that selection of human saliva for head and neck cancer detection may be a good alternative.
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Vibhute NA, Jagtap SV, Patil SV. Velscope guided oral cancer screening: A ray of hope in early oral cancer diagnosis. J Oral Maxillofac Pathol 2021; 25:548-549. [PMID: 35281151 PMCID: PMC8859611 DOI: 10.4103/jomfp.jomfp_315_20] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 05/18/2021] [Accepted: 10/19/2021] [Indexed: 11/12/2022] Open
Abstract
Context: Early oral cancer diagnosis is an important factor in reducing cancer-associated mortality and morbidity. Traditional oral cancer screening by Conventional Oral Examination (COE) is limited. A new approach in this regard is the use of “optical biopsy systems” like VELscope. Aims: Hence, this study aimed to determine the diagnostic value of VELscope, an autofluorescence-based handheld device in detection of dysplasia and oral squamous cell carcinoma (OSCC) in general oral potentially malignant disorder. Settings and Design: A prospective, cross-sectional study was conducted at a tertiary hospital in western Maharashtra, India. Materials and Methods: Thirty patients with presence of clinically suspicious oral lesions were included, and for each lesion, both the COE and Autofluorescence Examination by VELscope were carried out at the same appointment by different experts. All lesions were biopsied and histopathological findings were documented and analyzed. Statistical Analysis Used: Sensitivity, specificity, positive predictive value and negative predictive value were estimated to determine the accuracy of VELscope examination analysis outcome. Results: The study included a total of 30 subjects including 19 (63.33%) males and 11 (26.66%) females. Autofluorescence examination by VELscope (AFV) revealed Autofluorescence Loss in 24 (80%) patients, while 6 (20%) patients showed Autofluorescence Retained. Comparison between the “high-risk lesions” (moderate/severe dysplasia and OSCC) and “low-risk lesions” (no/mild dysplasia) showed a 90.47% sensitivity but only 44.44% specificity. Conclusions: The findings of our study indicate that although AFV cannot be a substitute for COE, it can be used as a potential complementary diagnostic aid in surveillance of the high-risk patient population.
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Affiliation(s)
- Nupura Aniket Vibhute
- Department of Oral Pathology and Microbiology, School of Dental Sciences, Krishna Institute of Medical Sciences Deemed to be University, Karad, Maharashtra, India
| | - Sunil Vitthalrao Jagtap
- Department of Pathology, Krishna Institute of Medical Sciences Deemed to be University, Karad, Maharashtra, India
| | - Sujata Vijaysinh Patil
- Department of Community Medicine, Krishna Institute of Medical Sciences Deemed to be University, Karad, Maharashtra, India
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Lyu Z, Jiang H, Xiao F, Rong J, Zhang T, Wandell B, Farrell J. Simulations of fluorescence imaging in the oral cavity. BIOMEDICAL OPTICS EXPRESS 2021; 12:4276-4292. [PMID: 34457414 PMCID: PMC8367257 DOI: 10.1364/boe.429995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 05/31/2021] [Accepted: 06/01/2021] [Indexed: 06/13/2023]
Abstract
We describe an end-to-end image systems simulation that models a device capable of measuring fluorescence in the oral cavity. Our software includes a 3D model of the oral cavity and excitation-emission matrices of endogenous fluorophores that predict the spectral radiance of oral mucosal tissue. The predicted radiance is transformed by a model of the optics and image sensor to generate expected sensor image values. We compare simulated and real camera data from tongues in healthy individuals and show that the camera sensor chromaticity values can be used to quantify the fluorescence from porphyrins relative to the bulk fluorescence from multiple fluorophores (elastin, NADH, FAD, and collagen). Validation of the simulations supports the use of soft-prototyping in guiding system design for fluorescence imaging.
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Affiliation(s)
- Zheng Lyu
- Stanford Center for Image Systems Engineering, Stanford, California 94305, USA
- Department of Electrical Engineering, Stanford, California 94305, USA
| | | | - Feng Xiao
- Fengyun Vision Technologies, Beijing 100080, China
| | - Jian Rong
- Fengyun Vision Technologies, Beijing 100080, China
| | | | - Brian Wandell
- Stanford Center for Image Systems Engineering, Stanford, California 94305, USA
- Psychology Department, Stanford, California 94305, USA
| | - Joyce Farrell
- Stanford Center for Image Systems Engineering, Stanford, California 94305, USA
- Department of Electrical Engineering, Stanford, California 94305, USA
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Band-Selection of a Portal LED-Induced Autofluorescence Multispectral Imager to Improve Oral Cancer Detection. SENSORS 2021; 21:s21093219. [PMID: 34066507 PMCID: PMC8125388 DOI: 10.3390/s21093219] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 05/01/2021] [Accepted: 05/01/2021] [Indexed: 11/26/2022]
Abstract
This aim of this study was to find effective spectral bands for the early detection of oral cancer. The spectral images in different bands were acquired using a self-made portable light-emitting diode (LED)-induced autofluorescence multispectral imager equipped with 365 and 405 nm excitation LEDs, emission filters with center wavelengths of 470, 505, 525, 532, 550, 595, 632, 635, and 695 nm, and a color image sensor. The spectral images of 218 healthy points in 62 healthy participants and 218 tumor points in 62 patients were collected in the ex vivo trials at China Medical University Hospital. These ex vivo trials were similar to in vivo because the spectral images of anatomical specimens were immediately acquired after the on-site tumor resection. The spectral images associated with red, blue, and green filters correlated with and without nine emission filters were quantized by four computing method, including summated intensity, the highest number of the intensity level, entropy, and fractional dimension. The combination of four computing methods, two excitation light sources with two intensities, and 30 spectral bands in three experiments formed 264 classifiers. The quantized data in each classifier was divided into two groups: one was the training group optimizing the threshold of the quantized data, and the other was validating group tested under this optimized threshold. The sensitivity, specificity, and accuracy of each classifier were derived from these tests. To identify the influential spectral bands based on the area under the region and the testing results, a single-layer network learning process was used. This was compared to conventional rules-based approaches to show its superior and faster performance. Consequently, four emission filters with the center wavelengths of 470, 505, 532, and 550 nm were selected by an AI-based method and verified using a rule-based approach. The sensitivities of six classifiers using these emission filters were more significant than 90%. The average sensitivity of these was about 96.15%, the average specificity was approximately 69.55%, and the average accuracy was about 82.85%.
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Supawat B, Aye KT, Ritpanja J, Nueangwong W, Kothan S, Pan J, Tungjai M. Differences in Spectroscopic Properties of Saliva Taken From Normal Subjects and Oral Cancer Patients: Comparison Studies. J Fluoresc 2021; 31:747-754. [PMID: 33638767 DOI: 10.1007/s10895-021-02707-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 02/18/2021] [Indexed: 02/07/2023]
Abstract
Oral cancer disease is among the most common cancers in the world and are associated with mortality and morbidity. The characterization of saliva samples may help to distinguish patients with oral cancer disease from normal subjects. To characterize spectra of saliva samples from normal subjects and oral cancer patients by use of fluorescence, absorption, and 1H-NMR spectroscopy. Whole unstimulated saliva samples were collected from patients with oral cancer disease and normal subjects. The saliva samples were analyzed by absorption, fluorescence and 1H-NMR spectroscopic techniques. The characteristic spectra of saliva samples from patients with oral cancer disease and normal subjects were compared. For fluorescence spectroscopic studies, six fluorophores were found in saliva samples. Autofluorescence emission spectra and synchronous spectra of saliva were different between normal subjects and oral cancer patients. For absorption spectroscopic studies, the typical absorption spectra of saliva samples from normal subjects and oral cancer patients were also different in absorption intensity, 1st and 2nd derivative of absorption spectra values. For 1H-NMR studies, nine metabolites and four metabolites were found in saliva samples taken from normal subjects and oral cancer patients, respectively. The metabolic profiles of saliva samples from normal subjects and oral cancer patients were not similar. The characteristic spectra of saliva samples from normal subjects and oral cancer patients were found. These results showed differences in the spectra of saliva samples between both that groups. The spectra from each spectroscopic techniques could determine a candidate saliva biomarkers for distinguishing patients with oral cancer disease from normal subjects.
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Affiliation(s)
- Benjamaporn Supawat
- Department of Radiologic Technology, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, 50200, Thailand
- Center of Radiation Research and Medical Imaging, Department of Radiologic Technology, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Khin TheNu Aye
- Department of Radiologic Technology, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, 50200, Thailand
- Center of Radiation Research and Medical Imaging, Department of Radiologic Technology, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, 50200, Thailand
- Ph.D. degree program in biomedical sciences, Faculty of Associated Medical Sciences, Chiang Mai University, under the CMU Presidential Scholarship, Chiang Mai, 50200, Thailand
| | | | | | - Suchart Kothan
- Department of Radiologic Technology, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, 50200, Thailand
- Center of Radiation Research and Medical Imaging, Department of Radiologic Technology, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Jie Pan
- Center of Radiation Research and Medical Imaging, Department of Radiologic Technology, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, 50200, Thailand
- Shandong Provincial Key Laboratory of Animal Resistant Biology, College of Life Sciences, Shandong Normal University, Jinan, China
| | - Montree Tungjai
- Department of Radiologic Technology, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, 50200, Thailand.
- Center of Radiation Research and Medical Imaging, Department of Radiologic Technology, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, 50200, Thailand.
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15
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Lima IFP, Brand LM, de Figueiredo JAP, Steier L, Lamers ML. Use of autofluorescence and fluorescent probes as a potential diagnostic tool for oral cancer: A systematic review. Photodiagnosis Photodyn Ther 2020; 33:102073. [PMID: 33232819 DOI: 10.1016/j.pdpdt.2020.102073] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 10/08/2020] [Accepted: 10/19/2020] [Indexed: 02/08/2023]
Abstract
INTRODUCTION The prognosis of patients with Oral squamous cell carcinoma (OSCC) are directly related to the stage of development of the tumor at the time of diagnosis, but it is estimated an average delay in diagnosis of 2-5 months. New non-invasive techniques for the early diagnosis of OSCC are being developed, such as methodologies to detect spectral changes of tumor cells. We conducted a systematic review to analyze the potential use of autofluorescence and/or fluorescent probes for OSCC diagnosis. MATERIAL AND METHODS Four databases (PubMed, Scopus, Embase and Web of Science) were used as research sources. Protocol was registered with PROSPERO. It was included studies that evaluated tissue autofluorescence and/or used fluorescent probes as a method of diagnosing and/or treatment of oral cancer in humans. RESULTS Forty-five studies were selected for this systematic review, of which 28 dealt only with autofluorescence, 18 on fluorescent probes and 1 evaluated both methods. The VELscope® was the most used device for autofluorescence, exhibiting sensitivity (33%-100%) and specificity (12%-88.6%). 5-Aminolevulinic acid (5-ALA) was the most used fluorescent probe, exhibiting high sensitivity (90%-100%) and specificity (51.3%-96%). Hypericin, rhodamine 6 G, rhodamine 610, porphyrin and γ-glutamyl hydroxymethyl rhodamine green have also been reported. CONCLUSION Thus, the autofluorescence and fluorescent probes can provide an accurate diagnosis of oral cancer, assisting the dentist during daily clinical activity, but it is not yet possible to suggest that this method may replace histopathological examination.
