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Mali SB. Role of in vivo imaging in Head and Neck cancer management. Oral Oncol 2023; 146:106575. [PMID: 37741020 DOI: 10.1016/j.oraloncology.2023.106575] [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: 09/14/2023] [Accepted: 09/18/2023] [Indexed: 09/25/2023]
Abstract
Intravital microscopy (IVM) and optical coherency tomography (OCT) are powerful optical imaging tools that allow visualization of dynamic biological activities in living subjects with subcellular resolutions. They have been used in preclinical and clinical cancer imaging, providing insights into the complex physiological, cellular, and molecular behaviors of tumors. They have revolutionized cancer diagnosis and therapies, allowing for real-time observation of biologic processes in vivo, including angiogenesis and immune cell interactions. Recent developments in techniques for observing deep tissues of living animals have improved bioluminescent proteins, fluorescent proteins, fluorescent dyes, and detection technologies like two-photon excitation microscopy. These technologies have become indispensable tools in basic sciences, preclinical research, and modern drug development. In Vivo imaging can detect subcellular signaling or metabolic events in living animals, but depth-dependent signal attenuation limits the depth from which significant data can be obtained. Cancer cell motility and invasion are key features of metastatic tumors, but only a small portion of tumor cells are motile and metastasize due to genetic, epigenetic, and microenvironmental heterogeneities.
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Affiliation(s)
- Shrikant B Mali
- Mahatma Gandhi Vidyamandir's Karmaveer Bhausaheb Hiray Dental College & Hospital, Nashik, India.
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Yap T, Tan I, Ramani RS, Bhatia N, Demetrio de Souza Franca P, Angel C, Moore C, Reiner T, Bussau L, McCullough MJ. Acquisition and annotation in high resolution in vivo digital biopsy by confocal microscopy for diagnosis in oral precancer and cancer. Front Oncol 2023; 13:1209261. [PMID: 37469413 PMCID: PMC10352099 DOI: 10.3389/fonc.2023.1209261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 06/12/2023] [Indexed: 07/21/2023] Open
Abstract
Introduction Scanned fibre endomicroscopes are full point-scanning confocal microscopes with submicron lateral resolution with an optical slice thickness thin enough to isolate individual cell layers, allow active positioning of the optical slice in the z-axis and collection of megapixel images. Here we present descriptive findings and a brief atlas of an acquisition and annotation protocol high resolution in vivo capture of oral mucosal pathology including oral squamous cell carcinoma and dysplasia using a fluorescence scanned fibre endomicroscope with 3 topical fluorescent imaging agents: fluorescein, acriflavine and PARPi-FL. Methods Digital biopsy was successfully performed via an acquisition protocol in seventy-one patients presenting for investigation of oral mucosal abnormalities using a miniaturized, handheld scanned fibre endoscope. Multiple imaging agents were utilized and multiple time points sampled. Fifty-nine patients had a matched histopathology correlating in location with imaging. The images were annotated back to macrographic location using a purpose-built software, MouthMap™. Results Acquisition and annotation of cellular level resolved images was demonstrated with all 3 topical agents. Descriptive observations between clinically or histologically normal oral mucosa showed regular intranuclear distance, a regular nuclear profile and fluorescent homogeneity. This was dependent on the intraoral location and type of epithelium being observed. Key features of malignancy were a loss of intranuclear distance, disordered nuclear clustering and irregular nuclear fluorescence intensity and size. Perinuclear fluorescent granules were seen in the absence of irregular nuclear features in lichenoid inflammation. Discussion High resolution oral biopsy allows for painless and rapid capture of multiple mucosal sites, resulting in more data points to increase diagnostic precision. High resolution digital micrographs can be easily compared serially across multiple time points utilizing an annotation software. In the present study we have demonstrated realization of a high-resolution digital biopsy protocol of the oral mucosa for utility in the diagnosis of oral cancer and precancer..
