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Fan S, Zhang H, Meng Z, Li A, Luo Y, Liu Y. Comparing the diagnostic efficacy of optical coherence tomography and frozen section for margin assessment in breast-conserving surgery: a meta-analysis. J Clin Pathol 2024; 77:517-527. [PMID: 38862215 DOI: 10.1136/jcp-2024-209597] [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: 04/20/2024] [Accepted: 05/31/2024] [Indexed: 06/13/2024]
Abstract
AIMS This meta-analysis assessed the relative diagnostic accuracy of optical coherence tomography (OCT) versus frozen section (FS) in evaluating surgical margins during breast-conserving procedures. METHODS PubMed and Embase were searched for relevant studies published up to October 2023. The inclusion criteria encompassed studies evaluating the diagnostic accuracy of OCT or FS in patients undergoing breast-conserving surgery. Sensitivity and specificity were analysed using the DerSimonian and Laird method and subsequently transformed through the Freeman-Tukey double inverse sine method. RESULTS The meta-analysis encompassed 36 articles, comprising 16 studies on OCT and 20 on FS, involving 10 289 specimens from 8058 patients. The overall sensitivity of OCT was 0.93 (95% CI: 0.90 to 0.96), surpassing that of FS, which was 0.82 (95% CI: 0.71 to 0.92), indicating a significantly higher sensitivity for OCT (p=0.04). Conversely, the overall specificity of OCT was 0.89 (95% CI: 0.83 to 0.94), while FS exhibited a higher specificity at 0.97 (95% CI: 0.95 to 0.99), suggesting a superior specificity for FS (p<0.01). CONCLUSIONS Our meta-analysis reveals that OCT offers superior sensitivity but inferior specificity compared with FS in assessing surgical margins in breast-conserving surgery patients. Further larger well-designed prospective studies are needed, especially those employing a head-to-head comparison design. PROSPERO REGISTRATION NUMBER CRD42023483751.
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Affiliation(s)
- Shishun Fan
- Pathology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Huirui Zhang
- Pathology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Zhenyu Meng
- Pathology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Ang Li
- Pathology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Yuqing Luo
- Pathology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Yueping Liu
- Pathology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
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2
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Haj-Hosseini N, Lindblad J, Hasséus B, Kumar VV, Subramaniam N, Hirsch JM. Early Detection of Oral Potentially Malignant Disorders: A Review on Prospective Screening Methods with Regard to Global Challenges. J Maxillofac Oral Surg 2024; 23:23-32. [PMID: 38312957 PMCID: PMC10831018 DOI: 10.1007/s12663-022-01710-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 03/10/2022] [Indexed: 11/28/2022] Open
Abstract
Oral cancer is a cancer type that is widely prevalent in low-and middle-income countries with a high mortality rate, and poor quality of life for patients after treatment. Early treatment of cancer increases patient survival, improves quality of life and results in less morbidity and a better prognosis. To reach this goal, early detection of malignancies using technologies that can be used in remote and low resource areas is desirable. Such technologies should be affordable, accurate, and easy to use and interpret. This review surveys different technologies that have the potentials of implementation in primary health and general dental practice, considering global perspectives and with a focus on the population in India, where oral cancer is highly prevalent. The technologies reviewed include both sample-based methods, such as saliva and blood analysis and brush biopsy, and more direct screening of the oral cavity including fluorescence, Raman techniques, and optical coherence tomography. Digitalisation, followed by automated artificial intelligence based analysis, are key elements in facilitating wide access to these technologies, to non-specialist personnel and in rural areas, increasing quality and objectivity of the analysis while simultaneously reducing the labour and need for highly trained specialists.
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Affiliation(s)
- Neda Haj-Hosseini
- Department of Biomedical Engineering, Linköping University, Linköping, Sweden
- Centre for Medical Image Science and Visualization, Linköping University, Linköping, Sweden
| | - Joakim Lindblad
- Centre for Image Analysis, Department of Information Technology, Uppsala University, Uppsala, Sweden
| | - Bengt Hasséus
- Department of Oral Medicine and Pathology, Institute of Odontology, University of Gothenburg, The Sahlgrenska Academy, Gothenburg, Sweden
- Clinic of Oral Medicine, Public Dental Service, Gothenburg, Region Västra Götaland Sweden
| | - Vinay Vijaya Kumar
- Department of Head and Neck Oncology, Sri Shankara Cancer Hospital and Research Centre, Bangalore, India
- Department of Surgical Sciences, Odontology and Maxillofacial Surgery, Medical Faculty, Uppsala University, Uppsala, Sweden
| | - Narayana Subramaniam
- Department of Head and Neck Oncology, Sri Shankara Cancer Hospital and Research Centre, Bangalore, India
| | - Jan-Michaél Hirsch
- Department of Surgical Sciences, Odontology and Maxillofacial Surgery, Medical Faculty, Uppsala University, Uppsala, Sweden
- Department of Research & Development, Public Dental Services Region Stockholm, Stockholm, Sweden
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3
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Yang Y, Jiang Q, Zhang F. Nanocrystals for Deep-Tissue In Vivo Luminescence Imaging in the Near-Infrared Region. Chem Rev 2024; 124:554-628. [PMID: 37991799 DOI: 10.1021/acs.chemrev.3c00506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2023]
Abstract
In vivo imaging technologies have emerged as a powerful tool for both fundamental research and clinical practice. In particular, luminescence imaging in the tissue-transparent near-infrared (NIR, 700-1700 nm) region offers tremendous potential for visualizing biological architectures and pathophysiological events in living subjects with deep tissue penetration and high imaging contrast owing to the reduced light-tissue interactions of absorption, scattering, and autofluorescence. The distinctive quantum effects of nanocrystals have been harnessed to achieve exceptional photophysical properties, establishing them as a promising category of luminescent probes. In this comprehensive review, the interactions between light and biological tissues, as well as the advantages of NIR light for in vivo luminescence imaging, are initially elaborated. Subsequently, we focus on achieving deep tissue penetration and improved imaging contrast by optimizing the performance of nanocrystal fluorophores. The ingenious design strategies of NIR nanocrystal probes are discussed, along with their respective biomedical applications in versatile in vivo luminescence imaging modalities. Finally, thought-provoking reflections on the challenges and prospects for future clinical translation of nanocrystal-based in vivo luminescence imaging in the NIR region are wisely provided.
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Affiliation(s)
- Yang Yang
- College of Energy Materials and Chemistry, State Key Laboratory of Reproductive Regulation and Breeding of Grassland Livestock, Inner Mongolia University, Hohhot 010021, China
| | - Qunying Jiang
- College of Energy Materials and Chemistry, State Key Laboratory of Reproductive Regulation and Breeding of Grassland Livestock, Inner Mongolia University, Hohhot 010021, China
| | - Fan Zhang
- College of Energy Materials and Chemistry, State Key Laboratory of Reproductive Regulation and Breeding of Grassland Livestock, Inner Mongolia University, Hohhot 010021, China
- Department of Chemistry, State Key Laboratory of Molecular Engineering of Polymers, Shanghai Key Laboratory of Molecular Catalysis and Innovative Materials, Fudan University, Shanghai 200433, China
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4
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Moghtaderi S, Mandapati A, Davies G, Wahid KA, Lukong KE. Smart and low-cost fluorometer for identifying breast cancer malignancy based on lipid droplets accumulation. PLoS One 2023; 18:e0294988. [PMID: 38128020 PMCID: PMC10735024 DOI: 10.1371/journal.pone.0294988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 11/14/2023] [Indexed: 12/23/2023] Open
Abstract
The most common cause of breast cancer-related death is tumor recurrence. To develop more effective treatments, the identification of cancer cell specific malignancy indicators is therefore critical. Lipid droplets are known as an emerging hallmark in aggressive breast tumors. A common technique that can be used for observing molecules in cancer microenvironment is fluorescence microscopy. We describe the design, development and applicability of a smart fluorometer to detect lipid droplet accumulation based on the emitted fluorescence signals from highly malignant (MDA-MB-231) and mildly malignant (MCF7) breast cancer cell lines, that are stained with BODIPY dye. This device uses a visible-range light source as an excitation source and a spectral sensor as the detector. A commercial imaging system was used to examine the fluorescent cancer cell lines before being validated in a preclinical setting with the developed prototype. The outcomes indicate that this low-cost fluorometer can effectively detect the alterations levels of lipid droplets and hence distinguish between "moderately malignant" and "highly malignant" cancer cells. In comparison to prior research that used fluorescence spectroscopy techniques to detect cancer biomarkers, this study revealed enhanced capability in classifying mildly and highly malignant cancer cell lines.
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Affiliation(s)
- Shiva Moghtaderi
- Department of Electrical and Computer Engineering, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Aditya Mandapati
- Department of Biochemistry, Microbiology and Immunology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Gerald Davies
- Department of Biochemistry, Microbiology and Immunology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Khan A. Wahid
- Department of Electrical and Computer Engineering, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Kiven Erique Lukong
- Department of Biochemistry, Microbiology and Immunology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
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5
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Marumo T, Maduka CV, Ural E, Apu EH, Chung SJ, Tanabe K, van den Berg NS, Zhou Q, Martin BA, Miura T, Rosenthal EL, Shibahara T, Contag CH. Flavinated SDHA underlies the change in intrinsic optical properties of oral cancers. Commun Biol 2023; 6:1134. [PMID: 37945749 PMCID: PMC10636189 DOI: 10.1038/s42003-023-05510-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 10/26/2023] [Indexed: 11/12/2023] Open
Abstract
The molecular basis of reduced autofluorescence in oral squamous cell carcinoma (OSCC) cells relative to normal cells has been speculated to be due to lower levels of free flavin adenine dinucleotide (FAD). This speculation, along with differences in the intrinsic optical properties of extracellular collagen, lies at the foundation of the design of currently-used clinical optical detection devices. Here, we report that free FAD levels may not account for differences in autofluorescence of OSCC cells, but that the differences relate to FAD as a co-factor for flavination. Autofluorescence from a 70 kDa flavoprotein, succinate dehydrogenase A (SDHA), was found to be responsible for changes in optical properties within the FAD spectral region, with lower levels of flavinated SDHA in OSCC cells. Since flavinated SDHA is required for functional complexation with succinate dehydrogenase B (SDHB), decreased SDHB levels were observed in human OSCC tissue relative to normal tissues. Accordingly, the metabolism of OSCC cells was found to be significantly altered relative to normal cells, revealing vulnerabilities for both diagnosis and targeted therapy. Optimizing non-invasive tools based on optical and metabolic signatures of cancers will enable more precise and early diagnosis leading to improved outcomes in patients.