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Affiliation(s)
- Igor Felipe Pereira Lima
- Department of Oral Pathology, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Luiza Meurer Brand
- Academic in Dentistry, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - José Antônio Poli de Figueiredo
- Department of Morphological Sciences, Institute of Basic Health Sciences, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Liviu Steier
- Division of Restorative Dentistry, Penn Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Marcelo Lazzaron Lamers
- Department of Morphological Sciences, Institute of Basic Health Sciences, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil.
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16
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Pal R, Villarreal P, Yu X, Qiu S, Vargas G. Multimodal widefield fluorescence imaging with nonlinear optical microscopy workflow for noninvasive oral epithelial neoplasia detection: a preclinical study. JOURNAL OF BIOMEDICAL OPTICS 2020; 25:JBO-200213R. [PMID: 33200597 PMCID: PMC7667429 DOI: 10.1117/1.jbo.25.11.116008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 10/02/2020] [Indexed: 05/06/2023]
Abstract
SIGNIFICANCE Early detection of epithelial cancers and precancers/neoplasia in the presence of benign lesions is challenging due to the lack of robust in vivo imaging and biopsy guidance techniques. Label-free nonlinear optical microscopy (NLOM) has shown promise for optical biopsy through the detection of cellular and extracellular signatures of neoplasia. Although in vivo microscopy techniques continue to be developed, the surface area imaged in microscopy is limited by the field of view. FDA-approved widefield fluorescence (WF) imaging systems that capture autofluorescence signatures of neoplasia provide molecular information at large fields of view, which may complement the cytologic and architectural information provided by NLOM. AIM A multimodal imaging approach with high-sensitivity WF and high-resolution NLOM was investigated to identify and distinguish image-based features of neoplasia from normal and benign lesions. APPROACH In vivo label-free WF imaging and NLOM was performed in preclinical hamster models of oral neoplasia and inflammation. Analyses of WF imaging, NLOM imaging, and dual modality (WF combined with NLOM) were performed. RESULTS WF imaging showed increased red-to-green autofluorescence ratio in neoplasia compared to inflammation and normal oral mucosa (p < 0.01). In vivo assessment of the mucosal tissue with NLOM revealed subsurface cytologic (nuclear pleomorphism) and architectural (remodeling of extracellular matrix) atypia in histologically confirmed neoplastic tissue, which were not observed in inflammation or normal mucosa. Univariate and multivariate statistical analysis of macroscopic and microscopic image-based features indicated improved performance (94% sensitivity and 97% specificity) of a multiscale approach over WF alone, even in the presence of benign lesions (inflammation), a common confounding factor in diagnostics. CONCLUSIONS A multimodal imaging approach integrating strengths from WF and NLOM may be beneficial in identifying oral neoplasia. Our study could guide future studies on human oral neoplasia to further evaluate merits and limitations of multimodal workflows and inform the development of multiscale clinical imaging systems.
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Affiliation(s)
- Rahul Pal
- Massachusetts General Hospital and Harvard Medical School, Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, Massachusetts, United States
| | - Paula Villarreal
- The University of Texas Medical Branch, Biomedical Engineering and Imaging Sciences Group, Galveston, Texas, United States
- The University of Texas Medical Branch, Department of Neuroscience, Cell Biology, and Anatomy, Galveston, Texas, United States
| | - Xiaoying Yu
- The University of Texas Medical Branch, Department of Preventive Medicine and Population Health, Galveston, Texas, United States
| | - Suimin Qiu
- The University of Texas Medical Branch, Department of Pathology, Galveston, Texas, United States
| | - Gracie Vargas
- The University of Texas Medical Branch, Biomedical Engineering and Imaging Sciences Group, Galveston, Texas, United States
- The University of Texas Medical Branch, Department of Neuroscience, Cell Biology, and Anatomy, Galveston, Texas, United States
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17
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Lagarto JL, Villa F, Tisa S, Zappa F, Shcheslavskiy V, Pavone FS, Cicchi R. Real-time multispectral fluorescence lifetime imaging using Single Photon Avalanche Diode arrays. Sci Rep 2020; 10:8116. [PMID: 32415224 PMCID: PMC7229199 DOI: 10.1038/s41598-020-65218-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 04/24/2020] [Indexed: 12/19/2022] Open
Abstract
Autofluorescence spectroscopy has emerged in recent years as a powerful tool to report label-free contrast between normal and diseased tissues, both in vivo and ex vivo. We report the development of an instrument employing Single Photon Avalanche Diode (SPAD) arrays to realize real-time multispectral autofluorescence lifetime imaging at a macroscopic scale using handheld single-point fibre optic probes, under bright background conditions. At the detection end, the fluorescence signal is passed through a transmission grating and both spectral and temporal information are encoded in the SPAD array. This configuration allows interrogation in the spectral range of interest in real time. Spatial information is provided by an external camera together with a guiding beam that provides a visual reference that is tracked in real-time. Through fast image processing and data analysis, fluorescence lifetime maps are augmented on white light images to provide feedback of the measurements in real-time. We validate and demonstrate the practicality of this technique in the reference fluorophores and in articular cartilage samples mimicking the degradation that occurs in osteoarthritis. Our results demonstrate that SPADs together with fibre probes can offer means to report autofluorescence spectral and lifetime contrast in real-time and thus are suitable candidates for in situ tissue diagnostics.
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Affiliation(s)
- João L Lagarto
- National Institute of Optics National Research Council (INO-CNR), Largo Enrico Fermi 6, 50125, Florence, Italy.
- European Laboratory for Non-linear Spectroscopy (LENS), Via Nello Carrara 1, 50019, Sesto Fiorentino, Italy.
| | - Federica Villa
- Dipartimento di Elettronica, Informazione e Bioingegneria (DEIB), Politecnico di Milano, 20133, Milan, Italy
| | - Simone Tisa
- Micro Photon Device SRL, Via Waltraud Gebert Deeg 3g, I-39100, Bolzano, Italy
| | - Franco Zappa
- Dipartimento di Elettronica, Informazione e Bioingegneria (DEIB), Politecnico di Milano, 20133, Milan, Italy
| | - Vladislav Shcheslavskiy
- Becker & Hickl GmbH, Nunsdorfer Ring 7-9, 12277, Berlin, Germany
- Privolzhskiy Medical Research University, 603005, Nizhny Novgorod, Russia
| | - Francesco S Pavone
- National Institute of Optics National Research Council (INO-CNR), Largo Enrico Fermi 6, 50125, Florence, Italy
- European Laboratory for Non-linear Spectroscopy (LENS), Via Nello Carrara 1, 50019, Sesto Fiorentino, Italy
- Department of Physics, University of Florence, Via G. Sansone 1, 50019, Sesto Fiorentino, Italy
| | - Riccardo Cicchi
- National Institute of Optics National Research Council (INO-CNR), Largo Enrico Fermi 6, 50125, Florence, Italy
- European Laboratory for Non-linear Spectroscopy (LENS), Via Nello Carrara 1, 50019, Sesto Fiorentino, Italy
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18
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Vonk J, de Wit JG, Voskuil FJ, Witjes MJH. Improving oral cavity cancer diagnosis and treatment with fluorescence molecular imaging. Oral Dis 2020; 27:21-26. [PMID: 32072691 PMCID: PMC7818506 DOI: 10.1111/odi.13308] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 02/13/2020] [Accepted: 02/13/2020] [Indexed: 12/22/2022]
Abstract
Early diagnosis and radical surgical excision of oral squamous cell carcinomas are essential for achieving optimal treatment outcomes. To date, diagnostic tools that rely on anatomical anomalies provide limited information and resolution in clinical practice. As a result, oral cancer is often detected in an advanced stage. Also, no reliable real-time intraoperative tools are readily available for the evaluation of surgical resection margins. Fluorescence imaging visualises biological processes that occur in early carcinogenesis and could, therefore, enable detection of small tumours in early stages. Furthermore, due to the high sensitivity and spatial resolution, fluorescence imaging could assist in resection margin assessment during surgery. In this review, we discuss several techniques that employ fluorescence for early diagnosis and surgical guidance in oral squamous cell carcinoma and present future perspectives on the potential of fluorescence imaging in oral cancer in the near future.
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Affiliation(s)
- Jasper Vonk
- Department of Oral & Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Jaron Gérard de Wit
- Department of Oral & Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Floris Jan Voskuil
- Department of Oral & Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Max Johannes Hendrikus Witjes
- Department of Oral & Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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19
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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: 108] [Impact Index Per Article: 27.0] [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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20
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Emran S, Hurskainen M, Tomppo L, Lappalainen R, Kullaa AM, Myllymaa S. Bioimpedance spectroscopy and spectral camera techniques in detection of oral mucosal diseases: a narrative review of the state-of-the-art. J Med Eng Technol 2019; 43:474-491. [DOI: 10.1080/03091902.2019.1692940] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Affiliation(s)
- Shekh Emran
- SIB Labs, University of Eastern Finland, Kuopio, Finland
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| | - Miia Hurskainen
- SIB Labs, University of Eastern Finland, Kuopio, Finland
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| | - Laura Tomppo
- SIB Labs, University of Eastern Finland, Kuopio, Finland
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| | - Reijo Lappalainen
- SIB Labs, University of Eastern Finland, Kuopio, Finland
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| | - Arja M. Kullaa
- Institute of Dentistry, University of Eastern Finland, Kuopio, Finland
- Research Unit of Oral Health Sciences, University of Oulu, Oulu, Finland
- Educational Dental Clinic, Kuopio University Hospital, Kuopio, Finland
| | - Sami Myllymaa
- SIB Labs, University of Eastern Finland, Kuopio, Finland
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
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21
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Yang EC, Vohra IS, Badaoui H, Schwarz RA, Cherry KD, Jacob J, Rodriguez J, Williams MD, Vigneswaran N, Gillenwater AM, Richards-Kortum RR. Prospective evaluation of oral premalignant lesions using a multimodal imaging system: a pilot study. Head Neck 2019; 42:171-179. [PMID: 31621979 PMCID: PMC7003735 DOI: 10.1002/hed.25978] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 09/03/2019] [Accepted: 09/17/2019] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Multimodal optical imaging, incorporating reflectance and fluorescence modalities, is a promising tool to detect oral premalignant lesions in real-time. METHODS Images were acquired from 171 sites in 66 patient visits for clinical evaluation of oral lesions. An automated algorithm was used to classify lesions as high- or low-risk for neoplasia. Biopsies were acquired at clinically indicated sites and those classified as high-risk by imaging, at the surgeon's discretion. RESULTS Twenty sites were biopsied based on clinical examination or imaging. Of these, 12 were indicated clinically and by imaging; 58% were moderate dysplasia or worse. Four biopsies were indicated by imaging evaluation only; 75% were moderate dysplasia or worse. Finally, four biopsies were indicated by clinical evaluation only; 75% were moderate dysplasia or worse. CONCLUSION Multimodal imaging identified more cases of high-grade dysplasia than clinical evaluation, and can improve detection of high grade precancer in patients with oral lesions.