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Affiliation(s)
- Tami Yap
- Melbourne Dental School, Faculty of Medicine, Dentistry and Health Sciences, Carlton, VIC, Australia
- Oral Medicine Unit, Royal Dental Hospital of Melbourne, Carlton, VIC, Australia
| | - Ivy Tan
- Melbourne Dental School, Faculty of Medicine, Dentistry and Health Sciences, Carlton, VIC, Australia
- Oral Medicine Unit, Royal Dental Hospital of Melbourne, Carlton, VIC, Australia
| | - Rishi S. Ramani
- Melbourne Dental School, Faculty of Medicine, Dentistry and Health Sciences, Carlton, VIC, Australia
| | - Nirav Bhatia
- Oral Medicine Unit, Royal Dental Hospital of Melbourne, Carlton, VIC, Australia
| | - Paula Demetrio de Souza Franca
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, United States
- Department of Otorhinolaryngology and Head and Neck Surgery, Federal University of São Paulo, São Paulo, SP, Brazil
| | - Chris Angel
- Department of Pathology, Peter MacCallum Cancer Centre, Victorian Comprehensive Cancer Centre, Parkville, VIC, Australia
| | - Caroline Moore
- Melbourne Dental School, Faculty of Medicine, Dentistry and Health Sciences, Carlton, VIC, Australia
| | - Thomas Reiner
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | | | - Michael J. McCullough
- Melbourne Dental School, Faculty of Medicine, Dentistry and Health Sciences, Carlton, VIC, Australia
- Oral Medicine Unit, Royal Dental Hospital of Melbourne, Carlton, VIC, Australia
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Development, Implementation and Application of Confocal Laser Endomicroscopy in Brain, Head and Neck Surgery—A Review. Diagnostics (Basel) 2022; 12:diagnostics12112697. [PMID: 36359540 PMCID: PMC9689276 DOI: 10.3390/diagnostics12112697] [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: 09/11/2022] [Revised: 10/20/2022] [Accepted: 10/25/2022] [Indexed: 11/09/2022] Open
Abstract
When we talk about visualization methods in surgery, it is important to mention that the diagnosis of tumors and how we define tumor borders intraoperatively in a correct way are two main things that would not be possible to achieve without this grand variety of visualization methods we have at our disposal nowadays. In addition, histopathology also plays a very important role, and its importance cannot be neglected either. Some biopsy specimens, e.g., frozen sections, are examined by a histopathologist and lead to tumor diagnosis and the definition of its borders. Furthermore, surgical resection is a very important point when it comes to prognosis and life survival. Confocal laser endomicroscopy (CLE) is an imaging technique that provides microscopic information on the tissue in real time. CLE of disorders, such as head, neck and brain tumors, has only recently been suggested to contribute to both immediate tumor characterization and detection. It can be used as an additional tool for surgical biopsies during biopsy or surgical procedures and for inspection of resection margins during surgery. In this review, we analyze the development, implementation, advantages and disadvantages as well as the future directions of this technique in neurosurgical and otorhinolaryngological disciplines.
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Sievert M, Auberville M, Oetter N, Stelzle F, Maier A, Mantsopoulos K, Iro H, Goncalves M. [Confocal laser endomicroscopy of head and neck squamous cell carcinoma: a systematic review]. Laryngorhinootologie 2021; 100:875-881. [PMID: 33401329 DOI: 10.1055/a-1339-1635] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE Confocal laser endomicroscopy (CLE), with a magnification of up to 1000 ×, offers the possibility to visualize intercellular spaces in vivo. CLE has already established itself in different disciplines. This article gives an overview of the current research on CLE in the diagnosis of the head and neck squamous cell carcinoma. MATERIAL AND METHODS Systematic bibliographic research in the following online databases: PubMed, MEDLINE, Thompson Reuters Web of Science, SPIE using the following keywords: confocal laser endomicroscopy, CLE, endomicroscopy, head and neck, larynx. Evaluation of the scientific relevance according to defined criteria. RESULTS All studies were analyzed concerning the clinical application, clinical findings, and computer-aided data processing. CONCLUSIONS The recently published data suggest that CLE has a high potential to improve the diagnosis of malignant mucosal lesions in the upper aerodigestive tract.
