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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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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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Diagnostic Adjuncts for Oral Cavity Squamous Cell Carcinoma and Oral Potentially Malignant Disorders. ACTA ACUST UNITED AC 2020. [DOI: 10.1007/978-3-030-32316-5_9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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In vivo detection of oral precancer using a fluorescence-based, in-house-fabricated device: a Mahalanobis distance-based classification. Lasers Med Sci 2019; 34:1243-1251. [PMID: 30659473 DOI: 10.1007/s10103-019-02720-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Accepted: 01/10/2019] [Indexed: 02/04/2023]
Abstract
In vivo detection of oral precancer has been carried out by a fluorescence-based, in-house-developed handheld probe on three groups: oral squamous cell carcinoma (OSCC), dysplastic (precancer), and control (normal). Measurements have been performed on a total of 141 patients and volunteers of different age groups. Excitation wavelength of 405 nm was used and fluorescence emission spectra were recorded in the scan range of 450.14 to 763.41 nm at very low incident power (122 μW) from different oral sites buccal mucosa (BM), lateral boarder of tongue (LBT), and dorsal surface of tongue (DST). Spectral profiles are found to vary among the three groups as well as among the different oral sites. Major and minor bands of flavin adenine dinucleotide (FAD) and porphyrins near 500, 634, 676, 689, and 703 nm have been obtained. Porphyrin contribution is found to be more dominant than the FAD in OSCC and dysplastic groups as compared to the control group. A better classification has been observed using the entire spectral range rather than restricting to individual bands, by application of principal component analysis (PCA), Mahalanobis distance model, and receiver operating characteristic analysis (ROC). ROC on Mahalanobis distance differentiates OSCC to normal, dysplastic to normal, and OSCC to dysplastic with sensitivities from 71% to 98%, 92% to 94% and 81% to 93% and specificities 91% to 100%, 86% to 100% and 79% to 97% for oral sites BM, LBT and DST. LBT and DST appear to be more sensitive to dysplasia detection as compared to BM.
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Lesion oxygenation associates with clinical outcomes in premalignant and early stage head and neck tumors treated on a phase 1 trial of photodynamic therapy. Photodiagnosis Photodyn Ther 2017; 21:28-35. [PMID: 29113960 DOI: 10.1016/j.pdpdt.2017.10.015] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Revised: 10/06/2017] [Accepted: 10/19/2017] [Indexed: 12/16/2022]
Abstract
BACKGROUND We report on a Phase 1 trial of photodynamic therapy (PDT) for superficial head and neck (H&N) lesions. Due to known oxygen dependencies of PDT, translational measurements of lesion hemoglobin oxygen saturation (StO2) and blood volume (tHb) were studied for associations with patient outcomes. METHODS PDT with aminolevulinc acid (ALA) and escalating light doses was evaluated for high-grade dysplasia, carcinoma-in-situ, and microinvasive carcinomas of the H&N. Among 29 evaluable patients, most (18) had lesions of the tongue or floor of mouth (FOM). Disease was intact in 18 patients and present at surgical margins in 11 patients. In 26 patients, lesion StO2 and tHb was measured. RESULTS Local control (LC) at 24 months was 57.5% among all patients. In patients with tongue/FOM lesions LC was 42.7%, and it was 50.1% for those with intact lesions. Lesion tHb was not associated with 3-month complete response (CR), but StO2 was higher in patients with CR. In tongue/FOM lesions, baseline StO2 [mean(SE)] was 54(4)% in patients (n=12) with CR versus 23(8)% in patients (n=6) with local recurrence/persistence (p=0.01). Similarly, for intact disease, baseline StO2 was 54(3)% in patients (n=10) with CR versus 28(8)% in patients (n=5) without CR (p=0.03). In patients with intact disease, higher baseline StO2 associated with 24-month local control (p=0.02). CONCLUSIONS Measurement of the physiologic properties of target lesions may allow for identification of patients with the highest probability of benefiting from PDT. This provides opportunity for optimizing light delivery based on lesion characteristics and/or informing ongoing clinical decision-making in patients who would most benefit from PDT.