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Affiliation(s)
- Eric C Yang
- MD/PhD Medical Scientist Training Program, Baylor College of Medicine, Houston, Texas, USA
| | - Imran S Vohra
- Department of Bioengineering, Rice University, Houston, Texas, USA
| | - Hawraa Badaoui
- Department of Head and Neck Surgery, The University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | | | - Katelin D Cherry
- Department of Bioengineering, Rice University, Houston, Texas, USA
| | - Justin Jacob
- Department of Head and Neck Surgery, The University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Jessica Rodriguez
- Department of Head and Neck Surgery, The University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Michelle D Williams
- Department of Pathology, The University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Nadarajah Vigneswaran
- Department of Diagnostic and Biomedical Sciences, The University of Texas Health Science Center at Houston School of Dentistry, Houston, Texas
| | - Ann M Gillenwater
- Department of Head and Neck Surgery, The University of Texas M.D. Anderson Cancer Center, Houston, Texas
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22
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Pereira RHA, Prado AR, Caro LFCD, Zanardo TÉC, Alencar AP, Nogueira BV. A non-linear mathematical model using optical sensor to predict heart decellularization efficacy. Sci Rep 2019; 9:12211. [PMID: 31434981 PMCID: PMC6704168 DOI: 10.1038/s41598-019-48659-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Accepted: 08/07/2019] [Indexed: 12/14/2022] Open
Abstract
One of the main problems of the decellularization technique is the subjectivity of the final evaluation of its efficacy in individual organs. This problem can result in restricted cell repopulation reproducibility and worse responses to transplant tissues. Our proposal is to analyze the optical profiles produced by hearts during perfusion decellularization, as an additional method for evaluating the decellularization process of each individual organ. An apparatus comprised of a structured LED source and photo detector on an adjustable base was developed to capture the relationship between transmitted light during the perfusion of murine hearts, and residual DNA content. Voltage-time graphic records were used to identify a nonlinear mathematical model to discriminate between decellularizations with remaining DNA above (Incomplete Decellularization) and below (Complete Decellularization) the standardized limits. The results indicate that temporal optical evaluation of the process enables inefficient cell removal to be predicted in the initial stages, regardless of the apparent transparency of the organ. Our open system also creates new possibilities to add distinct photo detectors, such as for specific wavelengths, image acquisition, and physical-chemical evaluation of the scaffold, in order to collect different kinds of information, from dozens of studies. These data, when compiled and submitted to machine learning techniques, have the potential to initiate an exponential advance in tissue bioengineering research.
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Affiliation(s)
- Rayssa Helena Arruda Pereira
- Carlos Alberto Redins Cell Ultrastructure Laboratory (LUCCAR) and Tissue Engineering Core, Department of Morphology - Health Sciences Center, Federal University of Espírito Santo (UFES), Vitória, ES, Brazil.,Biotechnology Graduate Program - Rede Nordeste de Biotecnologia (RENORBIO), Vitória, ES, Brazil
| | - Adilson Ribeiro Prado
- Department of Control Engineering and Automation, Federal Institute of Espírito Santo, Serra, ES, Brazil
| | | | - Tadeu Ériton Caliman Zanardo
- Carlos Alberto Redins Cell Ultrastructure Laboratory (LUCCAR) and Tissue Engineering Core, Department of Morphology - Health Sciences Center, Federal University of Espírito Santo (UFES), Vitória, ES, Brazil.,Biotechnology Graduate Program - Rede Nordeste de Biotecnologia (RENORBIO), Vitória, ES, Brazil
| | - Airlane Pereira Alencar
- Department of Statistic, Institute of Mathematics and Statics, São Paulo University, São Paulo, SP, Brazil
| | - Breno Valentim Nogueira
- Carlos Alberto Redins Cell Ultrastructure Laboratory (LUCCAR) and Tissue Engineering Core, Department of Morphology - Health Sciences Center, Federal University of Espírito Santo (UFES), Vitória, ES, Brazil. .,Biotechnology Graduate Program - Rede Nordeste de Biotecnologia (RENORBIO), Vitória, ES, Brazil.
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23
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Shah AM, Bansal S, Shirsat PM, Prasad P, Desai RS. Exophytic verrucous hyperplasia in oral submucous fibrosis: A single-center study. J Oral Maxillofac Pathol 2019; 23:393-399. [PMID: 31942120 PMCID: PMC6948049 DOI: 10.4103/jomfp.jomfp_276_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Introduction: The present study analyzed the occurrence of exophytic verrucous hyperplasia (EVH) in the background of oral submucous fibrosis (OSF), which presents clinically as a solitary verrucopapillary lesion (VPL) mimicking malignancy. We also aimed to obtain additional information on VELscope appearance and histopathological features of EVH. Materials and Methods: The prevalence of EVH in OSF background was assessed from January 2014 to December 2018 using VELscope and histopathological examination. Results: Six hundred and sixty-two OSF patients were examined. Thirteen patients presented with solitary VPL in OSF background. A VELscope examination found ten cases with increased autofluorescence (fluorescence visualization increase, FVI), two cases with autofluorescence loss (fluorescence visualization loss, FVL), whereas one case exhibited dual autofluorescence (focal areas of FVL within FVI regions). Histopathologic examination revealed two FVL cases as oral verrucous carcinoma (OVC) and oral squamous cell carcinoma (OSCC) and one dual autofluorescence case as OVC, while six FVI cases showed nondysplastic epithelium having verrucopapillary pattern without connective tissue invasion, consistent with the clinicopathological diagnosis of EVH. Conclusion: The present study demonstrated the evidence of EVH in OSF background, which on histopathological examination revealed nondysplastic epithelium exhibiting the verrucopapillary pattern. A VELscope examination of these lesions showed increased autofluorescence, suggesting its nonneoplastic nature of clinically malignant-looking exophytic VPLs in OSF background. Present study suggests newer perspective for using the term oral verrucous hyperplasia (OVH) and EVH with justification and also proposes to introduce new terminology such as oral verrucous dysplasia and exophytic verrucous dysplasia.
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Affiliation(s)
- Aakruti M Shah
- Department of Oral Pathology, Nair Hospital Dental College, Mumbai, Maharashtra, India
| | - Shivani Bansal
- Department of Oral Pathology, Nair Hospital Dental College, Mumbai, Maharashtra, India
| | - Pankaj M Shirsat
- Department of Oral Pathology, Nair Hospital Dental College, Mumbai, Maharashtra, India
| | - Pooja Prasad
- Department of Oral Pathology, Nair Hospital Dental College, Mumbai, Maharashtra, India
| | - Rajiv S Desai
- Department of Oral Pathology, Nair Hospital Dental College, Mumbai, Maharashtra, India
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24
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Uthoff RD, Song B, Sunny S, Patrick S, Suresh A, Kolur T, Keerthi G, Spires O, Anbarani A, Wilder-Smith P, Kuriakose MA, Birur P, Liang R. Point-of-care, smartphone-based, dual-modality, dual-view, oral cancer screening device with neural network classification for low-resource communities. PLoS One 2018; 13:e0207493. [PMID: 30517120 PMCID: PMC6281283 DOI: 10.1371/journal.pone.0207493] [Citation(s) in RCA: 70] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Accepted: 10/30/2018] [Indexed: 01/17/2023] Open
Abstract
Oral cancer is a growing health issue in a number of low- and middle-income countries (LMIC), particularly in South and Southeast Asia. The described dual-modality, dual-view, point-of-care oral cancer screening device, developed for high-risk populations in remote regions with limited infrastructure, implements autofluorescence imaging (AFI) and white light imaging (WLI) on a smartphone platform, enabling early detection of pre-cancerous and cancerous lesions in the oral cavity with the potential to reduce morbidity, mortality, and overall healthcare costs. Using a custom Android application, this device synchronizes external light-emitting diode (LED) illumination and image capture for AFI and WLI. Data is uploaded to a cloud server for diagnosis by a remote specialist through a web app, with the ability to transmit triage instructions back to the device and patient. Finally, with the on-site specialist's diagnosis as the gold-standard, the remote specialist and a convolutional neural network (CNN) were able to classify 170 image pairs into 'suspicious' and 'not suspicious' with sensitivities, specificities, positive predictive values, and negative predictive values ranging from 81.25% to 94.94%.
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Affiliation(s)
- Ross D. Uthoff
- College of Optical Sciences, The University of Arizona, Tucson, Arizona, United States of America
- * E-mail: (RDU); (BS); (RL)
| | - Bofan Song
- College of Optical Sciences, The University of Arizona, Tucson, Arizona, United States of America
- * E-mail: (RDU); (BS); (RL)
| | - Sumsum Sunny
- Mazumdar Shaw Medical Centre, Bangalore, India
- Mazumdar Shaw Medical Foundation, Bangalore, India
| | | | - Amritha Suresh
- Mazumdar Shaw Medical Centre, Bangalore, India
- Mazumdar Shaw Medical Foundation, Bangalore, India
| | | | - G. Keerthi
- KLE Society’s Institute of Dental Sciences, Bangalore, India
| | - Oliver Spires
- College of Optical Sciences, The University of Arizona, Tucson, Arizona, United States of America
| | - Afarin Anbarani
- Beckman Laser Institute, University of California, Irvine, Irvine, California, United States of America
| | - Petra Wilder-Smith
- Beckman Laser Institute, University of California, Irvine, Irvine, California, United States of America
| | - Moni Abraham Kuriakose
- Mazumdar Shaw Medical Centre, Bangalore, India
- Mazumdar Shaw Medical Foundation, Bangalore, India
| | - Praveen Birur
- Biocon Foundation, Bangalore, India
- KLE Society’s Institute of Dental Sciences, Bangalore, India
| | - Rongguang Liang
- College of Optical Sciences, The University of Arizona, Tucson, Arizona, United States of America
- * E-mail: (RDU); (BS); (RL)
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25
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Strome A, Kossatz S, Zanoni DK, Rajadhyaksha M, Patel S, Reiner T. Current Practice and Emerging Molecular Imaging Technologies in Oral Cancer Screening. Mol Imaging 2018; 17:1536012118808644. [PMID: 32852263 PMCID: PMC6287312 DOI: 10.1177/1536012118808644] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Oral cancer is one of the most common cancers globally. Survival rates for patients are directly correlated with stage of diagnosis; despite this knowledge, 60% of individuals are presenting with late-stage disease. Currently, the initial evaluation of a questionable lesion is performed by a conventional visual examination with white light. If a lesion is deemed suspicious, a biopsy is taken for diagnosis. However, not all lesions present suspicious under visual white light examination, and there is limited specificity in differentiating between benign and malignant transformations. Several vital dyes, light-based detection systems, and cytology evaluation methods have been formulated to aid in the visualization process, but their lack of specific biomarkers resulted in high false-positive rates and thus limits their reliability as screening and guidance tools. In this review, we will analyze the current methodologies and demonstrate the need for specific intraoral imaging agents to aid in screening and diagnosis to identify patients earlier. Several novel molecular imaging agents will be presented as, by result of their molecular targeting, they aim to have high specificity for tumor pathways and can support in identifying dysplastic/cancerous lesions and guiding visualization of biopsy sites. Imaging agents that are easy to use, inexpensive, noninvasive, and specific can be utilized to increase the number of patients who are screened and monitored in a variety of different environments, with the ultimate goal of increasing early detection.