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Affiliation(s)
- Matti Sievert
- Hals-Nasen-Ohrenklinik, Kopf- und Hals-Chirurgie, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Deutschland
| | - Marc Auberville
- Bildverstehen und medizinische Anwendung der künstlichen Intelligenz, Fakultät Informatik, Technische Hochschule Ingolstadt, Deutschland
| | - Nicolai Oetter
- Klinik und Poliklinik für Mund-Kiefer-Gesichtschirurgie, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Deutschland
| | - Florian Stelzle
- Klinik und Poliklinik für Mund-Kiefer-Gesichtschirurgie, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Deutschland
| | - Andreas Maier
- Pattern Recognition Lab, Computer Science, Friedrich-Alexander-Universität Erlangen-Nürnberg, Deutschland
| | - Konstantinos Mantsopoulos
- Hals-Nasen-Ohrenklinik, Kopf- und Hals-Chirurgie, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Deutschland
| | - Heinrich Iro
- Hals-Nasen-Ohrenklinik, Kopf- und Hals-Chirurgie, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Deutschland
| | - Miguel Goncalves
- Hals-Nasen-Ohrenklinik, Kopf- und Hals-Chirurgie, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Deutschland
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Nie Z, Yeh SCA, LePalud M, Badr F, Tse F, Armstrong D, Liu LWC, Deen MJ, Fang Q. Optical Biopsy of the Upper GI Tract Using Fluorescence Lifetime and Spectra. Front Physiol 2020; 11:339. [PMID: 32477151 PMCID: PMC7237753 DOI: 10.3389/fphys.2020.00339] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Accepted: 03/24/2020] [Indexed: 12/11/2022] Open
Abstract
Screening and surveillance for gastrointestinal (GI) cancers by endoscope guided biopsy is invasive, time consuming, and has the potential for sampling error. Tissue endogenous fluorescence spectra contain biochemical and physiological information, which may enable real-time, objective diagnosis. We first briefly reviewed optical biopsy modalities for GI cancer diagnosis with a focus on fluorescence-based techniques. In an ex vivo pilot clinical study, we measured fluorescence spectra and lifetime on fresh biopsy specimens obtained during routine upper GI screening procedures. Our results demonstrated the feasibility of rapid acquisition of time-resolved fluorescence (TRF) spectra from fresh GI mucosal specimens. We also identified spectroscopic signatures that can differentiate between normal mucosal samples obtained from the esophagus, stomach, and duodenum.
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Affiliation(s)
- Zhaojun Nie
- School of Biomedical Engineering, Faculty of Engineering, McMaster University, Hamilton, ON, Canada
| | - Shu-Chi Allison Yeh
- Advanced Microscopy Program, Center for Systems Biology and Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Michelle LePalud
- School of Biomedical Engineering, Faculty of Engineering, McMaster University, Hamilton, ON, Canada
| | - Fares Badr
- School of Biomedical Engineering, Faculty of Engineering, McMaster University, Hamilton, ON, Canada
| | - Frances Tse
- Division of Gastroenterology and Farncombe Family Digestive Health Research Institute, Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - David Armstrong
- Division of Gastroenterology and Farncombe Family Digestive Health Research Institute, Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Louis W. C. Liu
- Division of Gastrointestinal Diseases, Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - M. Jamal Deen
- School of Biomedical Engineering, Faculty of Engineering, McMaster University, Hamilton, ON, Canada
- Department of Electrical and Computer Engineering, Faculty of Engineering, McMaster University, Hamilton, ON, Canada
| | - Qiyin Fang
- School of Biomedical Engineering, Faculty of Engineering, McMaster University, Hamilton, ON, Canada
- Department of Engineering Physics, Faculty of Engineering, McMaster University, Hamilton, ON, Canada
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Stoeve M, Aubreville M, Oetter N, Knipfer C, Neumann H, Stelzle F, Maier A. Motion Artifact Detection in Confocal Laser Endomicroscopy Images. BILDVERARBEITUNG FÜR DIE MEDIZIN 2018 2018. [DOI: 10.1007/978-3-662-56537-7_85] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Englhard AS, Palaras A, Volgger V, Stepp H, Mack B, Libl D, Gires O, Betz CS. Confocal laser endomicroscopy in head and neck malignancies using FITC-labelled EpCAM- and EGF-R-antibodies in cell lines and tumor biopsies. JOURNAL OF BIOPHOTONICS 2017; 10:1365-1376. [PMID: 28106950 DOI: 10.1002/jbio.201600238] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Revised: 11/23/2016] [Accepted: 12/23/2016] [Indexed: 06/06/2023]
Abstract
Intraoperative detection of residual malignant cells at tumor margins following excision of primary tumors could help improving surgery and thus patients' outcome. The feasibility of the tumor antigens epidermal growth factor receptor (EGF-R) and epithelial cell adhesion molecule (EpCAM) for antibody-dependent confocal laser scanning endomicroscopy (CLE)-mediated visualization of malignant cells was addressed. Both tumor antigens are highly and frequently expressed in the majority of carcinomas, including head and neck squamous cell carcinomas (HNSCC), and represent prognostic and therapeutic tumor target molecules. FITC-conjugated EGF-R- and EpCAM-specific antibodies served as molecular tools for the detection of antigen-positive cells using the CLE technology. Specificity of both antibodies and their ability to discriminate tumor from non-tumor cells were assessed in vitro with human fibroblasts and PCI-1 HNSCC cell lines, and ex vivo on primary HNSCC samples (n = 11) and healthy mucosa (n = 5). Antigen specificity of the used EpCAM-specific antibody was superior to that of the EGF-R-specific antibody both in vitro and ex vivo (100% vs. 31.25%), and allowed visualization of cellular structures in CLE measurements. These results hold promise for possible future applications in humans.