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Bailey MJ, Verma N, Fradkin L, Lam S, MacAulay C, Poh C, Markey MK, Sokolov K. Detection of precancerous lesions in the oral cavity using oblique polarized reflectance spectroscopy: a clinical feasibility study. JOURNAL OF BIOMEDICAL OPTICS 2017; 22:65002. [PMID: 28609512 PMCID: PMC5469421 DOI: 10.1117/1.jbo.22.6.065002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Accepted: 05/18/2017] [Indexed: 05/20/2023]
Abstract
We developed a multifiber optical probe for oblique polarized reflectance spectroscopy (OPRS) in vivo and evaluated its performance in detection of dysplasia in the oral cavity. The probe design allows the implementation of a number of methods to enable depth resolved spectroscopic measurements including polarization gating, source–detector separation, and differential spectroscopy; this combination was evaluated in carrying out binary classification tasks between four major diagnostic categories: normal, benign, mild dysplasia (MD), and severe dysplasia (SD). Multifiber OPRS showed excellent performance in the discrimination of normal from benign, MD, SD, and MD plus SD yielding sensitivity/specificity values of 100%/93%, 96%/95%, 100%/98%, and 100%/100%, respectively. The classification of benign versus dysplastic lesions was more challenging with sensitivity and specificity values of 80%/93%, 71%/93%, and 74%/80% in discriminating benign from SD, MD, and SD plus MD categories, respectively; this challenge is most likely associated with a strong and highly variable scattering from a keratin layer that was found in these sites. Classification based on multiple fibers was significantly better than that based on any single detection pair for tasks dealing with benign versus dysplastic sites. This result indicates that the multifiber probe can perform better in the detection of dysplasia in keratinized tissues.
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Affiliation(s)
- Maria J. Bailey
- University of Texas M.D. Anderson Cancer Center, Department of Imaging Physics, Houston, Texas, United States
- University of Texas at Austin, Department of Biomedical Engineering, Austin, Texas, United States
| | - Nishant Verma
- University of Texas at Austin, Department of Biomedical Engineering, Austin, Texas, United States
| | - Leonid Fradkin
- University of Texas at Austin, Department of Biomedical Engineering, Austin, Texas, United States
| | - Sylvia Lam
- British Columbia Cancer Agency, Integrative Oncology Department, Vancouver, British Columbia, Canada
| | - Calum MacAulay
- British Columbia Cancer Agency, Integrative Oncology Department, Vancouver, British Columbia, Canada
| | - Catherine Poh
- British Columbia Cancer Agency, Integrative Oncology Department, Vancouver, British Columbia, Canada
| | - Mia K. Markey
- University of Texas M.D. Anderson Cancer Center, Department of Imaging Physics, Houston, Texas, United States
- University of Texas at Austin, Department of Biomedical Engineering, Austin, Texas, United States
| | - Konstantin Sokolov
- University of Texas M.D. Anderson Cancer Center, Department of Imaging Physics, Houston, Texas, United States
- University of Texas at Austin, Department of Biomedical Engineering, Austin, Texas, United States
- Rice University, Department of Bioengineering, Houston, Texas, United States
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Photodynamic Therapy-Induced Microvascular Changes in a Nonmelanoma Skin Cancer Model Assessed by Photoacoustic Microscopy and Diffuse Correlation Spectroscopy. PHOTONICS 2016. [DOI: 10.3390/photonics3030048] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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Towards monitoring dysplastic progression in the oral cavity using a hybrid fiber-bundle imaging and spectroscopy probe. Sci Rep 2016; 6:26734. [PMID: 27220821 PMCID: PMC4879668 DOI: 10.1038/srep26734] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Accepted: 05/06/2016] [Indexed: 02/06/2023] Open
Abstract
Intraepithelial dysplasia of the oral mucosa typically originates in the proliferative cell layer at the basement membrane and extends to the upper epithelial layers as the disease progresses. Detection of malignancies typically occurs upon visual inspection by non-specialists at a late-stage. In this manuscript, we validate a quantitative hybrid imaging and spectroscopy microendoscope to monitor dysplastic progression within the oral cavity microenvironment in a phantom and pre-clinical study. We use an empirical model to quantify optical properties and sampling depth from sub-diffuse reflectance spectra (450–750 nm) at two source-detector separations (374 and 730 μm). Average errors in recovering reduced scattering (5–26 cm−1) and absorption coefficients (0–10 cm−1) in hemoglobin-based phantoms were approximately 2% and 6%, respectively. Next, a 300 μm-thick phantom tumor model was used to validate the probe’s ability to monitor progression of a proliferating optical heterogeneity. Finally, the technique was demonstrated on 13 healthy volunteers and volume-averaged optical coefficients, scattering exponent, hemoglobin concentration, oxygen saturation, and sampling depth are presented alongside a high-resolution microendoscopy image of oral mucosa from one volunteer. This multimodal microendoscopy approach encompasses both structural and spectroscopic reporters of perfusion within the tissue microenvironment and can potentially be used to monitor tumor response to therapy.