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Affiliation(s)
- Tomoko Marumo
- Department of Oral and Maxillofacial Surgery, Tokyo Dental College, 2-9-18 Kanda-Misakicho, Chiyoda-ku, Tokyo, 101-0061, Japan
- Department of Biomedical Engineering, Michigan State University, East Lansing, MI, 48824, USA
- Institute for Quantitative Health Science & Engineering, Michigan State University, East Lansing, MI, 48824, USA
| | - Chima V Maduka
- Department of Biomedical Engineering, Michigan State University, East Lansing, MI, 48824, USA
- Institute for Quantitative Health Science & Engineering, Michigan State University, East Lansing, MI, 48824, USA
- Comparative Medicine & Integrative Biology, Michigan State University, East Lansing, MI, 48824, USA
- BioFrontiers Institute, University of Colorado, Boulder, CO, 80303, USA
| | - Evran Ural
- Department of Biomedical Engineering, Michigan State University, East Lansing, MI, 48824, USA
- Institute for Quantitative Health Science & Engineering, Michigan State University, East Lansing, MI, 48824, USA
| | - Ehsanul Hoque Apu
- Department of Biomedical Engineering, Michigan State University, East Lansing, MI, 48824, USA
- Institute for Quantitative Health Science & Engineering, Michigan State University, East Lansing, MI, 48824, USA
- Division of Hematology and Oncology, Department of Internal Medicine, Michigan Medicine, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Seock-Jin Chung
- Department of Biomedical Engineering, Michigan State University, East Lansing, MI, 48824, USA
- Institute for Quantitative Health Science & Engineering, Michigan State University, East Lansing, MI, 48824, USA
| | - Koji Tanabe
- Department of Biomedical Engineering, Iwate Medical University, 1-1-1 Idaidori, Yahaba-cho, Shiwa-gun, Iwate, 028-3694, Japan
| | - Nynke S van den Berg
- Department of Otolaryngology - Division of Head and Neck Surgery, Stanford University School of Medicine, 269 Campus Drive, Stanford, CA, 94305, USA
| | - Quan Zhou
- Department of Otolaryngology - Division of Head and Neck Surgery, Stanford University School of Medicine, 269 Campus Drive, Stanford, CA, 94305, USA
| | - Brock A Martin
- Department of Pathology, Stanford University School of Medicine, 3100 Pasteur Drive, Stanford, CA, 94305, USA
| | - Tadashi Miura
- Oral Health Science Center, Tokyo Dental College, 2-1-14 Kanda-Misakicho, Chiyoda-ku, Tokyo, 101-0061, Japan
| | - Eben L Rosenthal
- Department of Otolaryngology - Division of Head and Neck Surgery, Stanford University School of Medicine, 269 Campus Drive, Stanford, CA, 94305, USA
- Department of Otolaryngology - Head and Neck Surgery, Vanderbilt University Medical Center, 1211 Medical Center Dr, Nashville, TN, 37232, USA
| | - Takahiko Shibahara
- Department of Oral and Maxillofacial Surgery, Tokyo Dental College, 2-9-18 Kanda-Misakicho, Chiyoda-ku, Tokyo, 101-0061, Japan
| | - Christopher H Contag
- Department of Biomedical Engineering, Michigan State University, East Lansing, MI, 48824, USA.
- Institute for Quantitative Health Science & Engineering, Michigan State University, East Lansing, MI, 48824, USA.
- Department of Microbiology & Molecular Genetics, Michigan State University, East Lansing, MI, 48824, USA.
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Marumo T, Maduka CV, Ural E, Apu EH, Chung SJ, van den Berg NS, Zhou Q, Martin BA, Rosenthal EL, Shibahara T, Contag CH. Flavinated SDHA Underlies the Change in Intrinsic Optical Properties of Oral Cancers. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.07.30.551184. [PMID: 37577521 PMCID: PMC10418065 DOI: 10.1101/2023.07.30.551184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/15/2023]
Abstract
The molecular basis of reduced autofluorescence in oral squamous cell carcinoma (OSCC) cells relative to normal cells has been speculated to be due to lower levels of free flavin adenine dinucleotide (FAD). This speculation, along with differences in the intrinsic optical properties of extracellular collagen, lie at the foundation of the design of currently-used clinical optical detection devices. Here, we report that free FAD levels may not account for differences in autofluorescence of OSCC cells, but that the differences relate to FAD as a co-factor for flavination. Autofluorescence from a 70 kDa flavoprotein, succinate dehydrogenase A (SDHA), was found to be responsible for changes in optical properties within the FAD spectral region with lower levels of flavinated SDHA in OSCC cells. Since flavinated SDHA is required for functional complexation with succinate dehydrogenase B (SDHB), decreased SDHB levels were observed in human OSCC tissue relative to normal tissues. Accordingly, the metabolism of OSCC cells was found to be significantly altered relative to normal cells, revealing vulnerabilities for both diagnosis and targeted therapy. Optimizing non-invasive tools based on optical and metabolic signatures of cancers will enable more precise and early diagnosis leading to improved outcomes in patients.
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Affiliation(s)
- Tomoko Marumo
- Department of Oral and Maxillofacial Surgery, Tokyo Dental College, 2-9-18 Kanda-Misakicho, Chiyoda-ku, Tokyo 101-0061, Japan
- Department of Biomedical Engineering, Michigan State University, East Lansing, MI 48824, USA
- Institute for Quantitative Health Science & Engineering, Michigan State University, East Lansing, MI 48824, USA
| | - Chima V. Maduka
- Department of Biomedical Engineering, Michigan State University, East Lansing, MI 48824, USA
- Institute for Quantitative Health Science & Engineering, Michigan State University, East Lansing, MI 48824, USA
- Comparative Medicine & Integrative Biology, Michigan State University, East Lansing, MI 48824, USA
| | - Evran Ural
- Department of Biomedical Engineering, Michigan State University, East Lansing, MI 48824, USA
- Institute for Quantitative Health Science & Engineering, Michigan State University, East Lansing, MI 48824, USA
| | - Ehsanul Hoque Apu
- Department of Biomedical Engineering, Michigan State University, East Lansing, MI 48824, USA
- Institute for Quantitative Health Science & Engineering, Michigan State University, East Lansing, MI 48824, USA
- Division of Hematology and Oncology, Department of Internal Medicine, Michigan Medicine, University of Michigan, Ann Arbor, MI 48109, USA
| | - Seock-Jin Chung
- Department of Biomedical Engineering, Michigan State University, East Lansing, MI 48824, USA
- Institute for Quantitative Health Science & Engineering, Michigan State University, East Lansing, MI 48824, USA
| | - Nynke S. van den Berg
- Department of Otolaryngology – Division of Head and Neck Surgery, Stanford University School of Medicine, 269 Campus Drive, Stanford, CA 94305, USA
| | - Quan Zhou
- Department of Otolaryngology – Division of Head and Neck Surgery, Stanford University School of Medicine, 269 Campus Drive, Stanford, CA 94305, USA
| | - Brock A. Martin
- Department of Pathology, Stanford University School of Medicine, 3100 Pasteur Drive, Stanford, CA 94305, USA
| | - Eben L. Rosenthal
- Department of Otolaryngology – Division of Head and Neck Surgery, Stanford University School of Medicine, 269 Campus Drive, Stanford, CA 94305, USA
- Department of Otolaryngology – Head and Neck Surgery, Vanderbilt University Medical Center, 1211 Medical Center Dr, Nashville, TN 37232
| | - Takahiko Shibahara
- Department of Oral and Maxillofacial Surgery, Tokyo Dental College, 2-9-18 Kanda-Misakicho, Chiyoda-ku, Tokyo 101-0061, Japan
| | - Christopher H. Contag
- Department of Biomedical Engineering, Michigan State University, East Lansing, MI 48824, USA
- Institute for Quantitative Health Science & Engineering, Michigan State University, East Lansing, MI 48824, USA
- Department of Microbiology & Molecular Genetics, Michigan State University, East Lansing, MI 48824, USA
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7
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Tanskanen A, Malone J, Hohert G, Macaulay C, Lane P. Triple-clad W-type fiber mitigates multipath artifacts in multimodal optical coherence tomography. OPTICS EXPRESS 2023; 31:4465-4481. [PMID: 36785414 DOI: 10.1364/oe.476768] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 01/06/2023] [Indexed: 06/18/2023]
Abstract
Multimodal endoscopic optical coherence tomography (OCT) can be implemented with double-clad fiber by using the presumed single-mode core for OCT and the higher numerical aperture cladding for a secondary modality. However, the quality of OCT in double-clad fiber (DCF) based systems is compromised by the introduction of multipath artifacts that are nt present in single-mode fiber OCT systems. Herein, the mechanisms for multipath artifacts in DCF are linked to its modal contents using a commercial software package and experimental measurement. A triple-clad W-type fiber is proposed as a method for achieving multimodal imaging with single-mode quality OCT in an endoscopic system. Simulations of the modal contents of a W-type fiber are compared to DCF and single-mode fiber. Finally, a W-Type fiber rotary catheter is used in a DCF-based endoscopic OCT and autofluorescence imaging (AFI) system to demonstrate multipath artifact free OCT and AFI of a human fingertip.
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Coole JB, Brenes D, Mitbander R, Vohra I, Hou H, Kortum A, Tang Y, Maker Y, Schwarz RA, Carns J, Badaoui H, Williams M, Vigneswaran N, Gillenwater A, Richards-Kortum R. Multimodal optical imaging with real-time projection of cancer risk and biopsy guidance maps for early oral cancer diagnosis and treatment. JOURNAL OF BIOMEDICAL OPTICS 2023; 28:016002. [PMID: 36654656 PMCID: PMC9838568 DOI: 10.1117/1.jbo.28.1.016002] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 12/28/2022] [Indexed: 06/17/2023]
Abstract
SIGNIFICANCE Despite recent advances in multimodal optical imaging, oral imaging systems often do not provide real-time actionable guidance to the clinician who is making biopsy and treatment decisions. AIM We demonstrate a low-cost, portable active biopsy guidance system (ABGS) that uses multimodal optical imaging with deep learning to directly project cancer risk and biopsy guidance maps onto oral mucosa in real time. APPROACH Cancer risk maps are generated based on widefield autofluorescence images and projected onto the at-risk tissue using a digital light projector. Microendoscopy images are obtained from at-risk areas, and multimodal image data are used to calculate a biopsy guidance map, which is projected onto tissue. RESULTS Representative patient examples highlight clinically actionable visualizations provided in real time during an imaging procedure. Results show multimodal imaging with cancer risk and biopsy guidance map projection offers a versatile, quantitative, and precise tool to guide biopsy site selection and improve early detection of oral cancers. CONCLUSIONS The ABGS provides direct visible guidance to identify early lesions and locate appropriate sites to biopsy within those lesions. This represents an opportunity to translate multimodal imaging into real-time clinically actionable visualizations to help improve patient outcomes.
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Affiliation(s)
- Jackson B. Coole
- Rice University, Department of Bioengineering, Houston, Texas, United States
| | - David Brenes
- Rice University, Department of Bioengineering, Houston, Texas, United States
| | - Ruchika Mitbander
- Rice University, Department of Bioengineering, Houston, Texas, United States
| | - Imran Vohra
- Rice University, Department of Bioengineering, Houston, Texas, United States
| | - Huayu Hou
- Rice University, Department of Bioengineering, Houston, Texas, United States
| | - Alex Kortum
- Rice University, Department of Bioengineering, Houston, Texas, United States
| | - Yubo Tang
- Rice University, Department of Bioengineering, Houston, Texas, United States
| | - Yajur Maker
- Rice University, Department of Bioengineering, Houston, Texas, United States
| | - Richard A. Schwarz
- Rice University, Department of Bioengineering, Houston, Texas, United States
| | - Jennifer Carns
- Rice University, Department of Bioengineering, Houston, Texas, United States
| | - Hawraa Badaoui
- The University of Texas M. D. Anderson Cancer Center, Department of Head and Neck Surgery, Houston, Texas, United States
| | - Michelle Williams
- The University of Texas M. D. Anderson Cancer Center, Department of Pathology, Houston, Texas, United States
| | - Nadarajah Vigneswaran
- The University of Texas School of Dentistry, Department of Diagnostic and Biomedical Sciences, Houston, Texas, United States
| | - Ann Gillenwater
- The University of Texas M. D. Anderson Cancer Center, Department of Head and Neck Surgery, Houston, Texas, United States
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Amirchaghmaghi M, Mohtasham N, Delavarian Z, Shakeri MT, Taghizadeh A, Khazaeni K, Hatami M. Analyzing the relationship between tissue color observed in VELscope examination and histopathological factors in OSCC patients. Photodiagnosis Photodyn Ther 2022; 41:103248. [PMID: 36565733 DOI: 10.1016/j.pdpdt.2022.103248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 11/27/2022] [Accepted: 12/16/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Early detection of OSCC is a crucial step towards improving OSCC prognosis. In recent years, novel diagnostic aids such as light-based detection systems have been introduced for early diagnosis. VELscope is one such light-based device which is used to examine tissue fluorescence. Based on different studies, VELscope has a sensitivity of 90% in the diagnosis of oral premalignant and malignant lesions. Tumor depth of invasion and invasive front have recently been proposed as influential factors in OSCC prognosis. Therefore, the aim of this study was to assess the relationship between tissue color seen through this device and tumor depth of invasion. METHODS & MATERIALS 20 histopathologically approved OSCCs were included in this study. Conventional oral examination was carried out followed by an assessment of the lesion using VELscope. The H&E slides prepared following the final OSCC surgeries were then examined by an oral pathologist to assess tumor depth of invasion (interpreted as low-risk/high-risk), invasivefront (low-risk/high-risk) and perivascular and perineural invasions. Data was transferred to SPSS 16 software. The association between color changes and histopathological factors was analyzed using the fisher's exact and chi-square tests. RESULTS The mean age of the patients was 51/5+/-16/74, 60% of which were men. Most lesions were exophytic and the most common color seen during VELscope examination was red. 55% and 50% of the OSCCs showed high-risk tumor depths and high-risk invasive fronts respectively. Perivascular and perineural invasion was seen in 55% and 35% of the samples respectively. Statistical analysis showed that 72/2% of the lesions with high tumor depths and 70% with high-risk invasive fronts were seen as red, although these associations were not significant (P>0/05). Tumor depth was significantly correlated with invasive front (P<0/05). CONCLUSION There was no significant relationship between the type of color seen through VELscope and tumor depth of invasion, however most cases with high-risk depth of invasions were red.