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Affiliation(s)
- Anna S Englhard
- Department of Otorhinolaryngology-Head and Neck Surgery, Klinikum der Universität München, Marchioninistr. 15, 81377, Munich, Germany
| | - Alexander Palaras
- Laser-Forschungslabor, LIFE-Zentrum, Klinikum der Universität München, Feodor-Lynen-Str. 19, 81377, Munich, Germany
| | - Veronika Volgger
- Department of Otorhinolaryngology-Head and Neck Surgery, Klinikum der Universität München, Marchioninistr. 15, 81377, Munich, Germany
| | - Herbert Stepp
- Laser-Forschungslabor, LIFE-Zentrum, Klinikum der Universität München, Feodor-Lynen-Str. 19, 81377, Munich, Germany
- Department of Urology, Klinikum der Universität München, Marchioninistr. 15, 81377, Munich, Germany
| | - Brigitte Mack
- Department of Otorhinolaryngology-Head and Neck Surgery, Klinikum der Universität München, Marchioninistr. 15, 81377, Munich, Germany
| | - Darko Libl
- Department of Otorhinolaryngology-Head and Neck Surgery, Klinikum der Universität München, Marchioninistr. 15, 81377, Munich, Germany
| | - Olivier Gires
- Department of Otorhinolaryngology-Head and Neck Surgery, Klinikum der Universität München, Marchioninistr. 15, 81377, Munich, Germany
- Clinical Cooperation Group "Personalized Radiotherapy of Head and Neck Tumors", Helmholtz Zentrum, München, Germany
| | - Christian S Betz
- Department of Otorhinolaryngology-Head and Neck Surgery, Klinikum der Universität München, Marchioninistr. 15, 81377, Munich, Germany
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Chiew WM, Lin F, Seah HS. Demons registration for in vivo and deformable laser scanning confocal endomicroscopy. JOURNAL OF BIOMEDICAL OPTICS 2017; 22:1-11. [PMID: 28929643 DOI: 10.1117/1.jbo.22.9.096009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Accepted: 08/25/2017] [Indexed: 06/07/2023]
Abstract
A critical effect found in noninvasive in vivo endomicroscopic imaging modalities is image distortions due to sporadic movement exhibited by living organisms. In three-dimensional confocal imaging, this effect results in a dataset that is tilted across deeper slices. Apart from that, the sequential flow of the imaging-processing pipeline restricts real-time adjustments due to the unavailability of information obtainable only from subsequent stages. To solve these problems, we propose an approach to render Demons-registered datasets as they are being captured, focusing on the coupling between registration and visualization. To improve the acquisition process, we also propose a real-time visual analytics tool, which complements the imaging pipeline and the Demons registration pipeline with useful visual indicators to provide real-time feedback for immediate adjustments. We highlight the problem of deformation within the visualization pipeline for object-ordered and image-ordered rendering. Visualizations of critical information including registration forces and partial renderings of the captured data are also presented in the analytics system. We demonstrate the advantages of the algorithmic design through experimental results with both synthetically deformed datasets and actual in vivo, time-lapse tissue datasets expressing natural deformations. Remarkably, this algorithm design is for embedded implementation in intelligent biomedical imaging instrumentation with customizable circuitry.
