Optical diagnostic systems for assessing head and neck lesions

Enhancing Oral Cancer Detection: A Systematic Review of the Diagnostic Accuracy and Future Integration of Optical Coherence Tomography with Artificial Intelligence

Introduction: Optical Coherence Tomography (OCT) has emerged as an important imaging modality in non-invasive diagnosis for oral cancer and can provide real-time visualisation of tissue morphology with the required high resolution. This systematic review aims to assess the diagnostic accuracy of OCT in the detection of oral cancers, and to explore the potential integration of OCT with artificial intelligence (AI) and other imaging techniques to enhance diagnostic precision and clinical outcomes in oral healthcare. Methods: A systematic literature search was conducted across PubMed, Embase, Scopus, Google Scholar, Cochrane Central Register, and Web of Science from inception until August 2024. Studies were included if they employed OCT for oral cancer detection, reported diagnostic outcomes, such as sensitivity and specificity, and were conducted on human subjects. Data extraction and quality assessment were performed independently by two reviewers. The synthesis highlights advancements in OCT technology, including AI-enhanced interpretations. Results: A total of 9 studies met the inclusion criteria, encompassing a total of 860 events (cancer detections). The studies spanned from 2008 to 2022 and utilised various OCT techniques, including clinician-based, algorithm-based, and AI-driven interpretations. The findings indicate OCT's high diagnostic accuracy, with sensitivity ranging from 75% to 100% and specificity from 71% to 100%. AI-augmented OCT interpretations demonstrated the highest accuracy, emphasising OCT's potential in early cancer detection and precision in guiding surgical interventions. Conclusions: OCT could play a very prominent role as a new diagnostic tool for oral cancer, with very high sensitivity and specificity. Future research pointed towards integrating OCT with other imaging methods and AI systems in providing better accuracy of diagnoses, plus more clinical usability. Further development and validation with large-scale multicentre trials is imperative for the realisation of this potential in changing the way we practice oral healthcare.

Nano-diagnostics as an emerging platform for oral cancer detection: Current and emerging trends

Globally, oral cancer kills an estimated 150,000 individuals per year, with 300,000 new cases being diagnosed annually. The high incidence rate of oral cancer among the South-Asian and American populations is majorly due to overuse of tobacco, alcohol, and poor dental hygiene. Additionally, socio-economic issues and lack of general awareness delay the primary screening of the disease. The availability of early screening techniques for oral cancer can help in carving out a niche for accurate disease prognosis and also its prevention. However, conventional diagnostic approaches and therapeutics are still far from optimal. Thus, enhancing the analytical performance of diagnostic platforms in terms of specificity and precision can help in understanding the disease progression paradigm. Fabrication of efficient nanoprobes that are sensitive, noninvasive, cost-effective, and less labor-intensive can reduce the global cancer burden. Recent advances in optical, electrochemical, and spectroscopy-based nano biosensors that employ noble and superparamagnetic nanoparticles, have been proven to be extremely efficient. Further, these sensitive nanoprobes can also be employed for predicting disease relapse after chemotherapy, when the majority of the biomarker load is eliminated. Herein, we provide the readers with a brief summary of conventional and new-age oral cancer detection techniques. A comprehensive understanding of the inherent challenges associated with conventional oral cancer detection techniques is discussed. We also elaborate on how nanoparticles have shown tremendous promise and effectiveness in radically transforming the approach toward oral cancer detection. This article is categorized under: Diagnostic Tools > Biosensing Diagnostic Tools > Diagnostic Nanodevices Diagnostic Tools > In Vitro Nanoparticle-Based Sensing.

Bismuth Selenide Nanostructured Clusters as Optical Coherence Tomography Contrast Agents: Beyond Gold-Based Particles

Optical coherence tomography (OCT) is an imaging technique currently used in clinical practice to obtain optical biopsies of different biological tissues in a minimally invasive way. Among the contrast agents proposed to increase the efficacy of this imaging method, gold nanoshells (GNSs) are the best performing ones. However, their preparation is generally time-consuming, and they are intrinsically costly to produce. Herein, we propose a more affordable alternative to these contrast agents: Bi₂Se₃ nanostructured clusters with a desert rose-like morphology prepared via a microwave-assisted method. The structures are prepared in a matter of minutes, feature strong near-infrared extinction properties, and are biocompatible. They also boast a photon-to-heat conversion efficiency of close to 50%, making them good candidates as photothermal therapy agents. In vitro studies evidence the prowess of Bi₂Se₃ clusters as OCT contrast agents and prove that their performance is comparable to that of GNSs.