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Greening GJ, Rajaram N, Muldoon TJ. In vivo measurement of non-keratinized squamous epithelium using a spectroscopic microendoscope with multiple source-detector separations. PROCEEDINGS OF SPIE--THE INTERNATIONAL SOCIETY FOR OPTICAL ENGINEERING 2016; 9715. [PMID: 27134337 DOI: 10.1117/12.2211866] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
In the non-keratinized epithelia, dysplasia typically arises near the basement membrane and proliferates into the upper epithelial layers over time. We present a non-invasive, multimodal technique combining high-resolution fluorescence imaging and broadband sub-diffuse reflectance spectroscopy (sDRS) to monitor health at various tissue layers. This manuscript focuses on characterization of the sDRS modality, which contains two source-detector separations (SDSs) of 374 μm and 730 μm, so that it can be used to extract in vivo optical parameters from human oral mucosa at two tissue thicknesses. First, we present empirical lookup tables (LUTs) describing the relationship between reduced scattering (μs') and absorption coefficients (μa) and absolute reflectance. LUTS were shown to extract μs' and μa with accuracies of approximately 4% and 8%, respectively. We then present LUTs describing the relationship between μs', μa and sampling depth. Sampling depths range between 210-480 and 260-620 μm for the 374 and 730 μm SDSs, respectively. We then demonstrate the ability to extract in vivo μs', μa, hemoglobin concentration, bulk tissue oxygen saturation, scattering exponent, and sampling depth from the inner lip of thirteen healthy volunteers to elucidate the differences in the extracted optical parameters from each SDS (374 and 730 μm) within non-keratinized squamous epithelia.
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Affiliation(s)
- Gage J Greening
- Department of Biomedical Engineering, University of Arkansas, Fayetteville, AR, USA 72701
| | - Narasimhan Rajaram
- Department of Biomedical Engineering, University of Arkansas, Fayetteville, AR, USA 72701
| | - Timothy J Muldoon
- Department of Biomedical Engineering, University of Arkansas, Fayetteville, AR, USA 72701
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Rohrbach DJ, Rigual N, Arshad H, Tracy EC, Cooper MT, Shafirstein G, Wilding G, Merzianu M, Baumann H, Henderson BW, Sunar U. Intraoperative optical assessment of photodynamic therapy response of superficial oral squamous cell carcinoma. JOURNAL OF BIOMEDICAL OPTICS 2016; 21:18002. [PMID: 26780226 PMCID: PMC5996863 DOI: 10.1117/1.jbo.21.1.018002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2015] [Accepted: 12/11/2015] [Indexed: 06/05/2023]
Abstract
This study investigated whether diffuse optical spectroscopy (DOS) measurements could assess clinical response to photodynamic therapy (PDT) in patients with head and neck squamous cell carcinoma (HNSCC). In addition, the correlation between parameters measured with DOS and the crosslinking of signal transducer and activator of transcription 3 (STAT3), a molecular marker for PDT-induced photoreaction, was investigated. Thirteen patients with early stage HNSCC received the photosensitizer 2-[1-hexyloxyethyl]-2-devinylpyropheophorbide-a (HPPH) and DOS measurements were performed before and after PDT in the operating room (OR). In addition, biopsies were acquired after PDT to assess the STAT3 crosslinking. Parameters measured with DOS, including blood volume fraction, blood oxygen saturation (StO2), HPPH concentration (cHPPH), HPPH fluorescence, and blood flow index (BFI), were compared to the pathologic response and the STAT3 crosslinking. The best individual predictor of pathological response was a change in cHPPH (sensitivity=60%, specificity=100%), while discrimination analysis using a two-parameter classifier (change in cHPPH and change in StO2) classified pathological response with 100% sensitivity and 100% specificity. BFI showed the best correlation with the crosslinking of STAT3. These results indicate that DOS-derived parameters can assess the clinical response in the OR, allowing for earlier reintervention if needed.