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Affiliation(s)
| | - Feng Lin
- Nanyang Technological Univ., Singapore
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Noninvasive histological imaging of head and neck squamous cell carcinomas using confocal laser endomicroscopy. Eur Arch Otorhinolaryngol 2016; 273:4473-4483. [PMID: 27307282 DOI: 10.1007/s00405-016-4145-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Accepted: 06/11/2016] [Indexed: 01/27/2023]
Abstract
Confocal laser endomicroscopy (CLE) is an imaging technique that uses miniaturized fiberoptic probes to allow real-time histological imaging of human tissue. An application of CLE in otorhinolaryngology has hardly been investigated so far. In our study, we analyzed the applicability of CLE to visualize cancerous and healthy tissue of the head and neck region. Formalin-fixed tissue specimens from 135 head and neck squamous cell carcinoma (HNSCC) patients and 50 healthy controls were investigated using CLE with and without topical application of acriflavine. Four head and neck surgeons, four pathologists, and four laymen evaluated the CLE images of the HNSCC cases regarding the tumor localization and its border to healthy tissue. The tumor localization and the tumor border were correctly identified in 97 % by the pathologists, 85 % by the head and neck surgeons, and 70 % by the laymen. The main difference in evaluation results was seen in the correct identification of the tumor site (p < 0.05), while there was no significant difference in the identification of the tumor border. CLE is a valuable tool for real-time histological imaging of HNSCCs. It can help to visualize the tumor border and, thereby, facilitate a more precise tumor surgery.
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Oetter N, Knipfer C, Rohde M, von Wilmowsky C, Maier A, Brunner K, Adler W, Neukam FW, Neumann H, Stelzle F. Development and validation of a classification and scoring system for the diagnosis of oral squamous cell carcinomas through confocal laser endomicroscopy. J Transl Med 2016; 14:159. [PMID: 27255924 PMCID: PMC4891821 DOI: 10.1186/s12967-016-0919-4] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Accepted: 05/20/2016] [Indexed: 12/11/2022] Open
Abstract
Background Confocal laser endomicroscopy (CLE) is an optical biopsy method allowing in vivo microscopic imaging at 1000-fold magnification. It was the aim to evaluate CLE in the human oral cavity for the differentiation of physiological/carcinomatous mucosa and to establish and validate, for the first time, a scoring system to facilitate CLE assessment. Methods The study consisted of 4 phases: (1) CLE-imaging (in vivo) was performed after the intravenous injection of fluorescein in patients with histologically confirmed carcinomatous oral mucosa; (2) CLE-experts (n = 3) verified the applicability of CLE in the oral cavity for the differentiation between physiological and cancerous tissue compared to the gold standard of histopathological assessment; (3) based on specific patterns of tissue changes, CLE-experts (n = 3) developed a classification and scoring system (DOC-Score) to simplify the diagnosis of oral squamous cell carcinomas; (4) validation of the newly developed DOC-Score by non-CLE-experts (n = 3); final statistical evaluation of their classification performance (comparison to the results of CLE-experts and the histopathological analyses). Results Experts acquired and edited 45 sequences (260 s) of physiological and 50 sequences (518 s) of carcinomatous mucosa (total: 95 sequences/778 s). All sequences were evaluated independently by experts and non-experts (based on the newly proposed classification system). Sensitivity (0.953) and specificity (0.889) of the diagnoses by experts as well as sensitivity (0.973) and specificity (0.881) of the non-expert ratings correlated well with the results of the present gold standard of tissue histopathology. Experts had a positive predictive value (PPV) of 0.905 and a negative predictive value (NPV) of 0.945. Non-experts reached a PPV of 0.901 and a NPV of 0.967 with the help of the DOC-Score. Inter-rater reliability (Fleiss` kappa) was 0.73 for experts and 0.814 for non-experts. The intra-rater reliability (Cronbach’s alpha) of the experts was 0.989 and 0.884 for non-experts. Conclusions CLE is a suitable and valid method for experts to diagnose oral cancer. Using the DOC-Score system, an accurate chair-side diagnosis of oral cancer is feasible with comparable results to the gold standard of histopathology—even in daily clinical practice for non-experienced raters.