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Affiliation(s)
- Maryam Amirchaghmaghi
- Oral & Maxillofacial Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Nooshin Mohtasham
- Oral & Maxillofacial Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Zahra Delavarian
- Oral & Maxillofacial Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammad Taghi Shakeri
- Social Determinants of Health Research Center, Mashhad University o Medical Sciences, Mashhad, Iran
| | - Ava Taghizadeh
- Department of Oral Medicine, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran.
| | - Kamran Khazaeni
- Department of Otorhinolaryngology, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Masoud Hatami
- Assistant professor of oral and maxillofacial medicine, department of oral and maxillofacial medicine, school of dentistry, Kermanshah university of medical sciences, Kermanshah, Iran
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10
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Fernandes JR, Dos Santos LCF, Lamers ML. Applicability of autofluorescence and fluorescent probes in the trans-surgical of oral carcinomas: A systematic review. Photodiagnosis Photodyn Ther 2022; 41:103238. [PMID: 36509404 DOI: 10.1016/j.pdpdt.2022.103238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 11/07/2022] [Accepted: 12/08/2022] [Indexed: 12/13/2022]
Abstract
Oral cancer represents an important health problem, as it is the sixth most common type of cancer in the world and is associated with high rates of morbidity and mortality. The treatment considered the gold standard for this type of tumor is surgical resection with negative margins, with a distance of at least 5 mm from the tumor. This procedure is strongly associated with local control and disease-specific survival, however, in many cases, large amounts of healthy tissue are removed, resulting in surgical defects, compromising various functions and directly affecting the individual's quality of life. From this perspective, this systematic review aimed to evaluate the use of autofluorescence and fluorescent probes as potential adjuvant techniques to facilitate the delineation of surgical margins for oral cancers. A comprehensive search was performed in Pubmed, Scopus, Web of Science, LIVIVO, Embase, ProQuest Open Access Dissertations & Theses, Open Access Theses and Dissertations, and DART Europe databases, where 1948 articles were found. After the different stages of critical evaluation, 15 articles were selected, eligible for the inclusion criteria. Of these, 7 articles used autofluorescence, 7 used fluorescent probes and 1 article used both methods. As for autofluorescence, the most used device was the VELScope, and indocyanine green was the most used probe. Compared to histopathology, autofluorescence did not obtain significant and/or superiors results. In contrast to fluorescent probes that, most articles showed a good performance of margins during surgical resection, making them a promising alternative. However, it is still necessary to carry out the analysis of more articles, with more significant samples and sensitivity and specificity data to qualify the results.
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Affiliation(s)
- Julia Rodrigues Fernandes
- Department of Oral Pathology, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | | | - Marcelo Lazzaron Lamers
- Department of Morphological Sciences, Institute of Basic Health Sciences, Federal University of Rio Grande do Sul, Rua Ramiro Barcelos 2600, Porto Alegre, RS CEP 90035-003, Brazil.
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11
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Kim JS, Kim BG, Hwang SH. Efficacy of Artificial Intelligence-Assisted Discrimination of Oral Cancerous Lesions from Normal Mucosa Based on the Oral Mucosal Image: A Systematic Review and Meta-Analysis. Cancers (Basel) 2022; 14:cancers14143499. [PMID: 35884560 PMCID: PMC9320189 DOI: 10.3390/cancers14143499] [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: 06/29/2022] [Revised: 07/16/2022] [Accepted: 07/17/2022] [Indexed: 11/16/2022] Open
Abstract
Simple Summary Early detection of oral cancer is important to increase the survival rate and reduce morbidity. For the past few years, the early detection of oral cancer using artificial intelligence (AI) technology based on autofluorescence imaging, photographic imaging, and optical coherence tomography imaging has been an important research area. In this study, diagnostic values including sensitivity and specificity data were comprehensively confirmed in various studies that performed AI analysis of images. The diagnostic sensitivity of AI-assisted screening was 0.92. In subgroup analysis, there was no statistically significant difference in the diagnostic rate according to each image tool. AI shows good diagnostic performance with high sensitivity for oral cancer. Image analysis using AI is expected to be used as a clinical tool for early detection and evaluation of treatment efficacy for oral cancer. Abstract The accuracy of artificial intelligence (AI)-assisted discrimination of oral cancerous lesions from normal mucosa based on mucosal images was evaluated. Two authors independently reviewed the database until June 2022. Oral mucosal disorder, as recorded by photographic images, autofluorescence, and optical coherence tomography (OCT), was compared with the reference results by histology findings. True-positive, true-negative, false-positive, and false-negative data were extracted. Seven studies were included for discriminating oral cancerous lesions from normal mucosa. The diagnostic odds ratio (DOR) of AI-assisted screening was 121.66 (95% confidence interval [CI], 29.60; 500.05). Twelve studies were included for discriminating all oral precancerous lesions from normal mucosa. The DOR of screening was 63.02 (95% CI, 40.32; 98.49). Subgroup analysis showed that OCT was more diagnostically accurate (324.33 vs. 66.81 and 27.63) and more negatively predictive (0.94 vs. 0.93 and 0.84) than photographic images and autofluorescence on the screening for all oral precancerous lesions from normal mucosa. Automated detection of oral cancerous lesions by AI would be a rapid, non-invasive diagnostic tool that could provide immediate results on the diagnostic work-up of oral cancer. This method has the potential to be used as a clinical tool for the early diagnosis of pathological lesions.
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Affiliation(s)
- Ji-Sun Kim
- Department of Otolaryngology-Head and Neck Surgery, Eunpyeong St. Mary’s Hospital, College of Medicine, Catholic University of Korea, Seoul 03312, Korea; (J.-S.K.); (B.G.K.)
| | - Byung Guk Kim
- Department of Otolaryngology-Head and Neck Surgery, Eunpyeong St. Mary’s Hospital, College of Medicine, Catholic University of Korea, Seoul 03312, Korea; (J.-S.K.); (B.G.K.)
| | - Se Hwan Hwang
- Department of Otolaryngology-Head and Neck Surgery, Bucheon St. Mary’s Hospital, College of Medicine, Catholic University of Korea, Bucheon 14647, Korea
- Correspondence: ; Tel.: +82-32-340-7044
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12
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Duran-Sierra E, Cheng S, Cuenca R, Ahmed B, Ji J, Yakovlev VV, Martinez M, Al-Khalil M, Al-Enazi H, Jo JA. Clinical label-free endoscopic imaging of biochemical and metabolic autofluorescence biomarkers of benign, precancerous, and cancerous oral lesions. BIOMEDICAL OPTICS EXPRESS 2022; 13:3685-3698. [PMID: 35991912 PMCID: PMC9352301 DOI: 10.1364/boe.460081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 05/20/2022] [Accepted: 05/23/2022] [Indexed: 06/15/2023]
Abstract
Early detection is critical for improving the survival rate and quality of life of oral cancer patients; unfortunately, dysplastic and early-stage cancerous oral lesions are often difficult to distinguish from oral benign lesions during standard clinical oral examination. Therefore, there is a critical need for novel clinical technologies that would enable reliable oral cancer screening. The autofluorescence properties of the oral epithelial tissue provide quantitative information about morphological, biochemical, and metabolic tissue and cellular alterations accompanying carcinogenesis. This study aimed to identify novel biochemical and metabolic autofluorescence biomarkers of oral dysplasia and cancer that could be clinically imaged using novel multispectral autofluorescence lifetime imaging (maFLIM) endoscopy technologies. In vivo maFLIM clinical endoscopic images of benign, precancerous, and cancerous lesions from 67 patients were acquired using a novel maFLIM endoscope. Widefield maFLIM feature maps were generated, and statistical analyses were applied to identify maFLIM features providing contrast between dysplastic/cancerous vs. benign oral lesions. A total of 14 spectral and time-resolved maFLIM features were found to provide contrast between dysplastic/cancerous vs. benign oral lesions, representing novel biochemical and metabolic autofluorescence biomarkers of oral epithelial dysplasia and cancer. To the best of our knowledge, this is the first demonstration of clinical widefield maFLIM endoscopic imaging of novel biochemical and metabolic autofluorescence biomarkers of oral dysplasia and cancer, supporting the potential of maFLIM endoscopy for early detection of oral cancer.
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Affiliation(s)
- Elvis Duran-Sierra
- Department of Biomedical Engineering, Texas A&M University, College Station, TX 77843, USA
| | - Shuna Cheng
- Department of Biomedical Engineering, Texas A&M University, College Station, TX 77843, USA
| | - Rodrigo Cuenca
- School of Electrical and Computer Engineering, University of Oklahoma, Norman, OK 73019, USA
| | - Beena Ahmed
- School of Electrical Engineering and Telecommunications, University of New South Wales, Sydney 2052, Australia
| | - Jim Ji
- Department of Electrical and Computer Engineering, Texas A&M University at Qatar, Doha 23874, Qatar
| | - Vladislav V. Yakovlev
- Department of Biomedical Engineering, Texas A&M University, College Station, TX 77843, USA
| | - Mathias Martinez
- Department of Cranio-Maxillofacial Surgery, Hamad Medical Corporation, Doha 3050, Qatar
| | - Moustafa Al-Khalil
- Department of Cranio-Maxillofacial Surgery, Hamad Medical Corporation, Doha 3050, Qatar
| | - Hussain Al-Enazi
- Department of Otorhinolaryngology Head and Neck Surgery, Hamad Medical Corporation, Doha 3050, Qatar
| | - Javier A. Jo
- School of Electrical and Computer Engineering, University of Oklahoma, Norman, OK 73019, USA
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13
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Clinical Evaluation of the Optical Filter for Autofluorescence Glasses for Oral Cancer Curing Light Exposed (GOCCLES ®) in the Management of Potentially Premalignant Disorders: A Retrospective Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095579. [PMID: 35564975 PMCID: PMC9100244 DOI: 10.3390/ijerph19095579] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 04/23/2022] [Accepted: 05/01/2022] [Indexed: 02/05/2023]
Abstract
Background: Any oral potentially malignant disorders (OPMDs) must be regularly monitored through clinical examination to detect any possible malignant transformation. Conventional intraoral exams, however, can be difficult because these conditions may resemble benign lesions. For this reason, several non-invasive diagnostic technologies have been developed to help the clinician in detecting and distinguishing between cancerous and benign lesions. Epithelial dysplasia can be considered the most important predictor of malignant evolution. Therefore, in this study we aim to evaluate the ability of an optical filter for autofluorescence Glasses for Oral Cancer Curing Light Exposed (GOCCLES®) and of toluidine blue staining in identifying dysplastic areas in patients with OPMDs. Methods: In this retrospective study, medical records, photographs and videos of 25 patients with oral lesions were analyzed. Forty-two biopsy samples in 25 patients with OPMDs and at least one suspicious oral mucosa lesion that were evaluated in white light, autofluorescence with optical filter GOCCLES®, toluidine blue staining and then biopsied with histopathological analysis were analyzed. Results: The sensitivity and specificity for the autofluorescence evaluation with GOCCLES® for identifying dysplasia or carcinoma were 66% and 48%, respectively. The positive and negative predictive values were 34% and 77%, respectively, and the accuracy was 53%. The sensitivity and specificity for toluidine blue staining were 91% and 68%, respectively. The positive and negative predictive values were 55% and 95%, respectively, and the accuracy was 75%. Conclusions: The optical filter for autofluorescence (GOCCLES®) and toluidine blue staining are simple, inexpensive, rapid and non-invasive procedures that can assist the clinician in distinguishing OPMDs from healthy mucosa but they are not able to distinguish benign and malignant lesions.