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Affiliation(s)
- Daniel J. Rohrbach
- Roswell Park Cancer Institute, Department of Cell Stress Biology, Elm and Carlton Streets, Buffalo, New York 14263, United States
- Wright State University, Department of Biomedical, Industrial and Human Factors Engineering, 207 Russ Center, Dayton, Ohio 45435, United States
| | - Nestor Rigual
- Roswell Park Cancer Institute, Department of Head and Neck Surgery, Elm and Carlton Streets, Buffalo, New York 14263, United States
| | - Hassan Arshad
- Roswell Park Cancer Institute, Department of Head and Neck Surgery, Elm and Carlton Streets, Buffalo, New York 14263, United States
| | - Erin C. Tracy
- Roswell Park Cancer Institute, Department of Cellular and Molecular Biology, Elm and Carlton Streets, Buffalo, New York 14263, United States
| | - Michelle T. Cooper
- Roswell Park Cancer Institute, Department of Cell Stress Biology, Elm and Carlton Streets, Buffalo, New York 14263, United States
| | - Gal Shafirstein
- Roswell Park Cancer Institute, Department of Cell Stress Biology, Elm and Carlton Streets, Buffalo, New York 14263, United States
| | - Gregory Wilding
- Roswell Park Cancer Institute, Department of Biostatistics and Bioinformatics, Elm and Carlton Streets, Buffalo, New York 14263, United States
| | - Mihai Merzianu
- Roswell Park Cancer Institute, Department of Pathology and Laboratory Medicine, Elm and Carlton Streets, Buffalo, New York 14263, United States
| | - Heinz Baumann
- Roswell Park Cancer Institute, Department of Cellular and Molecular Biology, Elm and Carlton Streets, Buffalo, New York 14263, United States
| | - Barbara W. Henderson
- Roswell Park Cancer Institute, Department of Cell Stress Biology, Elm and Carlton Streets, Buffalo, New York 14263, United States
| | - Ulas Sunar
- Roswell Park Cancer Institute, Department of Cell Stress Biology, Elm and Carlton Streets, Buffalo, New York 14263, United States
- Wright State University, Department of Biomedical, Industrial and Human Factors Engineering, 207 Russ Center, Dayton, Ohio 45435, United States
- State University of New York at Buffalo, Department of Biomedical Engineering, 332 Bonner Hall, Buffalo, New York 14228, United States
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Sekine R, Yakushiji T, Tanaka Y, Shibahara T. A study on the intrapapillary capillary loop detected by narrow band imaging system in early oral squamous cell carcinoma. JOURNAL OF ORAL AND MAXILLOFACIAL SURGERY MEDICINE AND PATHOLOGY 2015. [DOI: 10.1016/j.ajoms.2014.11.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Gallagher-Colombo SM, Quon H, Malloy KM, Ahn PH, Cengel KA, Simone CB, Chalian AA, O'Malley BW, Weinstein GS, Zhu TC, Putt ME, Finlay JC, Busch TM. Measuring the Physiologic Properties of Oral Lesions Receiving Fractionated Photodynamic Therapy. Photochem Photobiol 2015; 91:1210-8. [PMID: 26037487 DOI: 10.1111/php.12475] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2014] [Accepted: 05/26/2015] [Indexed: 11/28/2022]
Abstract
Photodynamic therapy (PDT) can treat superficial, early-stage disease with minimal damage to underlying tissues and without cumulative dose-limiting toxicity. Treatment efficacy is affected by disease physiologic properties, but these properties are not routinely measured. We assessed diffuse reflectance spectroscopy (DRS) for the noninvasive, contact measurement of tissue hemoglobin oxygen saturation (St O2 ) and total hemoglobin concentration ([tHb]) in the premalignant or superficial microinvasive oral lesions of patients treated with 5-aminolevulinic acid (ALA)-PDT. Patients were enrolled on a Phase 1 study of ALA-PDT that evaluated fluences of 50, 100, 150 or 200 J cm(-2) delivered at 100 mW cm(-2) . To test the feasibility of incorporating DRS measurements within the illumination period, studies were performed in patients who received fractionated (two-part) illumination that included a dark interval of 90-180 s. Using DRS, tissue oxygenation at different depths within the lesion could also be assessed. DRS could be performed concurrently with contact measurements of photosensitizer levels by fluorescence spectroscopy, but a separate noncontact fluorescence spectroscopy system provided continuous assessment of photobleaching during illumination to greater tissue depths. Results establish that the integration of DRS into PDT of early-stage oral disease is feasible, and motivates further studies to evaluate its predictive and dosimetric value.