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Affiliation(s)
- Nicolai Oetter
- Department of Oral and Maxillofacial Surgery, Friedrich-Alexander University Erlangen-Nürnberg (FAU), University Hospital Erlangen, Glückstraße 11, 91054, Erlangen, Germany.
| | - Christian Knipfer
- Department of Oral and Maxillofacial Surgery, Friedrich-Alexander University Erlangen-Nürnberg (FAU), University Hospital Erlangen, Glückstraße 11, 91054, Erlangen, Germany.,SAOT-Erlangen Graduate School in Advanced Optical Technologies, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Paul Gordan Strasse 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.,SAOT-Erlangen Graduate School in Advanced Optical Technologies, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Paul Gordan Strasse 6, 91052, Erlangen, Germany
| | - Cornelius von Wilmowsky
- Department of Oral and Maxillofacial Surgery, Friedrich-Alexander University Erlangen-Nürnberg (FAU), University Hospital Erlangen, Glückstraße 11, 91054, Erlangen, Germany
| | - Andreas Maier
- Department of Computer Science 5, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Martensstraße 3, 91058, Erlangen, Germany.,SAOT-Erlangen Graduate School in Advanced Optical Technologies, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Paul Gordan Strasse 6, 91052, Erlangen, Germany
| | - Kathrin Brunner
- Institute of Pathology, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Krankenhausstr. 8-10, 91054, Erlangen, Germany
| | - Werner Adler
- Department of Medical Information Technology, Biometry and Epidemiology, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Waldstraße 6, 91054, Erlangen, Germany
| | - Friedrich-Wilhelm Neukam
- Department of Oral and Maxillofacial Surgery, Friedrich-Alexander University Erlangen-Nürnberg (FAU), University Hospital Erlangen, Glückstraße 11, 91054, Erlangen, Germany.,SAOT-Erlangen Graduate School in Advanced Optical Technologies, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Paul Gordan Strasse 6, 91052, Erlangen, Germany
| | - Helmut Neumann
- Department of Medicine I, Friedrich-Alexander University Erlangen-Nürnberg (FAU), University Hospital Erlangen, Ulmenweg 18, 91054, Erlangen, Germany.,SAOT-Erlangen Graduate School in Advanced Optical Technologies, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Paul Gordan Strasse 6, 91052, Erlangen, Germany
| | - Florian Stelzle
- Department of Oral and Maxillofacial Surgery, Friedrich-Alexander University Erlangen-Nürnberg (FAU), University Hospital Erlangen, Glückstraße 11, 91054, Erlangen, Germany.,SAOT-Erlangen Graduate School in Advanced Optical Technologies, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Paul Gordan Strasse 6, 91052, Erlangen, Germany
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Jendželovská Z, Jendželovský R, Kuchárová B, Fedoročko P. Hypericin in the Light and in the Dark: Two Sides of the Same Coin. FRONTIERS IN PLANT SCIENCE 2016; 7:560. [PMID: 27200034 PMCID: PMC4859072 DOI: 10.3389/fpls.2016.00560] [Citation(s) in RCA: 100] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2016] [Accepted: 04/11/2016] [Indexed: 06/05/2023]
Abstract
Hypericin (4,5,7,4',5',7'-hexahydroxy-2,2'-dimethylnaphtodianthrone) is a naturally occurring chromophore found in some species of the genus Hypericum, especially Hypericum perforatum L. (St. John's wort), and in some basidiomycetes (Dermocybe spp.) or endophytic fungi (Thielavia subthermophila). In recent decades, hypericin has been intensively studied for its broad pharmacological spectrum. Among its antidepressant and light-dependent antiviral actions, hypericin is a powerful natural photosensitizer that is applicable in the photodynamic therapy (PDT) of various oncological diseases. As the accumulation of hypericin is significantly higher in neoplastic tissue than in normal tissue, it can be used in photodynamic diagnosis (PDD) as an effective fluorescence marker for tumor detection and visualization. In addition, light-activated hypericin acts as a strong pro-oxidant agent with antineoplastic and antiangiogenic properties, since it effectively induces the apoptosis, necrosis or autophagy of cancer cells. Moreover, a strong affinity of hypericin for necrotic tissue was discovered. Thus, hypericin and its radiolabeled derivatives have been recently investigated as potential biomarkers for the non-invasive targeting of tissue necrosis in numerous disorders, including solid tumors. On the other hand, several light-independent actions of hypericin have also been described, even though its effects in the dark have not been studied as intensively as those of photoactivated hypericin. Various experimental studies have revealed no cytotoxicity of hypericin in the dark; however, it can serve as a potential antimetastatic and antiangiogenic agent. On the contrary, hypericin can induce the expression of some ABC transporters, which are often associated with the multidrug resistance (MDR) of cancer cells. Moreover, the hypericin-mediated attenuation of the cytotoxicity of some chemotherapeutics was revealed. Therefore, hypericin might represent another St. John's wort metabolite that is potentially responsible for negative herb-drug interactions. The main aim of this review is to summarize the benefits of photoactivated and non-activated hypericin, mainly in preclinical and clinical applications, and to uncover the "dark side" of this secondary metabolite, focusing on MDR mechanisms.