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14
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Patel KB, Liang W, Casper MJ, Voleti V, Li W, Yagielski AJ, Zhao HT, Perez Campos C, Lee GS, Liu JM, Philipone E, Yoon AJ, Olive KP, Coley SM, Hillman EMC. High-speed light-sheet microscopy for the in-situ acquisition of volumetric histological images of living tissue. Nat Biomed Eng 2022; 6:569-583. [PMID: 35347275 PMCID: PMC10353946 DOI: 10.1038/s41551-022-00849-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 01/21/2022] [Indexed: 11/09/2022]
Abstract
Histological examinations typically require the excision of tissue, followed by its fixation, slicing, staining, mounting and imaging, with timeframes ranging from minutes to days. This process may remove functional tissue, may miss abnormalities through under-sampling, prevents rapid decision-making, and increases costs. Here, we report the feasibility of microscopes based on swept confocally aligned planar excitation technology for the volumetric histological imaging of intact living tissue in real time. The systems' single-objective, light-sheet geometry and 3D imaging speeds enable roving image acquisition, which combined with 3D stitching permits the contiguous analysis of large tissue areas, as well as the dynamic assessment of tissue perfusion and function. Implemented in benchtop and miniaturized form factors, the microscopes also have high sensitivity, even for weak intrinsic fluorescence, allowing for the label-free imaging of diagnostically relevant histoarchitectural structures, as we show for pancreatic disease in living mice, for chronic kidney disease in fresh human kidney tissues, and for oral mucosa in a healthy volunteer. Miniaturized high-speed light-sheet microscopes for in-situ volumetric histological imaging may facilitate the point-of-care detection of diverse cellular-level biomarkers.
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Affiliation(s)
- Kripa B Patel
- Laboratory for Functional Optical Imaging, Departments of Biomedical Engineering and Radiology and the Mortimer B. Zuckerman Mind Brain Behavior Institute, Columbia University, New York, NY, USA
| | - Wenxuan Liang
- Laboratory for Functional Optical Imaging, Departments of Biomedical Engineering and Radiology and the Mortimer B. Zuckerman Mind Brain Behavior Institute, Columbia University, New York, NY, USA
| | - Malte J Casper
- Laboratory for Functional Optical Imaging, Departments of Biomedical Engineering and Radiology and the Mortimer B. Zuckerman Mind Brain Behavior Institute, Columbia University, New York, NY, USA
| | - Venkatakaushik Voleti
- Laboratory for Functional Optical Imaging, Departments of Biomedical Engineering and Radiology and the Mortimer B. Zuckerman Mind Brain Behavior Institute, Columbia University, New York, NY, USA
| | - Wenze Li
- Laboratory for Functional Optical Imaging, Departments of Biomedical Engineering and Radiology and the Mortimer B. Zuckerman Mind Brain Behavior Institute, Columbia University, New York, NY, USA
| | - Alexis J Yagielski
- Laboratory for Functional Optical Imaging, Departments of Biomedical Engineering and Radiology and the Mortimer B. Zuckerman Mind Brain Behavior Institute, Columbia University, New York, NY, USA
| | - Hanzhi T Zhao
- Laboratory for Functional Optical Imaging, Departments of Biomedical Engineering and Radiology and the Mortimer B. Zuckerman Mind Brain Behavior Institute, Columbia University, New York, NY, USA
| | - Citlali Perez Campos
- Laboratory for Functional Optical Imaging, Departments of Biomedical Engineering and Radiology and the Mortimer B. Zuckerman Mind Brain Behavior Institute, Columbia University, New York, NY, USA
| | - Grace Sooyeon Lee
- Laboratory for Functional Optical Imaging, Departments of Biomedical Engineering and Radiology and the Mortimer B. Zuckerman Mind Brain Behavior Institute, Columbia University, New York, NY, USA
| | - Joyce M Liu
- Laboratory for Functional Optical Imaging, Departments of Biomedical Engineering and Radiology and the Mortimer B. Zuckerman Mind Brain Behavior Institute, Columbia University, New York, NY, USA
| | - Elizabeth Philipone
- Department of Oral and Maxillofacial Pathology, Columbia University Irving Medical Center, New York, NY, USA
| | - Angela J Yoon
- Department of Oral and Maxillofacial Pathology, Columbia University Irving Medical Center, New York, NY, USA
| | - Kenneth P Olive
- Division of Digestive and Liver Disease, Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, New York, NY, USA
| | - Shana M Coley
- Department of Pathology and Cell Biology, Vagelos College of Physicians and Surgeons, Columbia University Medical Center, New York, NY, USA
| | - Elizabeth M C Hillman
- Laboratory for Functional Optical Imaging, Departments of Biomedical Engineering and Radiology and the Mortimer B. Zuckerman Mind Brain Behavior Institute, Columbia University, New York, NY, USA.
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15
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Tian Y, Tang C, Shi G, Wang G, Du Y, Tian J, Zhang H. Novel fluorescent GLUT1 inhibitor for precision detection and fluorescence image-guided surgery in oral squamous cell carcinoma. Int J Cancer 2022; 151:450-462. [PMID: 35478458 DOI: 10.1002/ijc.34049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 03/31/2022] [Accepted: 04/19/2022] [Indexed: 11/10/2022]
Abstract
Early detection and complete resection of oral squamous cell carcinoma (OSCC) are crucial to improving patient survival and prognosis. However, specifically targeted imaging probes for OSCC detection are limited. This study aimed to synthesize a novel near-infrared fluorescence (NIRF) probe for precision detection and fluorescence image-guided surgery in OSCC. Bioinformatics data indicated that glucose transporter 1 (GLUT1) is highly expressed in patients with OSCC. We demonstrated high and specific GLUT1 expression upon immunohistochemical staining of samples from 20 patients with OSCC. The specific expression of GLUT1 was further validated in both human OSCC cell lines and OSCC tumor xenografts. Based on these findings, the GLUT1 inhibitor WZB117 was utilized to synthesize a novel NIRF imaging probe, WZB117-IR820. The fluorescence molecular imaging data revealed that WZB117-IR820 could specifically bind to the tumor areas in an orthotopic OSCC mouse model after intravenous injection and could be further applied for precision fluorescence image-guided surgery with no residual tumor in the orthotopic CAL27-fLUC mouse tumor model. For further clinical translational application in patients with OSCC, precise delineation of OSCC tumor areas was achieved following topical application of the WZB117-IR820 imaging probe and was validated by histopathological and immunohistochemical analyses. In conclusion, we synthesized a novel fluorescent imaging probe, WZB117-IR820, which has potential clinical applications for early detection and fluorescence image-guided surgery in OSCC with no observable toxicity. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Yu Tian
- Medical School of Chinese PLA, Beijing, China.,Department of Stomatology, The First Medical Centre, Chinese PLA General Hospital, Beijing, China.,CAS Key Laboratory of Molecular Imaging, The State Key Laboratory of Management and Control for Complex Systems, Institute of Automation, Chinese Academy of Sciences, Beijing, China
| | - Chu Tang
- Engineering Research Center of Molecular and Neuro Imaging, Ministry of Education, School of Life Science and Technology, Xidian University, Shanxi, China
| | - Guangyuan Shi
- University of Science and Technology of China, Anhui, China
| | - Guorong Wang
- Department of Radiology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Yang Du
- CAS Key Laboratory of Molecular Imaging, The State Key Laboratory of Management and Control for Complex Systems, Institute of Automation, Chinese Academy of Sciences, Beijing, China.,Beijing Key Laboratory of Molecular Imaging, Beijing, China.,University of Chinese Academy of Sciences, Beijing, China
| | - Jie Tian
- CAS Key Laboratory of Molecular Imaging, The State Key Laboratory of Management and Control for Complex Systems, Institute of Automation, Chinese Academy of Sciences, Beijing, China.,Beijing Key Laboratory of Molecular Imaging, Beijing, China.,University of Chinese Academy of Sciences, Beijing, China.,Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, School of Medicine, Beihang University, Beijing, China.,Engineering Research Center of Molecular and Neuro Imaging of Ministry of Education, School of Life Science and Technology, Xidian University, Shaanxi, China
| | - Haizhong Zhang
- Department of Stomatology, The First Medical Centre, Chinese PLA General Hospital, Beijing, China
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16
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Are the imaging-based techniques for early diagnosis of oral potentially malignant lesions effective? Evid Based Dent 2022; 23:26-27. [PMID: 35338324 DOI: 10.1038/s41432-022-0244-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Accepted: 02/21/2022] [Indexed: 11/09/2022]
Abstract
Design The study was a systematic review and meta-analysis conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement and the guidelines from the Cochrane handbook for systematic reviews of interventions.Data sources Literature searches of free text and MeSH terms were performed using Medline (PubMed), Scopus, Google Scholar and the Cochrane Library (from 2000 to 30 June 2020). The search strategy was: ("oral screening devices" or "autofluorescence" or "chemiluminescence" or "optical imaging" or "imaging technique") and ("oral dysplasia" or "oral malignant lesions" or "oral precancerosis").Data analysis After identification of 1,282 potential articles, an analysis applying the eligibility criteria to the research identified 43 articles for qualitative evaluation and 34 for quantitative analysis.Results The results presented were inconsistent, both in the whole and in technique groups. There was evidence of high risk of bias in the evaluated studies. Moreover, the results were homogeneous across studies, which makes it challenging to carry out a reliable comparison of measures like specificity or positive/negative predictive values.Conclusions Imaging-based techniques for early diagnosis of potentially malignant oral lesions must improve technology and accuracy. In addition, none of the evaluated methods can substitute the oral biopsy.
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17
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Xu Y, Deng X, Sun Y, Wang X, Xiao Y, Li Y, Chen Q, Jiang L. Optical Imaging in the Diagnosis of OPMDs Malignant Transformation. J Dent Res 2022; 101:749-758. [PMID: 35114846 DOI: 10.1177/00220345211072477] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Oral potentially malignant disorders (OPMDs) are a heterogeneous group of oral lesions with a variable risk of malignant transformation to oral squamous cell carcinoma. The current OPMDs malignant transformation screening depends on conventional oral examination (COE) and is confirmed by biopsy and histologic examination. However, early malignant lesions with subtle mucosal changes are easily unnoticed by COE based on visual inspection and palpation. Optical techniques have been used to determine the biological structure, composition, and function of cells and tissues noninvasively by analyzing the changes in their optical properties. The oral epithelium and stroma undergo persistent structural, functional, and biochemical alterations during malignant transformation, leading to variations in optical tissue properties; optical techniques are thus powerful tools for detecting OPMDs malignant transformation. The optical imaging methods already used to detect OPMDs malignant transformation in vivo include autofluorescence imaging, narrowband imaging, confocal reflectance microscopy, and optical coherence tomography. They exhibit advantages over COE in detecting biochemical or morphologic changes at the molecular or cellular level in vivo; however, limitations also exist. This article comprehensively reviews the various real-time in vivo optical imaging methods used in the adjunctive diagnosis of OPMDs malignant transformation. We focus on the principles of these techniques, review their clinical application, and compare and summarize their advantages and disadvantages. Finally, we conclude with a discussion of current challenges and future directions of this field.