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Affiliation(s)
| | - Harry Quon
- Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Kelly M Malloy
- Department of Otorhinolaryngology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Peter H Ahn
- Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Keith A Cengel
- Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Charles B Simone
- Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Ara A Chalian
- Department of Otorhinolaryngology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Bert W O'Malley
- Department of Otorhinolaryngology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Gregory S Weinstein
- Department of Otorhinolaryngology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Timothy C Zhu
- Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Mary E Putt
- Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Jarod C Finlay
- Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Theresa M Busch
- Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
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Omar E. Current concepts and future of noninvasive procedures for diagnosing oral squamous cell carcinoma--a systematic review. Head Face Med 2015; 11:6. [PMID: 25889859 PMCID: PMC4396078 DOI: 10.1186/s13005-015-0063-z] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2014] [Accepted: 02/04/2015] [Indexed: 12/21/2022] Open
Abstract
Background Oral squamous cell carcinoma (OSCC) has a remarkably high incidence worldwide, and a fairly serious prognosis, encouraging further research into advanced technologies for noninvasive methods of making early diagnoses, ideally in primary care settings. Objectives Our purpose was to examine the validity of using advanced noninvasive technologies in diagnosis of OSCC by identifying and evaluating relevant published reports. Data source MEDLINE, EMBASE, and CINAHL were searched to identify clinical trials and other information published between 1990 and 10 June 2014; the searches of MEDLINE and EMBASE were updated to November 2014. Study selection: Studies of noninvasive methods of diagnosing OSCC, including oral brush biopsy, optical biopsy, saliva-based oral cancer diagnosis, and others were included. Data extraction Data were abstracted and evaluated in duplicate for possible relevance on two occasions at an interval of 2 months before being included or excluded. Data synthesis This study identified 163 studies of noninvasive methods for diagnosing OSCC that met the inclusion criteria. These included six studies of oral brush biopsy, 42 of saliva-based oral diagnosis, and 115 of optical biopsy. Sixty nine of these studies were assessed by the modified version of the QUADAS instrument. Saliva-based oral cancer diagnosis and optical biopsy were found to be promising noninvasive methods for diagnosing OSCC. Limitation The strength of evidence was rated low for accuracy outcomes because the studies did not report important details required to assess the risk for bias. Conclusions It is clear that screening for and early detection of cancer and pre-cancerous lesions have the potential to reduce the morbidity and mortality of this disease. Advances in technologies for saliva-based oral diagnosis and optical biopsy are promising pathways for the future development of more effective noninvasive methods for diagnosing OSCC that are easy to perform clinically in primary care settings.
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Affiliation(s)
- Esam Omar
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Taibah University, Madinah, Saudi Arabia.
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Fuller C, Camilon R, Nguyen S, Jennings J, Day T, Gillespie MB. Adjunctive diagnostic techniques for oral lesions of unknown malignant potential: Systematic review with meta-analysis. Head Neck 2014; 37:755-62. [PMID: 24596227 DOI: 10.1002/hed.23667] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2013] [Revised: 02/12/2014] [Accepted: 03/01/2014] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND The purpose of this study was to critically review the published evidence concerning adjunctive diagnostic techniques in the diagnosis of oral lesions of unknown malignant potential. METHODS We conducted a systematic literature review with meta-analysis using PubMed to search for articles published from June 1993 through June 2013 to identify prospective studies evaluating any diagnostic method, with tissue biopsy confirmation, in clinically evident oral lesions of unknown malignant potential. Aggregate weighted totals and SEs for true, false-positive, false-negative, and inadequate results were calculated and compared among subgroups. RESULTS Forty-eight articles satisfying inclusion criteria were identified. Twenty-five were included in quantitative synthesis. CONCLUSION Oral cytology holds higher diagnostic value than specialist's oral examination, which holds higher value than in vivo toluidine blue staining. This study does not support the use of computer-aided or liquid-based cytology. Future studies should be designed to test multiple methods in the same patient population to allow direct comparison among various techniques.
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Affiliation(s)
- Colin Fuller
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina
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Nazeer SS, Asish R, Venugopal C, Anita B, Gupta AK, Jayasree RS. Noninvasive assessment of the risk of tobacco abuse in oral mucosa using fluorescence spectroscopy: a clinical approach. JOURNAL OF BIOMEDICAL OPTICS 2014; 19:057013. [PMID: 24870273 DOI: 10.1117/1.jbo.19.5.057013] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2014] [Accepted: 05/01/2014] [Indexed: 06/03/2023]
Abstract
Tobacco abuse and alcoholism cause cancer, emphysema, and heart disease, which contribute to high death rates, globally. Society pays a significant cost for these habits whose first demonstration in many cases is in the oral cavity. Oral cavity disorders are highly curable if a screening procedure is available to diagnose them in the earliest stages. The aim of the study is to identify the severity of tobacco abuse, in oral cavity, as reflected by the emission from endogenous fluorophores and the chromophore hemoglobin. A group who had no tobacco habits and another with a history of tobacco abuse were included in this study. To compare the results with a pathological condition, a group of leukoplakia patients were also included. Emission from porphyrin and the spectral filtering modulation effect of hemoglobin were collected from different sites. Multivariate analysis strengthened the spectral features with a sensitivity of 60% to 100% and a specificity of 76% to 100% for the discrimination. Total hemoglobin and porphyrin levels of habitués and leukoplakia groups were comparable, indicating the alarming situation about the risk of tobacco abuse. Results prove that fluorescence spectroscopy along with multivariate analysis is an effective noninvasive tool for the early diagnosis of pathological changes due to tobacco abuse.