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In vivo confocal microscopy for the oral cavity: Current state of the field and future potential. Oral Oncol 2016; 54:28-35. [PMID: 26786962 DOI: 10.1016/j.oraloncology.2016.01.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2015] [Revised: 12/24/2015] [Accepted: 01/04/2016] [Indexed: 12/13/2022]
Abstract
Confocal microscopy (CM) has been shown to correlate with oral mucosal histopathology in vivo. The purposes of this review are to summarize what we know so far about in vivo CM applications for oral mucosal pathologies, to highlight some current developments with CM devices relevant for oral applications, and to formulate where in vivo CM could hold further application for oral mucosal diagnosis and management. Ovid Medline® and/or Google® searches were performed using the terms 'microscopy, confocal', 'mouth neoplasms', 'mouth mucosa', 'leukoplakia, oral', 'oral lichen planus', 'gingiva', 'cheilitis', 'taste', 'inflammatory oral confocal', 'mucosal confocal' and 'confocal squamous cell oral'. In summary, inclusion criteria were in vivo use of any type of CM for the human oral mucosa and studies on normal or pathological oral mucosa. Experimental studies attempting to identify proteins of interest and microorganisms were excluded. In total 25 relevant articles were found, covering 8 main topics, including normal oral mucosal features (n=15), oral dysplasia or neoplasia (n=7), inflamed oral mucosa (n=3), taste impairment (n=3), oral autoimmune conditions (n=2), pigmented oral pathology/melanoma (n=1), delayed type hypersensitivity (n=1), and cheilitis glandularis (n=1). The evidence for using in vivo CM in these conditions is poor, as it is limited to mainly small descriptive studies. Current device developments for oral CM include improved probe design. The authors propose that future applications for in vivo oral CM may include burning mouth syndrome, intra-operative mapping for cancer surgery, and monitoring and targeted biopsies within field cancerization.
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Volgger V, Girschick S, Ihrler S, Englhard AS, Stepp H, Betz CS. Evaluation of confocal laser endomicroscopy as an aid to differentiate primary flat lesions of the larynx: A prospective clinical study. Head Neck 2015; 38 Suppl 1:E1695-704. [DOI: 10.1002/hed.24303] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2015] [Revised: 08/09/2015] [Accepted: 09/19/2015] [Indexed: 01/26/2023] Open
Affiliation(s)
- Veronika Volgger
- Department of Otorhinolaryngology; Head and Neck Surgery; Klinikum der Universität München; Munich Germany
| | - Susanne Girschick
- Department of Otorhinolaryngology; Head and Neck Surgery; Klinikum der Universität München; Munich Germany
- Laser-Forschungslabor; LIFE Center; Klinikum der Universität München; Munich Germany
| | - Stephan Ihrler
- Labor für Dermatohistologie und Oralpathologie; Munich Germany
| | - Anna Sophie Englhard
- Department of Otorhinolaryngology; Head and Neck Surgery; Klinikum der Universität München; Munich Germany
| | - Herbert Stepp
- Laser-Forschungslabor; LIFE Center; Klinikum der Universität München; Munich Germany
| | - Christian Stephan Betz
- Department of Otorhinolaryngology; Head and Neck Surgery; Klinikum der Universität München; Munich Germany
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Dittberner A, Rodner E, Ortmann W, Stadler J, Schmidt C, Petersen I, Stallmach A, Denzler J, Guntinas-Lichius O. Automated analysis of confocal laser endomicroscopy images to detect head and neck cancer. Head Neck 2015; 38 Suppl 1:E1419-26. [PMID: 26560348 DOI: 10.1002/hed.24253] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/25/2015] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND The purpose of this study was to develop an automated image analysis algorithm to discriminate between head and neck cancer and nonneoplastic epithelium in confocal laser endomicroscopy (CLE) images. METHODS CLE was applied to image head and neck cancer epithelium in vivo. Histopathologic diagnosis from biopsies was used to classify the CLE images offline as cancer or noncancer tissue. The classified images were used to train automated software based on distance map histograms. The performance of the final algorithm was confirmed by "leave 2 patients out" cross-validation and area under the curve (AUC)/receiver operating characteristic (ROC) analysis. RESULTS Ninety-two CLE videos and 92 biopsies were analyzed from 12 patients. One hundred two frames of classified neoplastic tissue and 52 frames of nonneoplastic tissue were used for cross-validation of the developed algorithm. AUC varied from 0.52 to 0.92. CONCLUSION The proposed software allows an objective classification of CLE images of head and neck cancer and adjacent nonneoplastic epithelium. © 2015 Wiley Periodicals, Inc. Head Neck 38: E1419-E1426, 2016.