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Affiliation(s)
- Y Xu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Chinese Academy of Medical Sciences Research Unit of Oral Carcinogenesis and Management, Department of Oral Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - X Deng
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Chinese Academy of Medical Sciences Research Unit of Oral Carcinogenesis and Management, Department of Oral Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Y Sun
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Chinese Academy of Medical Sciences Research Unit of Oral Carcinogenesis and Management, Department of Oral Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - X Wang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Chinese Academy of Medical Sciences Research Unit of Oral Carcinogenesis and Management, Department of Oral Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Y Xiao
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Chinese Academy of Medical Sciences Research Unit of Oral Carcinogenesis and Management, Department of Oral Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Y Li
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Q Chen
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Chinese Academy of Medical Sciences Research Unit of Oral Carcinogenesis and Management, Department of Oral Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - L Jiang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Chinese Academy of Medical Sciences Research Unit of Oral Carcinogenesis and Management, Department of Oral Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, China
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18
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Goto M, Ryoo I, Naffouje S, Mander S, Christov K, Wang J, Green A, Shilkaitis A, Das Gupta TK, Yamada T. Image-guided surgery with a new tumour-targeting probe improves the identification of positive margins. EBioMedicine 2022; 76:103850. [PMID: 35108666 PMCID: PMC8814381 DOI: 10.1016/j.ebiom.2022.103850] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 01/06/2022] [Accepted: 01/14/2022] [Indexed: 02/06/2023] Open
Abstract
Background Given the lack of visual discrepancy between malignant and surrounding normal tissue, current breast conserving surgery (BCS) is associated with a high re-excision rate. Due to the increasing cases of BCS, a novel method of complete tumour removal at the initial surgical resection is critically needed in the operating room to help optimize the surgical procedure and to confirm tumour-free edges. Methods We developed a unique near-infrared (NIR) fluorescence imaging probe, ICG-p28, composed of the clinically nontoxic tumour-targeting peptide p28 and the FDA-approved NIR dye indocyanine green (ICG). ICG-p28 was characterized in vitro and evaluated in multiple breast cancer animal models with appropriate control probes. Our experimental approach with multiple-validations and -blinded procedures was designed to determine whether ICG-p28 can accurately identify tumour margins in mimicked intraoperative settings. Findings The in vivo kinetics were analysed to optimize settings for potential clinical use. Xenograft tumours stably expressing iRFP as a tumour marker showed significant colocalization with ICG-p28, but not ICG alone. Image-guided surgery with ICG-p28 showed an over 6.6 × 103-fold reduction in residual normalized tumour DNA at the margin site relative to control approaches (i.e., surgery with ICG or palpation/visible inspection alone), resulting in an improved tumour recurrence rate (92% specificity) in multiple breast cancer animal models independent of the receptor expression status. ICG-p28 allowed accurate identification of tumour cells in the margin to increase the complete resection rate. Interpretation Our simple and cost-effective approach has translational potential and offers a new surgical procedure that enables surgeons to intraoperatively identify tumour margins in a real-time, 3D fashion and that notably improves overall outcomes by reducing re-excision rates. Funding This work was supported by NIH/ National Institute of Biomedical Imaging and Bioengineering, R01EB023924.
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Affiliation(s)
- Masahide Goto
- Department of Surgery, Division of Surgical Oncology, University of Illinois College of Medicine, Chicago, IL 60612, USA
| | - Ingeun Ryoo
- Department of Surgery, Division of Surgical Oncology, University of Illinois College of Medicine, Chicago, IL 60612, USA
| | - Samer Naffouje
- Department of Surgery, Division of Surgical Oncology, University of Illinois College of Medicine, Chicago, IL 60612, USA; Surgical Oncology, Moffitt Cancer Center, Tampa, FL 33612, USA
| | - Sunam Mander
- Department of Surgery, Division of Surgical Oncology, University of Illinois College of Medicine, Chicago, IL 60612, USA
| | - Konstantin Christov
- Department of Surgery, Division of Surgical Oncology, University of Illinois College of Medicine, Chicago, IL 60612, USA
| | - Jing Wang
- Department of Mathematics, Statistics and Computer Science, University of Illinois College of Liberal Arts and Sciences, IL 60607, USA
| | - Albert Green
- Department of Surgery, Division of Surgical Oncology, University of Illinois College of Medicine, Chicago, IL 60612, USA
| | - Anne Shilkaitis
- Department of Surgery, Division of Surgical Oncology, University of Illinois College of Medicine, Chicago, IL 60612, USA
| | - Tapas K Das Gupta
- Department of Surgery, Division of Surgical Oncology, University of Illinois College of Medicine, Chicago, IL 60612, USA
| | - Tohru Yamada
- Department of Surgery, Division of Surgical Oncology, University of Illinois College of Medicine, Chicago, IL 60612, USA; Department of Bioengineering, University of Illinois College of Engineering, Chicago, IL 60607, USA.
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19
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In Vivo Imaging-Based Techniques for Early Diagnosis of Oral Potentially Malignant Disorders-Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182211775. [PMID: 34831531 PMCID: PMC8622517 DOI: 10.3390/ijerph182211775] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 11/04/2021] [Accepted: 11/08/2021] [Indexed: 12/24/2022]
Abstract
Objectives: Oral potentially malignant disorders (OPMDs) are lesions that may undergo malignant transformation to oral cancer. The early diagnosis and surveillance of OPMDs reduce the morbidity and mortality of patients. Diagnostic techniques based on medical images analysis have been developed to diagnose clinical conditions. This systematic review and meta-analysis aimed to evaluate the efficacy of imaging-based techniques compared to the gold standard of histopathology to assess their ability to correctly identify the presence of OPMDs. Design: Literature searches of free text and MeSH terms were performed using MedLine (PubMed), Scopus, Google Scholar, and the Cochrane Library (from 2000 to 30 June 2020). The keywords used in the search strategy were: (“oral screening devices” or “autofluorescence” or “chemiluminescence” or “optical imaging” or “imaging technique”) and (“oral dysplasia” or “oral malignant lesions” or “oral precancerosis”). Results: The search strategy identified 1282 potential articles. After analyzing the results and applying the eligibility criteria, the remaining 43 papers were included in the qualitative synthesis, and 34 of these were included in the meta-analysis. Conclusions: None of the analyzed techniques based on assessing oral images can replace the biopsy. Further studies are needed to explore the role of techniques-based imaging analysis to identify an early noninvasive screening method.
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20
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Machine-Learning Assisted Discrimination of Precancerous and Cancerous from Healthy Oral Tissue Based on Multispectral Autofluorescence Lifetime Imaging Endoscopy. Cancers (Basel) 2021; 13:cancers13194751. [PMID: 34638237 PMCID: PMC8507537 DOI: 10.3390/cancers13194751] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 09/13/2021] [Accepted: 09/15/2021] [Indexed: 12/20/2022] Open
Abstract
Multispectral autofluorescence lifetime imaging (maFLIM) can be used to clinically image a plurality of metabolic and biochemical autofluorescence biomarkers of oral epithelial dysplasia and cancer. This study tested the hypothesis that maFLIM-derived autofluorescence biomarkers can be used in machine-learning (ML) models to discriminate dysplastic and cancerous from healthy oral tissue. Clinical widefield maFLIM endoscopy imaging of cancerous and dysplastic oral lesions was performed at two clinical centers. Endoscopic maFLIM images from 34 patients acquired at one of the clinical centers were used to optimize ML models for automated discrimination of dysplastic and cancerous from healthy oral tissue. A computer-aided detection system was developed and applied to a set of endoscopic maFLIM images from 23 patients acquired at the other clinical center, and its performance was quantified in terms of the area under the receiver operating characteristic curve (ROC-AUC). Discrimination of dysplastic and cancerous from healthy oral tissue was achieved with an ROC-AUC of 0.81. This study demonstrates the capabilities of widefield maFLIM endoscopy to clinically image autofluorescence biomarkers that can be used in ML models to discriminate dysplastic and cancerous from healthy oral tissue. Widefield maFLIM endoscopy thus holds potential for automated in situ detection of oral dysplasia and cancer.
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21
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Sun LF, Wang CX, Cao ZY, Han W, Guo SS, Wang YZ, Meng Y, Hou CX, Zhu QH, Tang YT, Li HQ, Zhang T, Ye JH. Evaluation of autofluorescence visualization system in the delineation of oral squamous cell carcinoma surgical margins. Photodiagnosis Photodyn Ther 2021; 36:102487. [PMID: 34411738 DOI: 10.1016/j.pdpdt.2021.102487] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 08/09/2021] [Accepted: 08/13/2021] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Delineating the margins of Oral squamous cell carcinoma (OSCC) is a critical step for optimaltumor resection. The aim of this study was to evaluate the accuracy of lesion surgical margin identification using autofluorescence visualization. MATERIALS AND METHODS Thirty patients with OSCC were included in this study. For each lesion, the fluorescence loss boundary was determined using VELscope before ablative surgical resection (with a 1.5-2cm safety margin) was performed. A total of 126 samples were obtained from 30 surgical specimens, each containing the tissue from the fluorescence loss boundary to surgical margin. The status of each sample was determined by oral pathologists and the staining intensities of Ki-67, E-cadherin, and Vimentin at the fluorescence loss boundary and surgical margin were evaluated by immunohistochemistry. RESULTS Fluorescence loss regions were identified in all patients. Of the 126 samples collected, HE staining identified 77 normal epithelia (61.1%), 26 mild dysplasia (20.6%), 17 severe dysplasia (13.4%) and 6 carcinomas in situ (4.9%). A significant correlation was found between the differentiation grade of tumor cells and the pathological status of the surgical marginal specimens (P<0.05). Forty-two of the 126 samples were randomly selected for further immunohistochemical staining. No significant differences were seen in Ki-67, E-cadherin, or Vimentin expression at the fluorescence loss boundary or surgical margin, however, the proteins' expression level was positively correlated with the degree of dysplasia (P<0.01). CONCLUSION Autofluorescence visualization has potential as a simple surgical margin setting device for OSCC and may help delineate the superficial area of OSCC with acceptable accuracy. However, when considering the inherent limitations of this system, we suggest that the approach should only be applied under certain conditions, such as when dealing with superficial, well-differentiated lesions.
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Affiliation(s)
- Li-Fan Sun
- Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing 210029, China; Depatment of Oral and Maxillofacial Surgery, Huaxia Stomatological Hospital Affiliated to Suzhou Health College, Suzhou 215000, China
| | - Chen-Xing Wang
- Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing 210029, China; Depatment of Oral and Maxillofacial Surgery, The Affiliated Stomatology Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Zheng-Yao Cao
- Depatment of Stomatology, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi 214023, China
| | - Wei Han
- Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing 210029, China; Depatment of Oral and Maxillofacial Surgery, The Affiliated Stomatology Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Song-Song Guo
- Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing 210029, China; Depatment of Oral and Maxillofacial Surgery, The Affiliated Stomatology Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Yi-Zhou Wang
- Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing 210029, China; Depatment of Oral and Maxillofacial Surgery, The Affiliated Stomatology Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Ying Meng
- Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing 210029, China; Depatment of Oral and Maxillofacial Surgery, The Affiliated Stomatology Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Chen-Xing Hou
- Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing 210029, China; Depatment of Oral and Maxillofacial Surgery, The Affiliated Stomatology Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Qing-Hai Zhu
- Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing 210029, China; Depatment of Oral and Maxillofacial Surgery, The Affiliated Stomatology Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Yu-Ting Tang
- Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing 210029, China; Depatment of Oral and Maxillofacial Surgery, The Affiliated Stomatology Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Huai-Qi Li
- Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing 210029, China; Depatment of Oral and Maxillofacial Surgery, The Affiliated Stomatology Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Tianzhu Zhang
- National Key Bioelectronics Stomatology Laboratory, School of Biological Sciences & Medical Engineering, Southeast University, Nanjing 210096, China
| | - Jin-Hai Ye
- Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing 210029, China; Depatment of Oral and Maxillofacial Surgery, The Affiliated Stomatology Hospital of Nanjing Medical University, Nanjing 210029, China.