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Affiliation(s)
- Shaiju S Nazeer
- Sree Chitra Tirunal Institute for Medical Sciences and Technology, Biomedical Technology Wing, Biophotonics and Imaging Laboratory, Poojappura, Thiruvananthapuram 695 012, Kerala, IndiabMar Ivanios College, Department of Physics, Thiruvananthapuram 695 01
| | - Rajashekharan Asish
- Government Dental College, Department of Oral Medicine and Radiology, Thiruvananthapuram 695 011, Kerala, India
| | - Chandrashekharan Venugopal
- Government Dental College, Department of Oral Medicine and Radiology, Thiruvananthapuram 695 011, Kerala, IndiadGeneral Hospital, Kerala Health Services, Trivandrum, Kerala, India
| | - Balan Anita
- Government Dental College, Department of Oral Medicine and Radiology, Thiruvananthapuram 695 011, Kerala, IndiaeGovernment Dental College, Department of Oral Medicine and Radiology, Kozhikkode 673 008, Kerala, India
| | - Arun Kumar Gupta
- Sree Chitra Tirunal Institute for Medical Sciences and Technology, Biomedical Technology Wing, Biophotonics and Imaging Laboratory, Poojappura, Thiruvananthapuram 695 012, Kerala, IndiafNational Institute of Mental Health and Neuro Sciences, Department of
| | - Ramapurath S Jayasree
- Sree Chitra Tirunal Institute for Medical Sciences and Technology, Biomedical Technology Wing, Biophotonics and Imaging Laboratory, Poojappura, Thiruvananthapuram 695 012, Kerala, India
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Sung KB, Shih KW, Hsu FW, Hsieh HP, Chuang MJ, Hsiao YH, Su YH, Tien GH. Accurate extraction of optical properties and top layer thickness of two-layered mucosal tissue phantoms from spatially resolved reflectance spectra. JOURNAL OF BIOMEDICAL OPTICS 2014; 19:77002. [PMID: 25027003 DOI: 10.1117/1.jbo.19.7.077002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2014] [Accepted: 06/17/2014] [Indexed: 05/11/2023]
Abstract
We are reporting on an experimental investigation of a movable diffuse reflectance spectroscopy system to extract diagnostically relevant optical properties of two-layered tissue phantoms simulating mucosae that are covered with stratified squamous epithelium. The reflectance spectra were measured at multiple sourcedetector separations using two imaging fiber bundles in contact with the phantoms, one with its optical axis perpendicular to the sample surface (perpendicular probe) and the other with its distal end beveled and optical axis tilted at 45 deg (oblique probe). Polystyrene microspheres and purified human hemoglobin were used to make tissue phantoms whose scattering and absorption properties could be well controlled and theoretically predicted. Monte Carlo simulations were used to predict the reflectance spectra for system calibration and an iterative curve fitting that simultaneously extracted the top layer reduced scattering coefficient, thickness, bottom layer reduced scattering coefficient, and hemoglobin concentration of the phantoms. The errors of the recovered parameters ranged from 7% to 20%. The oblique probe showed higher accuracy in the extracted top layer reduced scattering coefficient and thickness than the perpendicular probe. The developed system and data analysis methods provide a feasible tool to quantify the optical properties in vivo.