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Affiliation(s)
- Arianna Strome
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Susanne Kossatz
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | | | - Milind Rajadhyaksha
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Snehal Patel
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Thomas Reiner
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.,Department of Radiology, Weill-Cornell Medical College, New York, NY, USA
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Huang TT, Chen KC, Wong TY, Chen CY, Chen WC, Chen YC, Chang MH, Wu DY, Huang TY, Nioka S, Chung PC, Huang JS. Two-channel autofluorescence analysis for oral cancer. JOURNAL OF BIOMEDICAL OPTICS 2018; 24:1-10. [PMID: 30411551 PMCID: PMC6992899 DOI: 10.1117/1.jbo.24.5.051402] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2018] [Accepted: 08/01/2018] [Indexed: 06/08/2023]
Abstract
We created a two-channel autofluorescence test to detect oral cancer. The wavelengths 375 and 460 nm, with filters of 479 and 525 nm, were designed to excite and detect reduced-form nicotinamide adenine dinucleotide (NADH) and flavin adenine dinucleotide (FAD) autofluorescence. Patients with oral cancer or with precancerous lesions, and a control group with healthy oral mucosae, were enrolled. The lesion in the autofluorescent image was the region of interest. The average intensity and heterogeneity of the NADH and FAD were calculated. The redox ratio [(NADH)/(NADH + FAD)] was also computed. A quadratic discriminant analysis (QDA) was used to compute boundaries based on sensitivity and specificity. We analyzed 49 oral cancer lesions, 34 precancerous lesions, and 77 healthy oral mucosae. A boundary (sensitivity: 0.974 and specificity: 0.898) between the oral cancer lesions and healthy oral mucosae was validated. Oral cancer and precancerous lesions were also differentiated from healthy oral mucosae (sensitivity: 0.919 and specificity: 0.755). The two-channel autofluorescence detection device and analyses of the intensity and heterogeneity of NADH, and of FAD, and the redox ratio combined with a QDA classifier can differentiate oral cancer and precancerous lesions from healthy oral mucosae.
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Affiliation(s)
- Tze-Ta Huang
- National Cheng Kung University Hospital, Department of Stomatology, Division of Oral and Maxillofacial Surgery, Tainan, Taiwan
- National Cheng Kung University Medical College and Hospital, Institute of Oral Medicine, Tainan, Taiwan
| | - Ken-Chung Chen
- National Cheng Kung University Hospital, Department of Stomatology, Division of Oral and Maxillofacial Surgery, Tainan, Taiwan
- National Cheng Kung University Medical College and Hospital, Institute of Oral Medicine, Tainan, Taiwan
| | - Tung-Yiu Wong
- National Cheng Kung University Hospital, Department of Stomatology, Division of Oral and Maxillofacial Surgery, Tainan, Taiwan
- National Cheng Kung University Medical College and Hospital, Institute of Oral Medicine, Tainan, Taiwan
| | | | | | - Yi-Chun Chen
- National Cheng Kung University Medical College and Hospital, Institute of Oral Medicine, Tainan, Taiwan
| | - Ming-Hsuan Chang
- National Cheng Kung University, Institute of Computer and Communication Engineering, Tainan, Taiwan
| | - Dong-Yuan Wu
- National Cheng Kung University, Institute of Computer and Communication Engineering, Tainan, Taiwan
| | - Teng-Yi Huang
- National Cheng Kung University, Institute of Computer and Communication Engineering, Tainan, Taiwan
| | - Shoko Nioka
- University of Pennsylvania, Department of Radiology, Philadelphia, Pennsylvania, United States
| | - Pau-Choo Chung
- National Cheng Kung University, Department of Electrical Engineering, Tainan, Taiwan
| | - Jehn-Shyun Huang
- National Cheng Kung University Hospital, Department of Stomatology, Division of Oral and Maxillofacial Surgery, Tainan, Taiwan
- National Cheng Kung University Medical College and Hospital, Institute of Oral Medicine, Tainan, Taiwan
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Comparative evaluation of autofluorescence imaging and histopathological investigation for oral potentially malignant disorders in Taiwan. Clin Oral Investig 2018; 23:2395-2402. [PMID: 30302607 DOI: 10.1007/s00784-018-2691-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2018] [Accepted: 10/02/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVES Autofluorescence imaging is gaining popularity as an adjunctive test for oral potentially malignant disorders (OPMD). This study evaluated the efficacy of autofluorescence imaging based on the current standard oral mucosal disorder checklist in Taiwan. MATERIALS AND METHODS In total, 126 patients suspected to have mucosal disorders at the Division of Oral and Maxillofacial Surgery, Tri-Service General Hospital, Taipei, Taiwan, were enrolled. Following a conventional oral examination by using the oral mucosal disorder checklist and an autofluorescence imaging examination, all participants underwent histopathological examination to access epithelial dysplasia. RESULTS Among 126 patients, 68 patients were diagnosis as having an OPMD and 63 having epithelial dysplasia. Autofluorescence imaging exhibited a sensitivity, specificity, positivity predictive value (PPV), negative predictive value (NPV), and accuracy of 77.94%, 35.42%, 63.10%, 53.13%, and 60.34%, respectively, for OPMD and of 88.89%, 43.86%, 63.64%, 78.13%, and 67.50%, respectively, for epithelial dysplasia. After the exclusion of 48 non-OPMD cases according to the checklist, the sensitivity, specificity, PPV, NPV, and accuracy of autofluorescence imaging became 87.50%, 72.73%, 94.23%, 53.33%, and 85.07%, respectively, for epithelial dysplasia. CONCLUSION The efficacy of epithelial dysplasia identification and OPMD risk assessment can be increased after the exclusion of the non-OPMD cases through autofluorescence imaging. CLINICAL RELEVANCE Autofluorescence imaging is a useful adjunct that can assist specialists in assessing OPMD patients prone to dysplasia without compromising patient care.
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Kikuta S, Iwanaga J, Todoroki K, Shinozaki K, Tanoue R, Nakamura M, Kusukawa J. Clinical Application of the IllumiScan Fluorescence Visualization Device in Detecting Oral Mucosal Lesions. Cureus 2018; 10:e3111. [PMID: 30338186 PMCID: PMC6175259 DOI: 10.7759/cureus.3111] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objective: Fluorescence visualization devices are screening devices that can be used to examine lesions of the oral mucosa non-invasively. We observed oral squamous cell carcinoma (OSCC) and leukoplakia using the IllumiScan (Shofu, Kyoto, Japan) fluorescence visualization device and examined its usefulness and characteristics. Methods: We investigated 31 OSCC and nine leukoplakia in patients who were examined using the IllumiScan and treated in our department from January 2017 to February 2018. Images taken with the IllumiScan were analyzed using image analysis software. We also examined the lesions using narrowband imaging (NBI). Additionally, the IllumiScan and NBI images and the non-stained areas of iodine staining method (IOM) were visually evaluated. Results: The average luminance of OSCC in the keratinized mucosa was significantly lower than that of OSCC in non-keratinized mucosa. The average luminance of OSCC was significantly lower than that of leukoplakia. Even in keratinized mucosa where IOM is impossible to use, the OSCC lesion exhibited fluorescence visualization loss. Conclusion: The application of the fluorescence visualization device to the oral mucosa may be useful for distinguishing between cancer and normal areas and can be used to detect OSCC in the keratinized mucosa. The use of the IllumiScan in combination with other conventional screening methods may lead to a better diagnosis.
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Affiliation(s)
- Shogo Kikuta
- Dental and Oral Medical Center, Kurume University School of Medicine, Kurume, JPN
| | - Joe Iwanaga
- Medical Education and Simulation, Seattle Science Foundation, Seattle, USA
| | | | | | | | | | - Jingo Kusukawa
- Dental and Oral Medical Center, Kurume University School of Medicine, Kurume, JPN
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Singh P, Sahoo GR, Pradhan A. Spatio-temporal map for early cancer detection: Proof of concept. JOURNAL OF BIOPHOTONICS 2018; 11:e201700181. [PMID: 29411946 DOI: 10.1002/jbio.201700181] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Accepted: 01/21/2018] [Indexed: 06/08/2023]
Abstract
A spatio-temporal map of human cervical tissue is obtained from time-resolved fluorescence images with the dynamic contrast enhanced through principal component analysis (PCA) for clear demarcation of regions of normal and pre-cancerous conditions. Changes in the properties of fluorescence in different environments are captured through fluorescence lifetime maps in the human cervical tissue sample. The correlation embodied in the second principal component (PC) representing sectorial information free of background of the first PC, segregates fluorescence activities, as illustrated in the PC maps. It significantly enhances the contrast of the images which are majorly handicapped by the variations in fluorophore environment. The result is validated on phantoms, mimicking the changes in the environment of normal and abnormal tissues. This spatio-temporal map illustrates the potential of time resolved auto-fluorescence imaging of cervical tissue in combination with PCA to clearly demarcate normal and abnormal regions with enhanced contrast.
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Affiliation(s)
- Pankaj Singh
- Department of Physics, IIT Kanpur, Kanpur, India
| | | | - Asima Pradhan
- Department of Physics, IIT Kanpur, Kanpur, India
- Center for Laser and Photonics, IIT Kanpur, Kanpur, India
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30
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Fluorescence spectroscopic study on malignant and premalignant oral mucosa of patients undergoing treatment: An observational prospective study. Int J Surg 2018; 55:87-91. [DOI: 10.1016/j.ijsu.2018.05.029] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Revised: 04/10/2018] [Accepted: 05/22/2018] [Indexed: 11/20/2022]
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Sim FW, Xiao HD, Bell RB. Margin Analysis: Squamous Cell Carcinoma of the Oropharynx. Oral Maxillofac Surg Clin North Am 2018; 29:269-280. [PMID: 28709530 DOI: 10.1016/j.coms.2017.03.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Because of the common shared risk factors of smoking and heavy alcohol consumption, literature involving oropharyngeal squamous cell carcinoma (OPSCC) is often combined with oral squamous cell carcinoma. Human papilloma virus is now confirmed to be a major risk factor of OPSCC with its distinct epidemiology and favorable treatment outcome. The impact of adjuvant chemoradiation in the setting of positive surgical margins remains unclear but is likely influenced by tumor biology. This article reviews the tumor biology of OPSCC and summarizes recent findings on outcomes following surgical treatment of OPSCC.
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Affiliation(s)
- Felix W Sim
- Head and Neck Institute, Providence Cancer Center, Providence Portland Medical Center, 4805 Northeast Glisan Street, Suite 6N50, Portland, OR 97213, USA
| | - Hong D Xiao
- Head and Neck Pathologist, Department of Pathology, Providence Portland Medical Center, 4805 Northeast Glisan Street, Suite 6N50, Portland, OR 97213, USA
| | - R Bryan Bell
- Head and Neck Institute, Providence Cancer Center, Providence Portland Medical Center, 4805 Northeast Glisan Street, Suite 6N50, Portland, OR 97213, USA.