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22
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Vo-Phamhi JM, Yamauchi KA, Gómez-Sjöberg R. Validation and tuning of in situ transcriptomics image processing workflows with crowdsourced annotations. PLoS Comput Biol 2021; 17:e1009274. [PMID: 34370726 PMCID: PMC8376178 DOI: 10.1371/journal.pcbi.1009274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 08/19/2021] [Accepted: 07/14/2021] [Indexed: 11/24/2022] Open
Abstract
Recent advancements in in situ methods, such as multiplexed in situ RNA hybridization and in situ RNA sequencing, have deepened our understanding of the way biological processes are spatially organized in tissues. Automated image processing and spot-calling algorithms for analyzing in situ transcriptomics images have many parameters which need to be tuned for optimal detection. Having ground truth datasets (images where there is very high confidence on the accuracy of the detected spots) is essential for evaluating these algorithms and tuning their parameters. We present a first-in-kind open-source toolkit and framework for in situ transcriptomics image analysis that incorporates crowdsourced annotations, alongside expert annotations, as a source of ground truth for the analysis of in situ transcriptomics images. The kit includes tools for preparing images for crowdsourcing annotation to optimize crowdsourced workers' ability to annotate these images reliably, performing quality control (QC) on worker annotations, extracting candidate parameters for spot-calling algorithms from sample images, tuning parameters for spot-calling algorithms, and evaluating spot-calling algorithms and worker performance. These tools are wrapped in a modular pipeline with a flexible structure that allows users to take advantage of crowdsourced annotations from any source of their choice. We tested the pipeline using real and synthetic in situ transcriptomics images and annotations from the Amazon Mechanical Turk system obtained via Quanti.us. Using real images from in situ experiments and simulated images produced by one of the tools in the kit, we studied worker sensitivity to spot characteristics and established rules for annotation QC. We explored and demonstrated the use of ground truth generated in this way for validating spot-calling algorithms and tuning their parameters, and confirmed that consensus crowdsourced annotations are a viable substitute for expert-generated ground truth for these purposes.
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Affiliation(s)
- Jenny M. Vo-Phamhi
- Chan Zuckerberg Biohub, San Francisco, California, United States of America
| | - Kevin A. Yamauchi
- Chan Zuckerberg Biohub, San Francisco, California, United States of America
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23
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Lyu Z, Jiang H, Xiao F, Rong J, Zhang T, Wandell B, Farrell J. Simulations of fluorescence imaging in the oral cavity. BIOMEDICAL OPTICS EXPRESS 2021; 12:4276-4292. [PMID: 34457414 PMCID: PMC8367257 DOI: 10.1364/boe.429995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 05/31/2021] [Accepted: 06/01/2021] [Indexed: 06/13/2023]
Abstract
We describe an end-to-end image systems simulation that models a device capable of measuring fluorescence in the oral cavity. Our software includes a 3D model of the oral cavity and excitation-emission matrices of endogenous fluorophores that predict the spectral radiance of oral mucosal tissue. The predicted radiance is transformed by a model of the optics and image sensor to generate expected sensor image values. We compare simulated and real camera data from tongues in healthy individuals and show that the camera sensor chromaticity values can be used to quantify the fluorescence from porphyrins relative to the bulk fluorescence from multiple fluorophores (elastin, NADH, FAD, and collagen). Validation of the simulations supports the use of soft-prototyping in guiding system design for fluorescence imaging.
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Affiliation(s)
- Zheng Lyu
- Stanford Center for Image Systems Engineering, Stanford, California 94305, USA
- Department of Electrical Engineering, Stanford, California 94305, USA
| | | | - Feng Xiao
- Fengyun Vision Technologies, Beijing 100080, China
| | - Jian Rong
- Fengyun Vision Technologies, Beijing 100080, China
| | | | - Brian Wandell
- Stanford Center for Image Systems Engineering, Stanford, California 94305, USA
- Psychology Department, Stanford, California 94305, USA
| | - Joyce Farrell
- Stanford Center for Image Systems Engineering, Stanford, California 94305, USA
- Department of Electrical Engineering, Stanford, California 94305, USA
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24
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Romano A, Di Stasio D, Petruzzi M, Fiori F, Lajolo C, Santarelli A, Lucchese A, Serpico R, Contaldo M. Noninvasive Imaging Methods to Improve the Diagnosis of Oral Carcinoma and Its Precursors: State of the Art and Proposal of a Three-Step Diagnostic Process. Cancers (Basel) 2021; 13:cancers13122864. [PMID: 34201237 PMCID: PMC8228647 DOI: 10.3390/cancers13122864] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 06/05/2021] [Accepted: 06/07/2021] [Indexed: 12/13/2022] Open
Abstract
Simple Summary Oral squamous cell carcinoma (OSCC) accounts for 90–95% of malignant tumors of the lip and oral cavity and is associated with high mortality in the advanced stages. Early diagnosis is a challenge for oral pathologists and dentists, due to the ambiguous appearance of early OSCC, which is often misdiagnosed, mistreated, and associated with diagnostic delay. The gold standards for OSCC diagnosis are biopsy and histopathological assessment, but these procedures are invasive and time-consuming. Adjunctive noninvasive techniques allow the definition of the malignant features of a suspicious lesion in real time and noninvasively, thus improving the diagnostic procedure. The present review aimed to focus on some of the main promising noninvasive imaging techniques, to highlight their perspective adoption in a three-step diagnosis, which is idealistically faster and better, as well as enables the patient’s compliance. Abstract Oral squamous cell carcinoma (OSCC) is the most prevalent form of cancer of lips and oral cavity, and its diagnostic delay, caused by misdiagnosis at the early stages, is responsible for high mortality ratios. Biopsy and histopathological assessment are the gold standards for OSCC diagnosis, but they are time-consuming, invasive, and do not always enable the patient’s compliance, mainly in cases of follow-up with the need for more biopsies. The use of adjunctive noninvasive imaging techniques improves the diagnostic approach, making it faster and better accepted by patients. The present review aims to focus on the most consolidated diagnostic techniques, such as vital staining and tissue autofluorescence, and to report the potential role of some of the most promising innovative techniques, such as narrow-band imaging, high-frequency ultrasounds, optical coherence tomography, and in vivo confocal microscopy. According to their contribution to OSCC diagnosis, an ideal three-step diagnostic procedure is proposed, to make the diagnostic path faster, better, and more accurate.
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Affiliation(s)
- Antonio Romano
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Via Luigi de Crecchio, 6, 80138 Naples, Italy; (A.R.); (D.D.S.); (F.F.); (A.L.); (R.S.)
| | - Dario Di Stasio
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Via Luigi de Crecchio, 6, 80138 Naples, Italy; (A.R.); (D.D.S.); (F.F.); (A.L.); (R.S.)
| | - Massimo Petruzzi
- Interdisciplinary Department of Medicine, University of Bari “Aldo Moro”, Piazza Giulio Cesare 11, 70124 Bari, Italy;
| | - Fausto Fiori
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Via Luigi de Crecchio, 6, 80138 Naples, Italy; (A.R.); (D.D.S.); (F.F.); (A.L.); (R.S.)
| | - Carlo Lajolo
- Head and Neck Department, Fondazione Policlinico Universitario A. Gemelli–IRCCS, School of Dentistry, Università Cattolica del Sacro Cuore, Largo A. Gemelli, 8, 00168 Rome, Italy;
| | - Andrea Santarelli
- Department of Clinical Specialist and Dental Sciences, Marche Polytechnic University, Via Tronto 10, 60126 Ancona, Italy;
| | - Alberta Lucchese
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Via Luigi de Crecchio, 6, 80138 Naples, Italy; (A.R.); (D.D.S.); (F.F.); (A.L.); (R.S.)
| | - Rosario Serpico
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Via Luigi de Crecchio, 6, 80138 Naples, Italy; (A.R.); (D.D.S.); (F.F.); (A.L.); (R.S.)
| | - Maria Contaldo
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Via Luigi de Crecchio, 6, 80138 Naples, Italy; (A.R.); (D.D.S.); (F.F.); (A.L.); (R.S.)
- Correspondence: ; Tel.: +39-3204876058
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25
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Song B, Sunny S, Li S, Gurushanth K, Mendonca P, Mukhia N, Patrick S, Gurudath S, Raghavan S, Imchen T, Leivon ST, Kolur T, Shetty V, Bushan V, Ramesh R, Lima N, Pillai V, Wilder-Smith P, Sigamani A, Suresh A, Kuriakose MA, Birur P, Liang R. Mobile-based oral cancer classification for point-of-care screening. JOURNAL OF BIOMEDICAL OPTICS 2021; 26:JBO-210101R. [PMID: 34164967 PMCID: PMC8220969 DOI: 10.1117/1.jbo.26.6.065003] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 06/08/2021] [Indexed: 06/10/2023]
Abstract
SIGNIFICANCE Oral cancer is among the most common cancers globally, especially in low- and middle-income countries. Early detection is the most effective way to reduce the mortality rate. Deep learning-based cancer image classification models usually need to be hosted on a computing server. However, internet connection is unreliable for screening in low-resource settings. AIM To develop a mobile-based dual-mode image classification method and customized Android application for point-of-care oral cancer detection. APPROACH The dataset used in our study was captured among 5025 patients with our customized dual-modality mobile oral screening devices. We trained an efficient network MobileNet with focal loss and converted the model into TensorFlow Lite format. The finalized lite format model is ∼16.3 MB and ideal for smartphone platform operation. We have developed an Android smartphone application in an easy-to-use format that implements the mobile-based dual-modality image classification approach to distinguish oral potentially malignant and malignant images from normal/benign images. RESULTS We investigated the accuracy and running speed on a cost-effective smartphone computing platform. It takes ∼300 ms to process one image pair with the Moto G5 Android smartphone. We tested the proposed method on a standalone dataset and achieved 81% accuracy for distinguishing normal/benign lesions from clinically suspicious lesions, using a gold standard of clinical impression based on the review of images by oral specialists. CONCLUSIONS Our study demonstrates the effectiveness of a mobile-based approach for oral cancer screening in low-resource settings.
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Affiliation(s)
- Bofan Song
- The University of Arizona, Wyant College of Optical Sciences, Tucson, Arizona, United States
| | - Sumsum Sunny
- Mazumdar Shaw Medical Centre, Bangalore, Karnataka, India
| | - Shaobai Li
- The University of Arizona, Wyant College of Optical Sciences, Tucson, Arizona, United States
| | | | | | - Nirza Mukhia
- KLE Society’s Institute of Dental Sciences, Bangalore, Karnataka, India
| | | | - Shubha Gurudath
- KLE Society’s Institute of Dental Sciences, Bangalore, Karnataka, India
| | | | - Tsusennaro Imchen
- Christian Institute of Health Sciences and Research, Dimapur, Nagaland, India
| | - Shirley T Leivon
- Christian Institute of Health Sciences and Research, Dimapur, Nagaland, India
| | - Trupti Kolur
- Mazumdar Shaw Medical Foundation, Bangalore, Karnataka, India
| | - Vivek Shetty
- Mazumdar Shaw Medical Foundation, Bangalore, Karnataka, India
| | - Vidya Bushan
- Mazumdar Shaw Medical Foundation, Bangalore, Karnataka, India
| | - Rohan Ramesh
- Christian Institute of Health Sciences and Research, Dimapur, Nagaland, India
| | - Natzem Lima
- The University of Arizona, Wyant College of Optical Sciences, Tucson, Arizona, United States
| | - Vijay Pillai
- Mazumdar Shaw Medical Foundation, Bangalore, Karnataka, India
| | - Petra Wilder-Smith
- University of California, Beckman Laser Institute and Medical Clinic, Irvine, California, United States
| | - Alben Sigamani
- Mazumdar Shaw Medical Foundation, Bangalore, Karnataka, India
| | - Amritha Suresh
- Mazumdar Shaw Medical Centre, Bangalore, Karnataka, India
- Mazumdar Shaw Medical Foundation, Bangalore, Karnataka, India
| | - Moni A. Kuriakose
- Mazumdar Shaw Medical Centre, Bangalore, Karnataka, India
- Mazumdar Shaw Medical Foundation, Bangalore, Karnataka, India
- Cochin Cancer Research Center, Kochi, Kerala, India
| | - Praveen Birur
- KLE Society’s Institute of Dental Sciences, Bangalore, Karnataka, India
- Biocon Foundation, Bangalore, Karnataka, India
| | - Rongguang Liang
- The University of Arizona, Wyant College of Optical Sciences, Tucson, Arizona, United States
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26
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Sharma D, Rimal J, Kumar Maharjan I, Shrestha A, Shrestha A, Regmee P. Evaluation of oral potentially malignant disorders with autoflorescence, reflectance spectroscopy and vital staining and their correlation with histopathology - Hospital based prospective study. Oral Oncol 2021; 118:105312. [PMID: 34023743 DOI: 10.1016/j.oraloncology.2021.105312] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 03/24/2021] [Accepted: 04/18/2021] [Indexed: 02/08/2023]
Abstract
OBJECTIVES To evaluate diagnostic efficacy of Identafi® and toluidine blue in screening of Oral Potentially Malignant Disorders (OPMDs). MATERIALS AND METHODS Forty nine patients (63 lesions) with OPMDs visiting Department of Oral Medicine and Radiology, B.P.Koirala Institute of Health Science (BPKIHS) were included in the study. After thorough history and oral examination, screening was done by Identafi® followed by toluidine blue staining. Then incisional biopsy under local anesthesia was performed from the site showing positive change followed by histopathological examination. RESULTS The overall sensitivity and specificity of Identafi®'s violet light was 73% and 46.2%. The overall sensitivity and specificity of Identafi®'s green-amber light were 78.4% and 15.4% respectively. The overall sensitivity and specificity of toluidine blue were 51.4 and 84.6 respectively. A statistically-significant association was observed between the toluidine blue and histopathology results, (p = 0.04), p value set at ≤ 0.05. CONCLUSION Identafi®'s violet light and green amber light are more sensitive in detecting true positives. Toluidine blue is highly specific in ruling out true negative cases. The screening of OPMDs will help in selecting proper biopsy site followed by early diagnosis and intervention, hence increasing the prognosis, outcome and decrease complications associated with it.