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Affiliation(s)
- Kung-Bin Sung
- National Taiwan University, Graduate Institute of Biomedical Electronics and Bioinformatics, No. 1 Sec. 4 Roosevelt Road, Taipei 10617, TaiwanbNational Taiwan University, Department of Electrical Engineering, No. 1 Sec. 4 Roosevelt Road, Taipei 10617, Tai
| | - Kuang-Wei Shih
- National Taiwan University, Graduate Institute of Biomedical Electronics and Bioinformatics, No. 1 Sec. 4 Roosevelt Road, Taipei 10617, Taiwan
| | - Fang-Wei Hsu
- National Taiwan University, Graduate Institute of Biomedical Electronics and Bioinformatics, No. 1 Sec. 4 Roosevelt Road, Taipei 10617, Taiwan
| | - Hong-Po Hsieh
- National Taiwan University, Graduate Institute of Biomedical Electronics and Bioinformatics, No. 1 Sec. 4 Roosevelt Road, Taipei 10617, Taiwan
| | - Min-Jie Chuang
- National Taiwan University, Graduate Institute of Biomedical Electronics and Bioinformatics, No. 1 Sec. 4 Roosevelt Road, Taipei 10617, Taiwan
| | - Yi-Hsien Hsiao
- National Taiwan University, Graduate Institute of Biomedical Electronics and Bioinformatics, No. 1 Sec. 4 Roosevelt Road, Taipei 10617, Taiwan
| | - Yu-Hui Su
- National Taiwan University, Graduate Institute of Biomedical Electronics and Bioinformatics, No. 1 Sec. 4 Roosevelt Road, Taipei 10617, Taiwan
| | - Gen-Hao Tien
- National Taiwan University, Graduate Institute of Biomedical Electronics and Bioinformatics, No. 1 Sec. 4 Roosevelt Road, Taipei 10617, Taiwan
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17
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Lee LT, Chen PH, Chang CT, Wang J, Wong YK, Wang HW. Quantitative physiology and immunohistochemistry of oral lesions. BIOMEDICAL OPTICS EXPRESS 2013; 4:2696-2709. [PMID: 24298427 PMCID: PMC3829562 DOI: 10.1364/boe.4.002696] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2013] [Revised: 10/17/2013] [Accepted: 10/22/2013] [Indexed: 06/02/2023]
Abstract
Angiogenesis and hypoxia are reported to correlate with tumor aggressiveness. In this study, we investigated the potential of optically measured total hemoglobin concentration (THC) and blood oxygen saturation (StO2) as a quantitative measure of angiogenesis and hypoxia in oral lesions with an immunohistochemical comparison. 12 normal subjects and 40 oral patients (22 oral squamous cell carcinoma (SCC), 18 benign/premalignant lesions including 11 verrucous hyperplasia (VH) and 7 hyperkeratosis/parakeratosis (HK)) were studied. The results showed that the THC measurement was consistent with vascular endothelial growth factor (VEGF) and microvessel staining in the stromal area, but StO2 was not associated with HIF-1α. We observed inflammation induced neovascular formation in the stromal area of VH and HK that were likely attributed to higher-than-control THC and StO2 and resulted in no difference in optical measurements between all lesions. However, we found that in majority of SCC, the ratio of THC and StO2 levels between lesions and the surrounding tissues provide potential distinguishing characteristics from VH, which are not visually differentiable from SCC, with a sensitivity, specificity, and accuracy of 91%, 68%, and 76%, respectively.
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Affiliation(s)
- Li-Tzu Lee
- Department of Dentistry, Taichung Veterans General Hospital, Taichung, Taiwan
- School of Dentistry, National Yang-Ming University,155 Li-Nong Street, Sector 2, Taipei 11221, Taiwan
- Equal contribution
| | - Po-Hsiung Chen
- Equal contribution
- Institute of Biophotonics, National Yang-Ming University,155 Li-Nong Street, Sector 2, Taipei 11221, Taiwan
| | - Chiou-Tuz Chang
- Department of Dentistry, Taichung Veterans General Hospital, Taichung, Taiwan
| | - John Wang
- Department of Pathology,Taichung Veterans General Hospital, Taichung, Taiwan
| | - Yong-Kie Wong
- Department of Dentistry, Taichung Veterans General Hospital, Taichung, Taiwan
- School of Dentistry, National Yang-Ming University,155 Li-Nong Street, Sector 2, Taipei 11221, Taiwan
| | - Hsing-Wen Wang
- Institute of Biophotonics, National Yang-Ming University,155 Li-Nong Street, Sector 2, Taipei 11221, Taiwan
- Department of Bioengineering, University of Maryland, College Park, MD 20742, USA
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18
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Gomes AJ, Backman V. Algorithm for automated selection of application-specific fiber-optic reflectance probes. JOURNAL OF BIOMEDICAL OPTICS 2013; 18:27012. [PMID: 23455876 PMCID: PMC3585420 DOI: 10.1117/1.jbo.18.2.027012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2012] [Revised: 01/11/2013] [Accepted: 01/15/2013] [Indexed: 05/19/2023]
Abstract
Several optical techniques and fiber-optic probe systems have been designed to measure the optical properties of tissue. While a wide range of options is often beneficial, it poses a problem to investigators selecting which method to use for their biomedical application of interest. We present a methodology to optimally select a probe that matches the application requirements. Our method is based both on matching a probe's mean sampling depth with the optimal diagnostic depth of the clinical application and on choosing a probe whose interrogation depth and path length is the least sensitive to alterations in the target medium's optical properties. Satisfying these requirements ensures that the selected probe consistently assesses the relevant tissue volume with minimum variability. To aid in probe selection, we have developed a publicly available graphical user interface that takes the desired sampling depth and optical properties of the medium as its inputs and automatically ranks different techniques in their ability to robustly target the desired depth. Techniques investigated include single fiber spectroscopy, differential path length spectroscopy, polarization-gating, elastic light scattering spectroscopy, and diffuse reflectance. The software has been applied to biological case studies.