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Pellionisz PA, Badran KW, Grundfest WS, St. John MA. Detection of surgical margins in oral cavity cancer: the role of dynamic optical contrast imaging. Curr Opin Otolaryngol Head Neck Surg 2018; 26:102-107. [PMID: 29517537 PMCID: PMC5846197 DOI: 10.1097/moo.0000000000000444] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW The quantity of tissue removed during an oncologic surgical procedure is not standardized and there are numerous reports of local recurrence despite histologically adequate resection margins. The oral cavity is one of the sites in the head and neck with high chances of recurrence following negative margins. To address this need, this article reviews the recent applications of Dynamic Optical Contrast Imaging (DOCI) towards both oral screening and the intraoperative evaluation of tumor margins in head and neck surgery. RECENT FINDINGS Human ex-vivo and in-vivo trials suggest DOCI is well tolerated, low-cost, and sensitive for differentiating cancerous from normal tissues throughout the head and neck, in addition to the oral cavity. Ex-vivo imaging of OSCC specimens generated histologically verified image contrast. Furthermore, in-vivo intraoperative results demonstrate significant potential for image-guided detection and resection of oral cavity squamous cell carcinoma (OSCC). SUMMARY DOCI augments tissue contrast and may enable surgeons to clinically screen patients for oral cancer, make histologic evaluations in vivo with fewer unnecessary biopsies, delineate clinical margins for tumor resection, provide guidance in the choice of biopsy sites, and preserve healthy tissue to increase the postoperative functionality and quality of life of the patient.
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Affiliation(s)
- Peter A. Pellionisz
- Department of Bioengineering, Henry Samueli School of Engineering and Applied Sciences, UCLA, 420 Westwood Plaza, Los Angeles, CA, USA, 90025
- Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA, 200 Medical Plaza, Los Angeles, CA, USA, 90025
- Jonsson Comprehensive Cancer Center, UCLA
| | - Karam W. Badran
- Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA, 200 Medical Plaza, Los Angeles, CA, USA, 90025
- Jonsson Comprehensive Cancer Center, UCLA
- UCLA Head and Neck Cancer Program, Los Angeles CA 90025
| | - Warren S. Grundfest
- Department of Bioengineering, Henry Samueli School of Engineering and Applied Sciences, UCLA, 420 Westwood Plaza, Los Angeles, CA, USA, 90025
- Department of Electrical Engineering, UCLA, 420 Westwood Plaza, Los Angeles, CA, USA, 90025
- Department of Surgery, UCLA, 200 Medical Plaza, Los Angeles, CA, USA, 90025
| | - Maie A. St. John
- Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA, 200 Medical Plaza, Los Angeles, CA, USA, 90025
- Jonsson Comprehensive Cancer Center, UCLA
- UCLA Head and Neck Cancer Program, Los Angeles CA 90025
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Farah CS, Kordbacheh F, John K, Bennett N, Fox SA. Molecular classification of autofluorescence excision margins in oral potentially malignant disorders. Oral Dis 2018; 24:732-740. [DOI: 10.1111/odi.12818] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Revised: 11/26/2017] [Accepted: 12/04/2017] [Indexed: 12/23/2022]
Affiliation(s)
- C S Farah
- Australian Centre for Oral Oncology Research & Education; UWA Dental School; University of Western Australia; Nedlands WA Australia
- University of Queensland Centre for Clinical Research; The University of Queensland; Herston QLD Australia
| | - F Kordbacheh
- University of Queensland Centre for Clinical Research; The University of Queensland; Herston QLD Australia
| | - K John
- University of Queensland Centre for Clinical Research; The University of Queensland; Herston QLD Australia
| | - N Bennett
- University of Queensland Centre for Clinical Research; The University of Queensland; Herston QLD Australia
| | - S A Fox
- Australian Centre for Oral Oncology Research & Education; UWA Dental School; University of Western Australia; Nedlands WA Australia
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Kumar P, Singh A, Kumar Kanaujia S, Pradhan A. Human Saliva for Oral Precancer Detection: a Comparison of Fluorescence & Stokes Shift Spectroscopy. J Fluoresc 2017; 28:419-426. [PMID: 29256095 DOI: 10.1007/s10895-017-2203-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Accepted: 12/13/2017] [Indexed: 12/01/2022]
Abstract
We report here a study on human saliva tested as a diagnostic medium for oral cancer detection on three groups: oral squamous cell carcinoma (OSCC), oral sub mucous fibrosis (OSMF; precancer), and healthy controls (normal). Measurements have been conducted using fluorescence spectroscopy with 350 nm excitation and Stokes shift (SS) spectroscopy (SSS) with 120 nm shift from a total of 99 saliva samples. For classification, principal component analysis (PCA) and linear discriminant analysis (LDA) have been applied on the data sets. Linear discriminant (LD) scores of fluorescence spectra are able to differentiate OSCC to normal, OSMF to normal and OSCC to OSMF with sensitivities 91%, 92%, 91% and specificities 97%, 100%, 94% respectively, while LD scores of SS spectra differentiate respective groups with sensitivities 100%, 94%, 94% and specificities 97%, 100%, 94%. Cross-validation on the datasets of PC scores during LDA illustrates that sensitivity and specificity of SSS data are less affected than those of fluorescence data. Saliva is thus seen as a potential non-invasive and simple diagnostic medium, with SS spectroscopy as a better diagnostic tool for oral precancer.
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Affiliation(s)
- Pavan Kumar
- Department of Physics, Indian Institute of Technology Kanpur (IITK), Kanpur, 208016, India
| | - Ashutosh Singh
- Department of ENT, Ganesh Shankar Vidyarthi Memorial College (GSVM), Kanpur, 208002, India
| | | | - Asima Pradhan
- Department of Physics, Indian Institute of Technology Kanpur (IITK), Kanpur, 208016, India. .,Center for Lasers and Photonics (CELP), IIT Kanpur, Kanpur, 208016, India.
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35
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Identification of autofluorescent cells in human angioimmunoblastic T-cell lymphoma. Histochem Cell Biol 2017; 149:169-177. [PMID: 29197996 DOI: 10.1007/s00418-017-1624-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/29/2017] [Indexed: 02/08/2023]
Abstract
Endogenous cell autofluorescence is a common nuisance that complicates the use of fluorescence microscopy. When using fluorescence-labeled antibodies for specific cell labeling in tissue sections of human angioimmunoblastic T-cell lymphoma (AITL), we encountered with a problematic autofluorescence of multiple cells. These cells emitted fluorescence signals in the green, red and deep-red spectral range. Characterization of these autofluorescent cells solely on the basis of their autofluorescence failed. To identify these enigmatic cells residing the lymphoma tissue, we combined two imaging techniques-fluorescence and brightfield microscopy. Combined fluorescence/brightfield imaging of cells immunolabeled with a panel of CD antibodies raised against diverse cellular components allowed us to identify the autofluorescent cells in the AITL as eosinophils. These cells tended to accumulate in the vicinity of capillaries and arterioles apparently mediating the process of angiogenesis resembling other angiogenesis-associated diseases.
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Yamamoto N, Kawaguchi K, Fujihara H, Hasebe M, Kishi Y, Yasukawa M, Kumagai K, Hamada Y. Detection accuracy for epithelial dysplasia using an objective autofluorescence visualization method based on the luminance ratio. Int J Oral Sci 2017; 9:e2. [PMID: 29125138 PMCID: PMC5775331 DOI: 10.1038/ijos.2017.37] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/21/2017] [Indexed: 11/07/2022] Open
Abstract
The autofluorescence visualization method (AVM) uses blue excitation light to assist in the diagnosis of epithelial dysplasia. It detects epithelial dysplasia as a black area, which is known as fluorescence visualization loss (FVL). In this study, we evaluated the detection accuracy for epithelial dysplasia of the tongue using the objective AVM and assessed its possible clinical utility. Seventy-nine tongue specimens clinically suspected to have leukoplakia or squamous cell carcinoma (SCC) were analyzed. First, the AVM was subjectively performed using the Visually Enhanced Lesion scope (VELscope), and the iodine-staining method was then performed. After biopsy, the histopathological results and the luminance ratio between the lesion and healthy tissue were compared, and a receiver operating characteristic curve was created. The cutoff value for the objective AVM was determined; the lesion was considered FVL-positive or -negative when the luminance ratio was higher or lower than the cutoff value, respectively. The histopathological diagnoses among the 79 specimens were SCC (n=30), leukoplakia with dysplasia (n=34), and leukoplakia without dysplasia (n=15). The cutoff value of the luminance ratio was 1.62, resulting in 66 FVL-positive and 13 FVL-negative specimens. The luminance ratio was significantly higher in the epithelial dysplasia-positive than -negative group (P<0.000 1). The objective AVM showed much higher consistency between histopathological results than did the two methods (kappa statistic=0.656). In conclusion, objective autofluorescence visualization has a potential as an auxiliary method for diagnosis of epithelial dysplasia.
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Affiliation(s)
- Nanami Yamamoto
- Department of Oral and Maxillofacial Surgery, School of Dental Medicine, Tsurumi University, Yokohama, Japan
| | - Koji Kawaguchi
- Department of Oral and Maxillofacial Surgery, School of Dental Medicine, Tsurumi University, Yokohama, Japan
| | - Hisako Fujihara
- Department of Oral and Maxillofacial Surgery, School of Dental Medicine, Tsurumi University, Yokohama, Japan.,Department of Oral Hygiene, Tsurumi Junior College, Yokohama, Japan
| | - Mitsuhiko Hasebe
- Department of Oral and Maxillofacial Surgery, School of Dental Medicine, Tsurumi University, Yokohama, Japan
| | - Yuta Kishi
- Department of Oral and Maxillofacial Surgery, School of Dental Medicine, Tsurumi University, Yokohama, Japan
| | - Masaaki Yasukawa
- Department of Oral and Maxillofacial Surgery, School of Dental Medicine, Tsurumi University, Yokohama, Japan
| | - Kenichi Kumagai
- Department of Oral and Maxillofacial Surgery, School of Dental Medicine, Tsurumi University, Yokohama, Japan
| | - Yoshiki Hamada
- Department of Oral and Maxillofacial Surgery, School of Dental Medicine, Tsurumi University, Yokohama, Japan
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Ganga RS, Gundre D, Bansal S, Shirsat PM, Prasad P, Desai RS. Evaluation of the diagnostic efficacy and spectrum of autofluorescence of benign, dysplastic and malignant lesions of the oral cavity using VELscope. Oral Oncol 2017; 75:67-74. [PMID: 29224826 DOI: 10.1016/j.oraloncology.2017.10.023] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Revised: 10/23/2017] [Accepted: 10/26/2017] [Indexed: 10/18/2022]
Abstract
OBJECTIVES Conventional oral examination and biopsy are the only reliable methods for the early detection of oral cancer at present. Autofluorescence examination of oral tissues using the VELscope has been suggested as an adjunctive tool for cancer detection and diagnosis. The aim of our study was to evaluate the efficacy of the VELscope in recognizing dysplastic and/or neoplastic changes in oral mucosal lesions that were identified on conventional oral examination. MATERIALS AND METHODS Two hundred patients with oral mucosal lesions were subjected to conventional oral examination followed by VELscope examination and their autofluorescence characteristics were compared with the histopathological diagnosis. The sensitivity, specificity, positive and negative predictive values of the VELscope examination was calculated. RESULTS The VELscope examination showed sensitivity and specificity values of 76% (95% CI: 54.87-90.64%) and 66.29% (95% CI: 58.76-73.24%) respectively while the positive and negative predictive values were 24.36% (95% CI: 19.22-30.36%) and 95.08% (95% CI: 90.52-97.51%) respectively. CONCLUSION The VELscope examination alone cannot provide a definitive diagnosis as to the presence of dysplastic tissue change. In spite of having a reasonable sensitivity, the high number of false-positive results limits its efficiency as an adjunct. However, a high negative predictive value can serve to alleviate patient anxiety regarding suspicious mucosal lesions in a general practice setting.