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Affiliation(s)
- Deepa Sharma
- Department of Dentistry, Pokhara Academy of Health Sciences, Ramghat 10, Nepal.
| | - Jyotsna Rimal
- Department of Oral Medicine and Radiology, College of Dental Surgery, B.P. Koirala Institute of Health Science, Dharan 18, Nepal
| | - Iccha Kumar Maharjan
- Department of Oral Medicine and Radiology, College of Dental Surgery, B.P. Koirala Institute of Health Science, Dharan 18, Nepal
| | - Ashish Shrestha
- Department of Public Health Dentistry, College of Dental Surgery, B.P. Koirala Institute of Health Science, Dharan 18, Nepal
| | - Ashish Shrestha
- Department of Oral Pathology, College of Dental Surgery, B.P. Koirala Institute of Health Science, Dharan 18, Nepal
| | - Pragya Regmee
- Department of Oral Medicine and Radiology, College of Dental Surgery, B.P. Koirala Institute of Health Science, Dharan 18, Nepal
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A phase I study of a PARP1-targeted topical fluorophore for the detection of oral cancer. Eur J Nucl Med Mol Imaging 2021; 48:3618-3630. [PMID: 33954826 DOI: 10.1007/s00259-021-05372-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 04/15/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Visual inspection and biopsy is the current standard of care for oral cancer diagnosis, but is subject to misinterpretation and consequently to misdiagnosis. Topically applied PARPi-FL is a molecularly specific, fluorescent contrast-based approach that may fulfill the unmet need for a simple, in vivo, non-invasive, cost-effective, point-of-care method for the early diagnosis of oral cancer. Here, we present results from a phase I safety and feasibility study on fluorescent, topically applied PARPi-FL. Twelve patients with a histologically proven oral squamous cell carcinoma (OSCC) gargled a PARPi-FL solution for 60 s (15 mL, 100 nM, 250 nM, 500 nM, or 1000 nM), followed by gargling a clearing solution for 60 s. Fluorescence measurements of the lesion and surrounding oral mucosa were taken before PARPi-FL application, after PARPi-FL application, and after clearing. Blood pressure, oxygen levels, clinical chemistry, and CBC were obtained before and after tracer administration. RESULTS PARPi-FL was well-tolerated by all patients without any safety concerns. When analyzing the fluorescence signal, all malignant lesions showed a significant differential in contrast after administration of PARPi-FL, with the highest increase occurring at the highest dose level (1000 nM), where all patients had a tumor-to-margin fluorescence signal ratio of >3. A clearing step was essential to increase signal specificity, as it clears unbound PARPi-FL trapped in normal anatomical structures. PARPi-FL tumor cell specificity was confirmed by ex vivo tabletop confocal microscopy. We have demonstrated that the fluorescence signal arose from the nuclei of tumor cells, endorsing our macroscopic findings. CONCLUSIONS A PARPi-FL swish & spit solution is a rapid and non-invasive diagnostic tool that preferentially localizes fluorescent contrast to OSCC. This technique holds promise for the early detection of OSCC based on in vivo optical evaluation and targeted biopsy of suspicious lesions in the oral cavity. TRIAL REGISTRATION Clinicaltrials.gov -NCT03085147, registered on March 21st, 2017.
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28
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Hinsdale TA, Malik BH, Cheng S, Benavides OR, Giger ML, Wright JM, Patel PB, Jo JA, Maitland KC. Enhanced detection of oral dysplasia by structured illumination fluorescence lifetime imaging microscopy. Sci Rep 2021; 11:4984. [PMID: 33654229 PMCID: PMC7925521 DOI: 10.1038/s41598-021-84552-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 02/17/2021] [Indexed: 12/15/2022] Open
Abstract
We demonstrate that structured illumination microscopy has the potential to enhance fluorescence lifetime imaging microscopy (FLIM) as an early detection method for oral squamous cell carcinoma. FLIM can be used to monitor or detect changes in the fluorescence lifetime of metabolic cofactors (e.g. NADH and FAD) associated with the onset of carcinogenesis. However, out of focus fluorescence often interferes with this lifetime measurement. Structured illumination fluorescence lifetime imaging (SI-FLIM) addresses this by providing depth-resolved lifetime measurements, and applied to oral mucosa, can localize the collected signal to the epithelium. In this study, the hamster model of oral carcinogenesis was used to evaluate SI-FLIM in premalignant and malignant oral mucosa. Cheek pouches were imaged in vivo and correlated to histopathological diagnoses. The potential of NADH fluorescence signal and lifetime, as measured by widefield FLIM and SI-FLIM, to differentiate dysplasia (pre-malignancy) from normal tissue was evaluated. ROC analysis was carried out with the task of discriminating between normal tissue and mild dysplasia, when changes in fluorescence characteristics are localized to the epithelium only. The results demonstrate that SI-FLIM (AUC = 0.83) is a significantly better (p-value = 0.031) marker for mild dysplasia when compared to widefield FLIM (AUC = 0.63).
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Affiliation(s)
- Taylor A Hinsdale
- Department of Biomedical Engineering, Texas A&M University, College Station, USA
- Delft University of Technology, Delft, The Netherlands
| | - Bilal H Malik
- Department of Biomedical Engineering, Texas A&M University, College Station, USA
- QT Imaging, Inc, 3 Hamilton Landing, Suite 160, Novato, CA, 94949, USA
| | - Shuna Cheng
- Department of Biomedical Engineering, Texas A&M University, College Station, USA
| | - Oscar R Benavides
- Department of Biomedical Engineering, Texas A&M University, College Station, USA
| | | | - John M Wright
- Department of Diagnostic Science, Texas A&M College of Dentistry, Dallas, USA
| | - Paras B Patel
- Department of Diagnostic Science, Texas A&M College of Dentistry, Dallas, USA
| | - Javier A Jo
- Department of Biomedical Engineering, Texas A&M University, College Station, USA
- Department of Electrical and Computer Engineering, University of Oklahoma, Norman, USA
| | - Kristen C Maitland
- Department of Biomedical Engineering, Texas A&M University, College Station, USA.
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Marsden M, Weyers BW, Bec J, Sun T, Gandour-Edwards RF, Birkeland AC, Abouyared M, Bewley AF, Farwell DG, Marcu L. Intraoperative Margin Assessment in Oral and Oropharyngeal Cancer Using Label-Free Fluorescence Lifetime Imaging and Machine Learning. IEEE Trans Biomed Eng 2021; 68:857-868. [PMID: 32746066 PMCID: PMC8960054 DOI: 10.1109/tbme.2020.3010480] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/22/2023]
Abstract
OBJECTIVE To demonstrate the diagnostic ability of label-free, point-scanning, fiber-based Fluorescence Lifetime Imaging (FLIm) as a means of intraoperative guidance during oral and oropharyngeal cancer removal surgery. METHODS FLIm point-measurements acquired from 53 patients (n = 67893 pre-resection in vivo, n = 89695 post-resection ex vivo) undergoing oral or oropharyngeal cancer removal surgery were used for analysis. Discrimination of healthy tissue and cancer was investigated using various FLIm-derived parameter sets and classifiers (Support Vector Machine, Random Forests, CNN). Classifier output for the acquired set of point-measurements was visualized through an interpolation-based approach to generate a probabilistic heatmap of cancer within the surgical field. Classifier output for dysplasia at the resection margins was also investigated. RESULTS Statistically significant change (P 0.01) between healthy and cancer was observed in vivo for the acquired FLIm signal parameters (e.g., average lifetime) linked with metabolic activity. Superior classification was achieved at the tissue region level using the Random Forests method (ROC-AUC: 0.88). Classifier output for dysplasia (% probability of cancer) was observed to lie between that of cancer and healthy tissue, highlighting FLIm's ability to distinguish various conditions. CONCLUSION The developed approach demonstrates the potential of FLIm for fast, reliable intraoperative margin assessment without the need for contrast agents. SIGNIFICANCE Fiber-based FLIm has the potential to be used as a diagnostic tool during cancer resection surgery, including Transoral Robotic Surgery (TORS), helping ensure complete resections and improve the survival rate of oral and oropharyngeal cancer patients.
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30
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Pal R, Villarreal P, Yu X, Qiu S, Vargas G. Multimodal widefield fluorescence imaging with nonlinear optical microscopy workflow for noninvasive oral epithelial neoplasia detection: a preclinical study. JOURNAL OF BIOMEDICAL OPTICS 2020; 25:JBO-200213R. [PMID: 33200597 PMCID: PMC7667429 DOI: 10.1117/1.jbo.25.11.116008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 10/02/2020] [Indexed: 05/06/2023]
Abstract
SIGNIFICANCE Early detection of epithelial cancers and precancers/neoplasia in the presence of benign lesions is challenging due to the lack of robust in vivo imaging and biopsy guidance techniques. Label-free nonlinear optical microscopy (NLOM) has shown promise for optical biopsy through the detection of cellular and extracellular signatures of neoplasia. Although in vivo microscopy techniques continue to be developed, the surface area imaged in microscopy is limited by the field of view. FDA-approved widefield fluorescence (WF) imaging systems that capture autofluorescence signatures of neoplasia provide molecular information at large fields of view, which may complement the cytologic and architectural information provided by NLOM. AIM A multimodal imaging approach with high-sensitivity WF and high-resolution NLOM was investigated to identify and distinguish image-based features of neoplasia from normal and benign lesions. APPROACH In vivo label-free WF imaging and NLOM was performed in preclinical hamster models of oral neoplasia and inflammation. Analyses of WF imaging, NLOM imaging, and dual modality (WF combined with NLOM) were performed. RESULTS WF imaging showed increased red-to-green autofluorescence ratio in neoplasia compared to inflammation and normal oral mucosa (p < 0.01). In vivo assessment of the mucosal tissue with NLOM revealed subsurface cytologic (nuclear pleomorphism) and architectural (remodeling of extracellular matrix) atypia in histologically confirmed neoplastic tissue, which were not observed in inflammation or normal mucosa. Univariate and multivariate statistical analysis of macroscopic and microscopic image-based features indicated improved performance (94% sensitivity and 97% specificity) of a multiscale approach over WF alone, even in the presence of benign lesions (inflammation), a common confounding factor in diagnostics. CONCLUSIONS A multimodal imaging approach integrating strengths from WF and NLOM may be beneficial in identifying oral neoplasia. Our study could guide future studies on human oral neoplasia to further evaluate merits and limitations of multimodal workflows and inform the development of multiscale clinical imaging systems.