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Affiliation(s)
- Andreas Dittberner
- Department of Otorhinolaryngology, Jena University Hospital, Jena, Germany.,Department of Otorhinolaryngology, Head and Neck Surgery, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Erik Rodner
- Department of Computer Science, Friedrich Schiller University, Jena, Germany
| | - Wolfgang Ortmann
- Department of Computer Science, Friedrich Schiller University, Jena, Germany
| | - Joachim Stadler
- Department of Otorhinolaryngology, Jena University Hospital, Jena, Germany.,Department of Otorhinolaryngology, Heinrich-Braun-Klinikum, Zwickau, Germany
| | - Carsten Schmidt
- Division of Gastroenterology, Hepatology and Infectious Diseases, Department of Internal Medicine IV, Jena University Hospital, Jena, Germany
| | - Iver Petersen
- Institute of Pathology, Jena University Hospital, Jena, Germany
| | - Andreas Stallmach
- Division of Gastroenterology, Hepatology and Infectious Diseases, Department of Internal Medicine IV, Jena University Hospital, Jena, Germany
| | - Joachim Denzler
- Department of Computer Science, Friedrich Schiller University, Jena, Germany
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Keiser G, Xiong F, Cui Y, Shum PP. Review of diverse optical fibers used in biomedical research and clinical practice. JOURNAL OF BIOMEDICAL OPTICS 2014; 19:080902. [PMID: 25166470 DOI: 10.1117/1.jbo.19.8.080902] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2014] [Accepted: 08/05/2014] [Indexed: 05/13/2023]
Abstract
Optical fiber technology has significantly bolstered the growth of photonics applications in basic life sciences research and in biomedical diagnosis, therapy, monitoring, and surgery. The unique operational characteristics of diverse fibers have been exploited to realize advanced biomedical functions in areas such as illumination, imaging, minimally invasive surgery, tissue ablation, biological sensing, and tissue diagnosis. This review paper provides the necessary background to understand how optical fibers function, to describe the various categories of available fibers, and to illustrate how specific fibers are used for selected biomedical photonics applications. Research articles and vendor data sheets were consulted to describe the operational characteristics of conventional and specialty multimode and single-mode solid-core fibers, double-clad fibers, hard-clad silica fibers, conventional hollow-core fibers, photonic crystal fibers, polymer optical fibers, side-emitting and side-firing fibers, middle-infrared fibers, and optical fiber bundles. Representative applications from the recent literature illustrate how various fibers can be utilized in a wide range of biomedical disciplines. In addition to helping researchers refine current experimental setups, the material in this review paper will help conceptualize and develop emerging optical fiber-based diagnostic and analysis tools.
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Affiliation(s)
- Gerd Keiser
- Boston University, Department of Electrical and Computer Engineering, 8 Saint Mary's Street, Boston, Massachusetts 02215, United States
| | - Fei Xiong
- City University London, Department of Electrical and Electronic Engineering, Northampton Square, London, EC1V 0HB, United Kingdom
| | - Ying Cui
- Nanyang Technological University, Photonics Centre of Excellence, School of Electrical and Electronic Engineering, 50 Nanyang Avenue, 639798, SingaporedCINTRA CNRS/NTU/THALES, UMI 3288, Research Techno Plaza, 50 Nanyang Drive, 637553, Singapore
| | - Perry Ping Shum
- Nanyang Technological University, Photonics Centre of Excellence, School of Electrical and Electronic Engineering, 50 Nanyang Avenue, 639798, Singapore
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Chiew WM, Lin F, Qian K, Seah HS. A heterogeneous computing system for coupling 3D endomicroscopy with volume rendering in real-time image visualization. COMPUT IND 2014. [DOI: 10.1016/j.compind.2013.10.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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