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Affiliation(s)
- Ravikant S Ganga
- Department of Oral Pathology and Microbiology, Nair Hospital Dental College, Dr. A.L Nair Road, Mumbai Central, Mumbai 400008, India.
| | - Dipali Gundre
- Department of Oral Pathology and Microbiology, Nair Hospital Dental College, Dr. A.L Nair Road, Mumbai Central, Mumbai 400008, India.
| | - Shivani Bansal
- Department of Oral Pathology and Microbiology, Nair Hospital Dental College, Dr. A.L Nair Road, Mumbai Central, Mumbai 400008, India.
| | - Pankaj M Shirsat
- Department of Oral Pathology and Microbiology, Nair Hospital Dental College, Dr. A.L Nair Road, Mumbai Central, Mumbai 400008, India.
| | - Pooja Prasad
- Department of Oral Pathology and Microbiology, Nair Hospital Dental College, Dr. A.L Nair Road, Mumbai Central, Mumbai 400008, India.
| | - Rajiv S Desai
- Department of Oral Pathology and Microbiology, Nair Hospital Dental College, Dr. A.L Nair Road, Mumbai Central, Mumbai 400008, India.
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Abstract
The most important prognostic factor in predicting the outcome of oral and oropharyngeal cancer (OPC) is the stage at which it is diagnosed. Only 30% of patients are diagnosed with early-stage disease. The oral health care provider performs an important role in early diagnosis of oral cancer. The conventional oral examination consists of a visual and tactile assessment of accessible oral, and head and neck structures. Any suspicious or equivocal lesion should be reevaluated within 4 weeks. Evidence supporting the use of adjunctive devices to improve the ability to screen for and identify OPCs and oral premalignant lesions remains low.
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Affiliation(s)
- Michaell A Huber
- Department of Comprehensive Dentistry, UT Health San Antonio School of Dentistry, 7703 Floyd Curl Drive (Mail Code 7919), San Antonio, TX 78229, USA.
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Grillone GA, Wang Z, Krisciunas GP, Tsai AC, Kannabiran VR, Pistey RW, Zhao Q, Rodriguez-Diaz E, A'Amar OM, Bigio IJ. The color of cancer: Margin guidance for oral cancer resection using elastic scattering spectroscopy. Laryngoscope 2017; 127 Suppl 4:S1-S9. [PMID: 28752518 DOI: 10.1002/lary.26763] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2017] [Revised: 05/29/2017] [Accepted: 06/02/2017] [Indexed: 12/20/2022]
Abstract
OBJECTIVES/HYPOTHESIS To evaluate the usefulness of elastic scattering spectroscopy (ESS) as a diagnostic adjunct to frozen section analysis in patients with diagnosed squamous cell carcinoma of the oral cavity. STUDY DESIGN Prospective analytic study. METHODS Subjects for this single institution, institutional review board-approved study were recruited from among patients undergoing surgical resection for squamous cell cancer of the oral cavity. A portable ESS device with a contact fiberoptic probe was used to obtain spectral signals. Four to 10 spectral readings were obtained on each subject from various sites including gross tumor and normal-appearing mucosa in the surgical margin. Each reading was correlated with the histopathologic findings of biopsies taken from the exact location of the spectral readings. A diagnostic algorithm based on multidimensional pattern recognition/machine learning was developed. Sensitivity and specificity, error rate, and area under the curve were used as performance metrics for tests involving classification between disease and nondisease classes. RESULTS Thirty-four (34) subjects were enrolled in the study. One hundred seventy-six spectral data point/biopsy specimen pairs were available for analysis. ESS distinguished normal from abnormal tissue, with a sensitivity ranging from 84% to 100% and specificity ranging from 71% to 89%, depending on how the cutoff between normal and abnormal tissue was defined (i.e., mild, moderate, or severe dysplasia). There were statistically significant differences in malignancy scores between histologically normal tissue and invasive cancer and between noninflamed tissue and inflamed tissue. CONCLUSIONS This is the first study to evaluate the effectiveness of ESS in guiding mucosal resection margins in oral cavity cancer. ESS provides fast, real-time assessment of tissue without the need for pathology expertise. ESS appears to be effective in distinguishing between normal mucosa and invasive cancer and between "normal" tissue (histologically normal and mild dysplasia) and "abnormal" tissue (severe dysplasia and carcinoma in situ) that might require further margin resection. Further studies, however, are needed with a larger sample size to validate these findings and to determine the effectiveness of ESS in distinguishing visibly and histologically normal tissue from visibly normal but histologically abnormal tissue. LEVEL OF EVIDENCE NA Laryngoscope, 127:S1-S9, 2017.
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Affiliation(s)
- Gregory A Grillone
- Department of Otolaryngology-Head and Neck Surgery, Boston Medical Center/Boston University School of Medicine, Boston, Massachusetts
| | - Zimmern Wang
- Department of Otolaryngology-Head and Neck Surgery, Boston Medical Center/Boston University School of Medicine, Boston, Massachusetts
| | - Gintas P Krisciunas
- Department of Otolaryngology-Head and Neck Surgery, Boston Medical Center/Boston University School of Medicine, Boston, Massachusetts
| | - Angela C Tsai
- Department of Otolaryngology-Head and Neck Surgery, Boston Medical Center/Boston University School of Medicine, Boston, Massachusetts
| | - Vishnu R Kannabiran
- Department of Otolaryngology-Head and Neck Surgery, Boston Medical Center/Boston University School of Medicine, Boston, Massachusetts
| | - Robert W Pistey
- Department of Pathology and Laboratory Medicine, Boston Medical Center/Boston University School of Medicine, Boston, Massachusetts
| | - Qing Zhao
- Department of Pathology and Laboratory Medicine, Boston Medical Center/Boston University School of Medicine, Boston, Massachusetts
| | - Eladio Rodriguez-Diaz
- Department of Biomedical Engineering, Boston University College of Engineering, Boston, Massachusetts, U.S.A
| | - Ousama M A'Amar
- Department of Biomedical Engineering, Boston University College of Engineering, Boston, Massachusetts, U.S.A
| | - Irving J Bigio
- Department of Biomedical Engineering, Boston University College of Engineering, Boston, Massachusetts, U.S.A
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40
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Pal R, Edward K, Ma L, Qiu S, Vargas G. Spectroscopic characterization of oral epithelial dysplasia and squamous cell carcinoma using multiphoton autofluorescence micro-spectroscopy. Lasers Surg Med 2017; 49:866-873. [PMID: 28677822 DOI: 10.1002/lsm.22697] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/02/2017] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Multiphoton autofluorescence microscopy (MPAM) has shown potential in identifying features that are directly related to tissue microstructural and biochemical changes throughout epithelial neoplasia. In this study, we evaluate the autofluorescence spectral characteristics of neoplastic epithelium in dysplasia and oral squamous cell carcinoma (OSCC) using multiphoton autofluorescence spectroscopy (MPAS) in an in vivo hamster model of oral neoplasia in order to identify unique signatures that could be used to delineate normal oral mucosa from neoplasia. MATERIALS/METHODS A 9,10-dimethyl-1,2-benzanthracene (DMBA) hamster model of oral precancer and OSCC was used for in vivo MPAM and MPAS. Multiphoton Imaging and spectroscopy were performed with 780 nm excitation while a bandpass emission 450-650 nm was used for MPAM. Autofluorescence spectra was collected in the spectral window of 400-650 nm. RESULTS MPAS with fluorescence excitation at 780 nm revealed an overall red shift of a primary blue-green peak (480-520 nm) that is attributed to NADH and FAD. In the case of oral squamous cell carcinoma (OSCC) and some high-grade dysplasia an additional prominent peak at 635 nm, attributed to PpIX was observed. The fluorescence intensity at 635 nm and an intensity ratio of the primary blue-green peak versus 635 nm peak, showed statistically significant difference between control and neoplastic tissue. DISCUSSION Neoplastic transformation in the epithelium is known to alter the intracellular homeostasis of important tissue metabolites such as NADH, FAD, and PpIX, which was observed by MPAS in their native environment. A combination of deep tissue microscopy owing to higher penetration depth of multiphoton excitation and depth resolved spectroscopy could prove to be invaluable in identification of cytologic as well as biomolecular spectral characteristic of oral epithelial neoplasia. Lasers Surg. Med. 49:866-873, 2017. © 2017 Wiley Periodicals, Inc.
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Affiliation(s)
- Rahul Pal
- Center for Biomedical Engineering, The University of Texas Medical Branch, Galveston, Texas, 77555.,Department of Biochemistry and Molecular Biology, The University of Texas Medical Branch, Galveston, Texas, 77555
| | - Kert Edward
- Department of Physics, University of the West Indies, UWI Mona, Kingston 7, Mona, Jamaica
| | - Liang Ma
- Center for Biomedical Engineering, The University of Texas Medical Branch, Galveston, Texas, 77555
| | - Suimin Qiu
- Department of Pathology, The University of Texas Medical Branch, Galveston, Texas, 77555
| | - Gracie Vargas
- Center for Biomedical Engineering, The University of Texas Medical Branch, Galveston, Texas, 77555.,Department of Neuroscience and Cell Biology, The University of Texas Medical Branch, Galveston, Texas, 77555
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41
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Stelzle F, Rohde M, Riemann M, Oetter N, Adler W, Tangermann-Gerk K, Schmidt M, Knipfer C. Autofluorescence spectroscopy for nerve-sparing laser surgery of the head and neck-the influence of laser-tissue interaction. Lasers Med Sci 2017; 32:1289-1300. [PMID: 28551764 DOI: 10.1007/s10103-017-2240-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2016] [Accepted: 05/18/2017] [Indexed: 11/30/2022]
Abstract
The use of remote optical feedback systems represents a promising approach for minimally invasive, nerve-sparing laser surgery. Autofluorescence properties can be exploited for a fast, robust identification of nervous tissue. With regard to the crucial step towards clinical application, the impact of laser ablation on optical properties in the vicinity of structures of the head and neck has not been investigated up to now. We acquired 24,298 autofluorescence spectra from 135 tissue samples (nine ex vivo tissue types from 15 bisected pig heads) both before and after ER:YAG laser ablation. Sensitivities, specificities, and area under curve(AUC) values for each tissue pair as well as the confusion matrix were statistically calculated for pre-ablation and post-ablation autofluorescence spectra using principal component analysis (PCA), quadratic discriminant analysis (QDA), and receiver operating characteristics (ROC). The confusion matrix indicated a highly successful tissue discrimination rate before laser exposure, with an average classification error of 5.2%. The clinically relevant tissue pairs nerve/cancellous bone and nerve/salivary gland yielded an AUC of 100% each. After laser ablation, tissue discrimination was feasible with an average classification accuracy of 92.1% (average classification error 7.9%). The identification of nerve versus cancellous bone and salivary gland performed very well with an AUC of 100 and 99%, respectively. Nerve-sparing laser surgery in the area of the head and neck by means of an autofluorescence-based feedback system is feasible even after ER-YAG laser-tissue interactions. These results represent a crucial step for the development of a clinically applicable feedback tool for laser surgery interventions in the oral and maxillofacial region.