Probe-based confocal laser endomicroscopy for diagnosis of nasopharyngeal carcinoma in vivo

OBJECTIVES/HYPOTHESIS

Probe-based confocal laser endomicroscopy (pCLE) is a novel technique allowing real-time evaluation of the histological features of tissues in vivo at the cellular level. This study aimed to evaluate the feasibility of using pCLE in the diagnosis of nasopharyngeal carcinoma (NPC).

STUDY DESIGN

Feasibility study.

METHODS

In this study, the pCLE images of the lesions, as well as the surrounding or contralateral normal mucosa of the lesions, were acquired in vivo from each patient after intravenous injecting of 2.5 mL fluorescein. Biopsy specimens were collected at the imaged sites followed by a histopathological diagnosis by the pathologists, which was used as the gold standard. The pCLE images were compared to histopathological diagnosis of visualized sites by using sensitivity, specificity, negative predictive value (NPV), and positive predictive value (PPV).

RESULTS

Diagnoses based on pCLE images correlated well with the gold standard diagnoses based on tissue histology. The overall sensitivity, specificity, PPV, and NPV for diagnosis of carcinoma versus nondysplasia were 93.8% (67.7%-99.7%), 90.5% (68.2%-98.3%), 88.2% (62.3%-97.9%), and 95.0% (73.1%-99.7%), respectively, and the four indices for pCLE diagnosis of dysplasia versus nondysplasia were 60.0% (17.0%-92.7%), 80.9% (57.4%-93.7%), 42.9% (11.8%-79.8%), and 89.5% (65.5%-98.2%), respectively. The overall sensitivity for diagnosis of carcinoma versus dysplasia was 93.8% (67.7%-99.7%), specificity was 40% (7.3%-83.0%), PPV was 83.3% (57.7%-95.6%), and the NPV was 66.7% (12.5%-98.2%).

CONCLUSIONS

CLE is a suitable and valid method for otolaryngologists to diagnose of NPC in vivo.

LEVEL OF EVIDENCE

NA Laryngoscope, 129:897-902, 2019.

Nanotechnology: a promising method for oral cancer detection and diagnosis

Oral cancer is a common and aggressive cancer with high morbidity, mortality, and recurrence rate globally. Early detection is of utmost importance for cancer prevention and disease management. Currently, tissue biopsy remains the gold standard for oral cancer diagnosis, but it is invasive, which may cause patient discomfort. The application of traditional noninvasive methods-such as vital staining, exfoliative cytology, and molecular imaging-is limited by insufficient sensitivity and specificity. Thus, there is an urgent need for exploring noninvasive, highly sensitive, and specific diagnostic techniques. Nano detection systems are known as new emerging noninvasive strategies that bring the detection sensitivity of biomarkers to nano-scale. Moreover, compared to current imaging contrast agents, nanoparticles are more biocompatible, easier to synthesize, and able to target specific surface molecules. Nanoparticles generate localized surface plasmon resonances at near-infrared wavelengths, providing higher image contrast and resolution. Therefore, using nano-based techniques can help clinicians to detect and better monitor diseases during different phases of oral malignancy. Here, we review the progress of nanotechnology-based methods in oral cancer detection and diagnosis.

In-vivo optical imaging in head and neck oncology: basic principles, clinical applications and future directions

Head and neck cancers become a severe threat to human's health nowadays and represent the sixth most common cancer worldwide. Surgery remains the first-line choice for head and neck cancer patients. Limited resectable tissue mass and complicated anatomy structures in the head and neck region put the surgeons in a dilemma between the extensive resection and a better quality of life for the patients. Early diagnosis and treatment of the pre-malignancies, as well as real-time in vivo detection of surgical margins during en bloc resection, could be leveraged to minimize the resection of normal tissues. With the understanding of the head and neck oncology, recent advances in optical hardware and reagents have provided unique opportunities for real-time pre-malignancies and cancer imaging in the clinic or operating room. Optical imaging in the head and neck has been reported using autofluorescence imaging, targeted fluorescence imaging, high-resolution microendoscopy, narrow band imaging and the Raman spectroscopy. In this study, we reviewed the basic theories and clinical applications of optical imaging for the diagnosis and treatment in the field of head and neck oncology with the goal of identifying limitations and facilitating future advancements in the field.