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Affiliation(s)
- Andrew J. Gomes
- Northwestern University, Department of Biomedical Engineering, Evanston, Illinois 60218
| | - Vadim Backman
- Northwestern University, Department of Biomedical Engineering, Evanston, Illinois 60218
- Address all correspondence to: Vadim Backman, Northwestern University, Department of Biomedical Engineering, Evanston, Illinois 60218. Tel: (847) 491-3536; Fax: (847) 491-4928; E-mail:
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Karlsson H, Fredriksson I, Larsson M, Strömberg T. Inverse Monte Carlo for estimation of scattering and absorption in liquid optical phantoms. OPTICS EXPRESS 2012; 20:12233-12246. [PMID: 22714213 DOI: 10.1364/oe.20.012233] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
A spectroscopic probe with multiple detecting fibers was used for quantifying absorption and scattering in liquid optical phantoms. The phantoms were mixtures of Intralipid and red and blue food dyes. Intensity calibration for the detecting fibers was undertaken using either a microsphere suspension (absolute calibration) or a uniform detector illumination (relative calibration between detectors). Two different scattering phase functions were used in an inverse Monte Carlo algorithm. Data were evaluated for residual spectra (systematic deviations and magnitude) and accuracy in estimation of scattering and absorption. Spectral fitting was improved by allowing for a 10% intensity relaxation in the optimization algorithm. For a multi-detector setup, non-systematic residual spectrum was only found using the more complex Gegenbauer-kernel phase function. However, the choice of phase function did not influence the accuracy in the estimation of absorption and scattering. Similar estimation accuracy as in the multi-detector setup was also obtained using either two relative calibrated detectors or one absolute calibrated detector at a fiber separation of 0.46 mm.
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Affiliation(s)
- Hanna Karlsson
- Department of Biomedical Engineering, Linköping University, S-581 85 Linköping, Sweden.
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Fredriksson I, Larsson M, Strömberg T. Inverse Monte Carlo method in a multilayered tissue model for diffuse reflectance spectroscopy. JOURNAL OF BIOMEDICAL OPTICS 2012; 17:047004. [PMID: 22559695 DOI: 10.1117/1.jbo.17.4.047004] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Model based data analysis of diffuse reflectance spectroscopy data enables the estimation of optical and structural tissue parameters. The aim of this study was to present an inverse Monte Carlo method based on spectra from two source-detector distances (0.4 and 1.2 mm), using a multilayered tissue model. The tissue model variables include geometrical properties, light scattering properties, tissue chromophores such as melanin and hemoglobin, oxygen saturation and average vessel diameter. The method utilizes a small set of presimulated Monte Carlo data for combinations of different levels of epidermal thickness and tissue scattering. The path length distributions in the different layers are stored and the effect of the other parameters is added in the post-processing. The accuracy of the method was evaluated using Monte Carlo simulations of tissue-like models containing discrete blood vessels, evaluating blood tissue fraction and oxygenation. It was also compared to a homogeneous model. The multilayer model performed better than the homogeneous model and all tissue parameters significantly improved spectral fitting. Recorded in vivo spectra were fitted well at both distances, which we previously found was not possible with a homogeneous model. No absolute intensity calibration is needed and the algorithm is fast enough for real-time processing.
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Affiliation(s)
- Ingemar Fredriksson
- Linköping University, Department of Biomedical Engineering, University Hospital, 581 85 Linköping, Sweden.
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