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Affiliation(s)
- Florian Stelzle
- Department of Oral and Maxillofacial Surgery, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), University Hospital Erlangen, Glückstraße 11, 91054, Erlangen, Germany.,Graduate School in Advanced Optical Technologies (SAOT), Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Paul-Gordan-Str. 6, 91052, Erlangen, Germany
| | - Maximilian Rohde
- Department of Oral and Maxillofacial Surgery, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), University Hospital Erlangen, Glückstraße 11, 91054, Erlangen, Germany.,Graduate School in Advanced Optical Technologies (SAOT), Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Paul-Gordan-Str. 6, 91052, Erlangen, Germany
| | - Max Riemann
- Department of Oral and Maxillofacial Surgery, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), University Hospital Erlangen, Glückstraße 11, 91054, Erlangen, Germany
| | - Nicolai Oetter
- Department of Oral and Maxillofacial Surgery, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), University Hospital Erlangen, Glückstraße 11, 91054, Erlangen, Germany
| | - Werner Adler
- Department of Medical Informatics, Biometry and Epidemiology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Waldstraße 6, 91054, Erlangen, Germany
| | | | - Michael Schmidt
- Graduate School in Advanced Optical Technologies (SAOT), Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Paul-Gordan-Str. 6, 91052, Erlangen, Germany.,Bavarian Laser Center GmbH (blz), Konrad-Zuse-Straße 2-6, 91054, Erlangen, Germany.,Institute of Photonic Technologies, Friedrich-Alexander-University Erlangen-Nürnberg(FAU), Konrad-Zuse-Straße 3-5, 91052, Erlangen, Germany
| | - Christian Knipfer
- Graduate School in Advanced Optical Technologies (SAOT), Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Paul-Gordan-Str. 6, 91052, Erlangen, Germany. .,Department of Oral and Maxillofacial Surgery, University of Hamburg (UHH), University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany.
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42
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Yan YJ, Huang TW, Cheng NL, Hsieh YF, Tsai MH, Chiou JC, Duann JR, Lin YJ, Yang CS, Ou-Yang M. Portable LED-induced autofluorescence spectroscopy for oral cancer diagnosis. JOURNAL OF BIOMEDICAL OPTICS 2017; 22:45007. [PMID: 28421226 DOI: 10.1117/1.jbo.22.4.045007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Accepted: 03/07/2017] [Indexed: 06/07/2023]
Abstract
Oral cancer is a serious and growing problem in many developing and developed countries. To improve the cancer screening procedure, we developed a portable light-emitting-diode (LED)-induced autofluorescence (LIAF) imager that contains two wavelength LED excitation light sources and multiple filters to capture ex vivo oral tissue autofluorescence images. Compared with conventional means of oral cancer diagnosis, the LIAF imager is a handier, faster, and more highly reliable solution. The compact design with a tiny probe allows clinicians to easily observe autofluorescence images of hidden areas located in concave deep oral cavities. The ex vivo trials conducted in Taiwan present the design and prototype of the portable LIAF imager used for analyzing 31 patients with 221 measurement points. Using the normalized factor of normal tissues under the excitation source with 365 nm of the central wavelength and without the bandpass filter, the results revealed that the sensitivity was larger than 84%, the specificity was not smaller than over 76%, the accuracy was about 80%, and the area under curve of the receiver operating characteristic (ROC) was achieved at about 87%, respectively. The fact shows the LIAF spectroscopy has the possibilities of ex vivo diagnosis and noninvasive examinations for oral cancer.
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Affiliation(s)
- Yung-Jhe Yan
- National Chiao-Tung University, Institute of Electrical Control Engineering, Hsinchu City, Taiwan
| | - Ting-Wei Huang
- National Chiao-Tung University, Department of Electrical and Computer Engineering, Hsinchu City, Taiwan
| | - Nai-Lun Cheng
- National Chiao-Tung University, Institute of Biomedical Engineering, Hsinchu City, Taiwan
| | - Yao-Fang Hsieh
- National Central University, Department of Optics and Photonics, Jhongli City, Taoyuan County, Taiwan
| | - Ming-Hsui Tsai
- China Medical University, School of Medicine, Taichung City, Taiwan
| | - Jin-Chern Chiou
- National Chiao-Tung University, Institute of Electrical Control Engineering, Hsinchu City, TaiwanbNational Chiao-Tung University, Department of Electrical and Computer Engineering, Hsinchu City, TaiwaneChina Medical University, School of Medicine, Taichung City, Taiwan
| | - Jeng-Ren Duann
- China Medical University, School of Medicine, Taichung City, Taiwan
| | - Yung-Jiun Lin
- China Medical University, School of Medicine, Taichung City, Taiwan
| | - Chin-Siang Yang
- National Chiao-Tung University, Department of Electrical and Computer Engineering, Hsinchu City, Taiwan
| | - Mang Ou-Yang
- National Chiao-Tung University, Institute of Electrical Control Engineering, Hsinchu City, TaiwanbNational Chiao-Tung University, Department of Electrical and Computer Engineering, Hsinchu City, Taiwan
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43
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Chromophores in operative surgery: Current practice and rationalized development. J Control Release 2017; 249:123-130. [DOI: 10.1016/j.jconrel.2016.12.044] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Revised: 12/23/2016] [Accepted: 12/28/2016] [Indexed: 12/18/2022]
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Jané-Salas E, Blanco-Carrión A, Jover-Armengol L, López-López J. Autofluorescence and Diagnostic Accuracy of Lesions of Oral Mucosa: A Pilot Study. Braz Dent J 2017; 26:580-6. [PMID: 26963199 DOI: 10.1590/0103-6440201300181] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2014] [Accepted: 09/11/2015] [Indexed: 11/21/2022] Open
Abstract
The purpose of this study was to determine the accuracy of autofluorescence techniques for diagnosing oral mucosa lesions, using as reference pattern for comparison the visual diagnosis made by a clinical specialist. A pilot study was conducted with 60 patients divided in a control group without mucosal pathology and a study group with known clinical history for mucosal pathology. Both groups were examined by an oral medicine specialist and by a general dentist who used VELscope(r) system, which applies tissue fluorescence visualization to identify oral mucosal abnormalities. Using the VELscope(r) system, the general dentist made overdiagnosis in two cases and underdiagnosis in one case. The sensitivity and specificity for the oral medicine specialist were 1 (95% CI: 0.884 to 1). For the general dentist, the sensitivity did not improve significantly with the use of VELscope(r) system [0.53 (95% CI: 0.343 to 0.717) versus 0.49 (95% CI: 0.406 to 0.773)] and the specificity was 0.80 (95% CI: 0.614 to 0.923). A limitation of the study is the small sample size, which does not fully represent a population and extrapolation of the data should be done carefully. Based on the obtained results, no clinical benefits were obtained using this VELscope(r) system.
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Affiliation(s)
- Enric Jané-Salas
- Department of Dentistry and Stomatology, University of Barcelona, Catalonia, Spain
| | | | | | - José López-López
- Department of Dentistry and Stomatology, University of Barcelona, Catalonia, Spain
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45
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Brindha E, Rajasekaran R, Aruna P, Koteeswaran D, Ganesan S. High wavenumber Raman spectroscopy in the characterization of urinary metabolites of normal subjects, oral premalignant and malignant patients. SPECTROCHIMICA ACTA. PART A, MOLECULAR AND BIOMOLECULAR SPECTROSCOPY 2017; 171:52-59. [PMID: 27475997 DOI: 10.1016/j.saa.2016.06.048] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2015] [Revised: 06/15/2016] [Accepted: 06/28/2016] [Indexed: 06/06/2023]
Abstract
Urine has emerged as one of the diagnostically potential bio fluids, as it has many metabolites. As the concentration and the physiochemical properties of the urinary metabolites may vary under pathological transformation, Raman spectroscopic characterization of urine has been exploited as a significant tool in identifying several diseased conditions, including cancers. In the present study, an attempt was made to study the high wavenumber (HWVN) Raman spectroscopic characterization of urine samples of normal subjects, oral premalignant and malignant patients. It is concluded that the urinary metabolites flavoproteins, tryptophan and phenylalanine are responsible for the observed spectral variations between the normal and abnormal groups. Principal component analysis-based linear discriminant analysis was carried out to verify the diagnostic potentiality of the present technique. The discriminant analysis performed across normal and oral premalignant subjects classifies 95.6% of the original and 94.9% of the cross-validated grouped cases correctly. In the second analysis performed across normal and oral malignant groups, the accuracy of the original and cross-validated grouped cases was 96.4% and 92.1% respectively. Similarly, the third analysis performed across three groups, normal, oral premalignant and malignant groups, classifies 93.3% and 91.2% of the original and cross-validated grouped cases correctly.
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46
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Autofluorescence Imaging and Spectroscopy of Human Lung Cancer. APPLIED SCIENCES-BASEL 2016. [DOI: 10.3390/app7010032] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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47
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Tajudeen BA, Taylor ZD, Garritano J, Cheng H, Pearigen A, Sherman AJ, Palma-Diaz F, Mishra P, Bhargava S, Pesce J, Kim I, Sebastian C, Razfar A, Papour A, Stafsudd O, Grundfest W, St. John M. Dynamic optical contrast imaging as a novel modality for rapidly distinguishing head and neck squamous cell carcinoma from surrounding normal tissue. Cancer 2016; 123:879-886. [DOI: 10.1002/cncr.30338] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Revised: 06/01/2016] [Accepted: 06/02/2016] [Indexed: 11/09/2022]
Affiliation(s)
- Bobby A. Tajudeen
- Department of Head and Neck Surgery, David Geffen School of Medicine; University of California Los Angeles; Los Angeles California
- Head and Neck Cancer Program, David Geffen School of Medicine; University of California Los Angeles; Los Angeles California
| | - Zachary D. Taylor
- Head and Neck Cancer Program, David Geffen School of Medicine; University of California Los Angeles; Los Angeles California
- Department of Bioengineering, Henry Samueli School of Engineering and Applied Sciences; University of California Los Angeles; Los Angeles California
- Department of Surgery, David Geffen School of Medicine; University of California Los Angeles; Los Angeles California
| | - James Garritano
- Department of Bioengineering, Henry Samueli School of Engineering and Applied Sciences; University of California Los Angeles; Los Angeles California
| | - Harrison Cheng
- Department of Bioengineering, Henry Samueli School of Engineering and Applied Sciences; University of California Los Angeles; Los Angeles California
| | - Aidan Pearigen
- Department of Bioengineering, Henry Samueli School of Engineering and Applied Sciences; University of California Los Angeles; Los Angeles California
| | - Adria J. Sherman
- Department of Bioengineering, Henry Samueli School of Engineering and Applied Sciences; University of California Los Angeles; Los Angeles California
| | - Fernando Palma-Diaz
- Department of Pathology, David Geffen School of Medicine; University of California Los Angeles; Los Angeles California
| | - Pratik Mishra
- Department of Bioengineering, Henry Samueli School of Engineering and Applied Sciences; University of California Los Angeles; Los Angeles California
| | - Siddharth Bhargava
- Department of Bioengineering, Henry Samueli School of Engineering and Applied Sciences; University of California Los Angeles; Los Angeles California
| | - Julianna Pesce
- Department of Head and Neck Surgery, David Geffen School of Medicine; University of California Los Angeles; Los Angeles California
- Head and Neck Cancer Program, David Geffen School of Medicine; University of California Los Angeles; Los Angeles California
| | - Irene Kim
- Department of Head and Neck Surgery, David Geffen School of Medicine; University of California Los Angeles; Los Angeles California
- Head and Neck Cancer Program, David Geffen School of Medicine; University of California Los Angeles; Los Angeles California
| | - Christine Sebastian
- Department of Head and Neck Surgery, David Geffen School of Medicine; University of California Los Angeles; Los Angeles California
- Head and Neck Cancer Program, David Geffen School of Medicine; University of California Los Angeles; Los Angeles California
| | - Ali Razfar
- Department of Head and Neck Surgery, David Geffen School of Medicine; University of California Los Angeles; Los Angeles California
- Head and Neck Cancer Program, David Geffen School of Medicine; University of California Los Angeles; Los Angeles California
| | - Asael Papour
- Department of Electrical Engineering, Henry Samueli School of Engineering and Applied Sciences; University of California Los Angeles; Los Angeles California
| | - Oscar Stafsudd
- Department of Electrical Engineering, Henry Samueli School of Engineering and Applied Sciences; University of California Los Angeles; Los Angeles California
| | - Warren Grundfest
- Department of Bioengineering, Henry Samueli School of Engineering and Applied Sciences; University of California Los Angeles; Los Angeles California
- Department of Surgery, David Geffen School of Medicine; University of California Los Angeles; Los Angeles California
- Department of Electrical Engineering, Henry Samueli School of Engineering and Applied Sciences; University of California Los Angeles; Los Angeles California
| | - Maie St. John
- Department of Head and Neck Surgery, David Geffen School of Medicine; University of California Los Angeles; Los Angeles California
- Head and Neck Cancer Program, David Geffen School of Medicine; University of California Los Angeles; Los Angeles California
- Jonsson Comprehensive Cancer Center, David Geffen School of Medicine; University of California Los Angeles; Los Angeles California
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48
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Cepeda-Pérez E, López-Luke T, Plascencia-Villa G, Perez-Mayen L, Ceja-Fdez A, Ponce A, Vivero-Escoto J, de la Rosa E. SERS and integrative imaging upon internalization of quantum dots into human oral epithelial cells. JOURNAL OF BIOPHOTONICS 2016; 9:683-693. [PMID: 27120043 DOI: 10.1002/jbio.201600034] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Revised: 04/01/2016] [Accepted: 04/03/2016] [Indexed: 06/05/2023]
Abstract
CdTe quantum dots (QDs) are widely used in bio-applications due to their size and highly efficient optical properties. However internalization mechanisms thereof for the variety of freshly extracted, not cultivated human cells and their specific molecular interactions remains an open topic for discussion. In this study, we assess the internalization mechanism of CdTe quantum dots (3.3 nm) capped with thioglycolic acid using non cultivated oral epithelial cells obtained from healthy donors. Naked gold nanoparticles (40 nm) were successfully used as nanosensors for surface-enhanced Raman spectroscopy to efficiently identify characteristic Raman peaks, providing new evidence indicating that the first interactions of these QDs with epithelial cells occurred preferentially with aromatic rings and amine groups of amino acid residues and glycans from trans-membrane proteins and cytoskeleton. Using an integrative combination of advanced imaging techniques, including ultra-high resolution SEM, high resolution STEM coupled with EDX spectroscopy together with the results obtained by Raman spectroscopy, it was determined that thioglycolic acid capped CdTe QDs are efficiently internalized into freshly extracted oral epithelial cells only by facilitated diffusion, distributed into cytoplasm and even within the cell nucleus in three minutes.
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Affiliation(s)
| | | | - Germán Plascencia-Villa
- Department of Physics and Astronomy, University of Texas at San Antonio, One UTSA Circle, San Antonio, TX 78249, USA
| | | | | | - Arturo Ponce
- Department of Physics and Astronomy, University of Texas at San Antonio, One UTSA Circle, San Antonio, TX 78249, USA
| | - Juan Vivero-Escoto
- The University of North Carolina-Charlotte, Department of Chemistry, 9201 University City Blvd., Charlotte, NC 28223, USA
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Pande P, Shrestha S, Park J, Gimenez-Conti I, Brandon J, Applegate BE, Jo JA. Automated analysis of multimodal fluorescence lifetime imaging and optical coherence tomography data for the diagnosis of oral cancer in the hamster cheek pouch model. BIOMEDICAL OPTICS EXPRESS 2016; 7:2000-15. [PMID: 27231638 PMCID: PMC4871098 DOI: 10.1364/boe.7.002000] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Revised: 04/18/2016] [Accepted: 04/19/2016] [Indexed: 05/15/2023]
Abstract
It is known that the progression of oral cancer is accompanied by changes in both tissue biochemistry and morphology. A multimodal imaging approach combining functional and structural imaging modalities could therefore provide a more comprehensive prognosis of oral cancer. This idea forms the central theme of the current study, wherein this premise is examined in the context of a multimodal imaging system that combines fluorescence lifetime imaging (FLIM) and optical coherence tomography (OCT). Towards this end, in the first part of the present study, the diagnostic advantage obtained by using both fluorescence intensity and lifetime information is assessed. In the second part of the study, the diagnostic potential of FLIM-derived biochemical features is compared with that of OCT-derived morphological features. For an objective assessment, several quantitative biochemical and morphological features from FLIM and OCT data, respectively, were obtained using signal and image processing techniques. These features were subsequently used in a statistical classification framework to quantify the diagnostic potential of different features. The classification accuracy for combined FLIM and OCT features was estimated to be 87.4%, which was statistically higher than accuracy based on only FLIM (83.2%) or OCT (81.0%) features. Moreover, the complimentary information provided by FLIM and OCT features, resulted in highest sensitivity and specificity for the combined FLIM and OCT features for discriminating benign (88.2% sens., 92.0% spec.), pre-cancerous (81.5% sens., 96.0% spec.), and cancerous (90.1% sens., 92.0% spec.) classes.
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Affiliation(s)
- Paritosh Pande
- Biomedical Engineering Department, Texas A&M University, College Station, Texas 77843,
USA
| | - Sebina Shrestha
- Biomedical Engineering Department, Texas A&M University, College Station, Texas 77843,
USA
| | - Jesung Park
- Biomedical Engineering Department, Texas A&M University, College Station, Texas 77843,
USA
| | - Irma Gimenez-Conti
- Department of Carcinogenesis, The University of Texas M.D. Anderson Cancer Center, Smithville, Texas 78957,
USA
| | - Jimi Brandon
- Department of Carcinogenesis, The University of Texas M.D. Anderson Cancer Center, Smithville, Texas 78957,
USA
| | - Brian E. Applegate
- Biomedical Engineering Department, Texas A&M University, College Station, Texas 77843,
USA
| | - Javier A. Jo
- Biomedical Engineering Department, Texas A&M University, College Station, Texas 77843,
USA
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50
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Ohnishi Y, Fujii T, Ugaki Y, Yasui H, Watanabe M, Dateoka S, Kakudo K. Usefulness of a fluorescence visualization system for the detection of oral precancerous and early cancerous lesions. Oncol Rep 2016; 36:514-20. [PMID: 27121913 DOI: 10.3892/or.2016.4776] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2016] [Accepted: 03/10/2016] [Indexed: 11/05/2022] Open
Abstract
Early detection of precancerous and early cancerous lesions could greatly reduce both the mortality and morbidity of oral cancer. The objective of this study was to analyze a fluorescence visualization (FV) system for the detection of precancerous and early cancerous lesions in rat tongue carcinogenesis and human oral cancerous lesions using for the first time a 4NQO rat model and human tissue. Based on the results from the rat tongue carcinogenesis model, under direct FV, the normal oral mucosa emitted various shades of pale green autofluorescence. In the precancerous and early cancerous cases, the lesion appeared as an irregular dark area. Histological examination of the lesions showed that the VELscope system had a sensitivity of 95% and specificity of 100% in discriminating normal mucosa from dysplasia/carcinoma in situ (CIS) or invasive carcinoma. The proliferating cell nuclear antigen (PCNA) protein level was gradually increased with progression of carcinogenic transformation. Furthermore, the results of PCNA and FV loss (FVL) were correlated. Next, results from 17 patients were also presented. Histological examination of the lesions showed that the VELscope system had a sensitivity of 95% and specificity of 100% in discriminating normal mucosa from severe dysplasia/CIS or invasive carcinoma. There were no normal epithelium cells in any of the FVL regions. Furthermore, to clarify the usefulness of FV compared to vital staining with iodine, we investigated the surgical margins of early oral squamous cell carcinoma (OSCC) tissues and compared the FVL and iodine unstained area (IU). The percentage of various types of dysplasia were almost equal when comparing the FVL and IU. These results suggest that this direct FV device has the potential for simple, cost-effective screening, detection and margin determination of oral precancerous and early cancerous lesions.
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Affiliation(s)
- Yuichi Ohnishi
- Second Department of Oral and Maxillofacial Surgery, Osaka Dental University, Osaka 573-1121, Japan
| | - Tomoko Fujii
- Second Department of Oral and Maxillofacial Surgery, Osaka Dental University, Osaka 573-1121, Japan
| | - Yoshihide Ugaki
- Second Department of Oral and Maxillofacial Surgery, Osaka Dental University, Osaka 573-1121, Japan
| | - Hiroki Yasui
- Second Department of Oral and Maxillofacial Surgery, Osaka Dental University, Osaka 573-1121, Japan
| | - Masahiro Watanabe
- Second Department of Oral and Maxillofacial Surgery, Osaka Dental University, Osaka 573-1121, Japan
| | - Suguru Dateoka
- Department of Dentistry for Disability and Oral Health, Osaka Dental University Hospital, Osaka 540-0008, Japan
| | - Kenji Kakudo
- Second Department of Oral and Maxillofacial Surgery, Osaka Dental University, Osaka 573-1121, Japan
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