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Affiliation(s)
- Rahul Pal
- Massachusetts General Hospital and Harvard Medical School, Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, Massachusetts, United States
| | - Paula Villarreal
- The University of Texas Medical Branch, Biomedical Engineering and Imaging Sciences Group, Galveston, Texas, United States
- The University of Texas Medical Branch, Department of Neuroscience, Cell Biology, and Anatomy, Galveston, Texas, United States
| | - Xiaoying Yu
- The University of Texas Medical Branch, Department of Preventive Medicine and Population Health, Galveston, Texas, United States
| | - Suimin Qiu
- The University of Texas Medical Branch, Department of Pathology, Galveston, Texas, United States
| | - Gracie Vargas
- The University of Texas Medical Branch, Biomedical Engineering and Imaging Sciences Group, Galveston, Texas, United States
- The University of Texas Medical Branch, Department of Neuroscience, Cell Biology, and Anatomy, Galveston, Texas, United States
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Tomo S, da Cruz TM, Figueira JA, Cunha JLS, Miyahara GI, Simonato LE. Fluorescence-guided surgical management of medication-related osteonecrosis of the jaws. Photodiagnosis Photodyn Ther 2020; 32:102003. [PMID: 32916330 DOI: 10.1016/j.pdpdt.2020.102003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 08/15/2020] [Accepted: 09/04/2020] [Indexed: 12/12/2022]
Abstract
Medication-related osteonecrosis of the jaw (MRONJ) results in progressive destruction of the jawbones, and advanced cases demand surgical intervention. The total removal of necrotic bone is required to prevent recurrence and infection. However, determining the limits between necrotic and healthy bone is a challenge. The use of fluorescence to detect tissue alterations and determine necrosis extension is a promising method to avoid inadequate bone debridement. In the literature, there are several studies and reported cases that successfully use fluorescence-guided surgery (FGS) of MRONJ. The objective of this study was to present a critical review of the literature regarding the intraoperative use of optic fluorescence to differentiate healthy and necrotic bone in MRONJ. Studies that evaluated the intraoperative use of optic fluorescence to determine the surgical margins of MRONJ were searched in Pubmed/Medline and Scopus databases using the following terms: "medication-related osteonecrosis of the jaws" and "fluorescence". Eighteen papers describing the intraoperative use of FGS in ONJ management were selected, totalizing 218 patients. Of those 18 papers, only 5 were prospective studies, and the other 13 were isolated case reports, case series, and technical notes. The use of FGS to delimitate the resection margin of MRONJ is a promising method. There is no need for the application of exogenous fluorophore to perform FGS and the most often used light device was the VELScope® system. Further prospective studies with larger samples are still required to ascertain the fluorescence validity as a supporting method in MRONJ surgical treatment and to establish clinical protocols.
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Affiliation(s)
- Saygo Tomo
- Oral Oncology Center, São Paulo State University (UNESP), School of Dentistry, Araçatuba, SP, Brazil; Department of Diagnosis and Surgery, São Paulo State University (UNESP), School of Dentistry, Araçatuba, SP, Brazil.
| | | | - Jéssica Araújo Figueira
- Oral Oncology Center, São Paulo State University (UNESP), School of Dentistry, Araçatuba, SP, Brazil; Department of Diagnosis and Surgery, São Paulo State University (UNESP), School of Dentistry, Araçatuba, SP, Brazil
| | - John Lennon Silva Cunha
- Oral Pathology Section, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, SP, Brazil
| | - Glauco Issamu Miyahara
- Oral Oncology Center, São Paulo State University (UNESP), School of Dentistry, Araçatuba, SP, Brazil; Department of Diagnosis and Surgery, São Paulo State University (UNESP), School of Dentistry, Araçatuba, SP, Brazil
| | - Luciana Estevam Simonato
- Postgraduate Program in Bioengineering, Universidade Brasil, São Paulo, Brazil; Dental School, University Brasil, Fenandópolis, SP, Brazil
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Tiwari L, Kujan O, Farah CS. Clinico-pathological correlation of optical fluorescence imaging in oral mucosal lesions. Oral Dis 2020; 26:1230-1239. [PMID: 32198955 DOI: 10.1111/odi.13334] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2019] [Revised: 02/22/2020] [Accepted: 03/15/2020] [Indexed: 12/14/2022]
Abstract
OBJECTIVES This study aimed to identify clinical and pathological characteristics of oral mucosal lesions that may be predictive of optical autofluorescence imaging patterns. METHODS Clinical data and archival histopathological material were collected from patients who presented with at least one oral mucosal lesion and underwent assessment via conventional oral examination, optical autofluorescence imaging and histopathological analysis. An open-source digital pathology image analysis software was used to perform histomorphometric measurements. Classification and regression trees were used to determine histopathological characteristics most predictive of a clinical autofluorescence outcome. RESULTS Histomorphometric features associated with tissue architecture, epithelial changes, inflammation and vasculature were found to be significantly associated with autofluorescence patterns. Diascopic fluorescence was found to be significantly predicted by lichenoid inflammation and was significantly associated with a diagnosis of oral lichen planus. Loss of autofluorescence with partial blanching was significantly associated with histopathological features noted in dysplastic and malignant lesions. CONCLUSIONS This study provides evidence for the use of diascopic fluorescence as a technique to aid in clinical differentiation of benign inflammatory lesions from potentially malignant pathology. Based on the findings of this study, optical fluorescence imaging is a technique of added value in discernment of oral mucosal lesions, and our results support its clinical use.
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Affiliation(s)
- Lalima Tiwari
- UWA Dental School, University of Western Australia, Nedlands, WA, Australia
| | - Omar Kujan
- UWA Dental School, University of Western Australia, Nedlands, WA, Australia
| | - Camile S Farah
- Australian Centre for Oral Oncology Research & Education, Nedlands, WA, Australia
- Oral, Maxillofacial and Dental Surgery, Fiona Stanley Hospital, Murdoch, WA, Australia
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Biamonte F, Buffone C, Santamaria G, Battaglia AM, Mignogna C, Fortunato L, Costanzo FS, Giudice A. Gene expression analysis of autofluorescence margins in leukoplakia and oral carcinoma: A pilot study. Oral Dis 2020; 27:193-203. [PMID: 32645756 DOI: 10.1111/odi.13525] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 06/18/2020] [Accepted: 06/20/2020] [Indexed: 12/16/2022]
Abstract
OBJECTIVES Autofluorescence is considered a useful technique in the early detection of oral mucosal alterations. However, its efficacy to discriminate tumor margins is still under debate. The purpose of this pilot study was to confirm the existence of molecular divergence from the center of a lesion compared to white light and autofluorescence (VELscopeTM ) visualized margins in leukoplakia and oral carcinoma. MATERIALS AND METHODS Molecular divergence from the center of the lesion to white light and VELscopeTM defined margins was compared in patients with leukoplakia (n = 3) and oral carcinoma (n = 4). Expression profiling of 45 selected genes was performed through custom-made TaqMan arrays. Gene Ontology was used for biological pathway analysis. RESULTS Irrespective of pathology, the greatest molecular divergence existed between the center of the lesion and both white light and VELscopeTM margins. VELscopeTM and white light margins were also molecularly distinct in oral carcinoma samples. Indeed, the white light margin retained molecular abnormalities observed in the center of the lesion thus suggesting the existence of a "partially transformed" cell population. CONCLUSION Despite the limited low number of patients, our data confirm the benefit of combining autofluorescence with conventional oral examination in identifying surgical margins during biopsy procedures for leukoplakia and oral carcinoma.
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Affiliation(s)
- Flavia Biamonte
- Research Center of Biochemistry and Advanced Molecular Biology, Department of Experimental and Clinical Medicine, "Magna Graecia" University of Catanzaro, Catanzaro, Italy
| | - Caterina Buffone
- Department of Health Sciences, "Magna Graecia" University of Catanzaro, Catanzaro, Italy
| | - Gianluca Santamaria
- Klinikum rechts der Isar, Department of Regenerative Medicine in Cardiovascular Disease, Technical University of Munich, Munich, Germany
| | - Anna Martina Battaglia
- Research Center of Biochemistry and Advanced Molecular Biology, Department of Experimental and Clinical Medicine, "Magna Graecia" University of Catanzaro, Catanzaro, Italy
| | - Chiara Mignogna
- Department of Health Sciences, "Magna Graecia" University of Catanzaro, Catanzaro, Italy.,Interdepartmental Center of Services (CIS), "Magna Graecia" University of Catanzaro, Catanzaro, Italy
| | - Leonzio Fortunato
- Department of Health Sciences, "Magna Graecia" University of Catanzaro, Catanzaro, Italy
| | - Francesco Saverio Costanzo
- Research Center of Biochemistry and Advanced Molecular Biology, Department of Experimental and Clinical Medicine, "Magna Graecia" University of Catanzaro, Catanzaro, Italy.,Interdepartmental Center of Services (CIS), "Magna Graecia" University of Catanzaro, Catanzaro, Italy
| | - Amerigo Giudice
- Department of Health Sciences, "Magna Graecia" University of Catanzaro, Catanzaro, Italy
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Panayides AS, Amini A, Filipovic ND, Sharma A, Tsaftaris SA, Young A, Foran D, Do N, Golemati S, Kurc T, Huang K, Nikita KS, Veasey BP, Zervakis M, Saltz JH, Pattichis CS. AI in Medical Imaging Informatics: Current Challenges and Future Directions. IEEE J Biomed Health Inform 2020; 24:1837-1857. [PMID: 32609615 PMCID: PMC8580417 DOI: 10.1109/jbhi.2020.2991043] [Citation(s) in RCA: 105] [Impact Index Per Article: 26.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
This paper reviews state-of-the-art research solutions across the spectrum of medical imaging informatics, discusses clinical translation, and provides future directions for advancing clinical practice. More specifically, it summarizes advances in medical imaging acquisition technologies for different modalities, highlighting the necessity for efficient medical data management strategies in the context of AI in big healthcare data analytics. It then provides a synopsis of contemporary and emerging algorithmic methods for disease classification and organ/ tissue segmentation, focusing on AI and deep learning architectures that have already become the de facto approach. The clinical benefits of in-silico modelling advances linked with evolving 3D reconstruction and visualization applications are further documented. Concluding, integrative analytics approaches driven by associate research branches highlighted in this study promise to revolutionize imaging informatics as known today across the healthcare continuum for both radiology and digital pathology applications. The latter, is projected to enable informed, more accurate diagnosis, timely prognosis, and effective treatment planning, underpinning precision medicine.
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35
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Shang LW, Ma DY, Fu JJ, Lu YF, Zhao Y, Xu XY, Yin JH. Fluorescence imaging and Raman spectroscopy applied for the accurate diagnosis of breast cancer with deep learning algorithms. BIOMEDICAL OPTICS EXPRESS 2020; 11:3673-3683. [PMID: 33014559 PMCID: PMC7510916 DOI: 10.1364/boe.394772] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 05/16/2020] [Accepted: 05/27/2020] [Indexed: 06/11/2023]
Abstract
Deep learning is usually combined with a single detection technique in the field of disease diagnosis. This study focused on simultaneously combining deep learning with multiple detection technologies, fluorescence imaging and Raman spectroscopy, for breast cancer diagnosis. A number of fluorescence images and Raman spectra were collected from breast tissue sections of 14 patients. Pseudo-color enhancement algorithm and a convolutional neural network were applied to the fluorescence image processing, so that the discriminant accuracy of test sets, 88.61%, was obtained. Two different BP-neural networks were applied to the Raman spectra that mainly comprised collagen and lipid, so that the discriminant accuracy of 95.33% and 98.67% of test sets were gotten, respectively. Then the discriminant results of fluorescence images and Raman spectra were counted and arranged into a characteristic variable matrix to predict the breast tissue samples with partial least squares (PLS) algorithm. As a result, the predictions of all samples are correct, with minor error of predictive value. This study proves that deep learning algorithms can be applied into multiple diagnostic optics/spectroscopy techniques simultaneously to improve the accuracy in disease diagnosis.
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Affiliation(s)
- Lin-Wei Shang
- Department of Biomedical Engineering, Nanjing University of Aeronautics and Astronautics, Nanjing 210016, China
| | - Dan-Ying Ma
- Department of Biomedical Engineering, Nanjing University of Aeronautics and Astronautics, Nanjing 210016, China
| | - Juan-Juan Fu
- Department of Biomedical Engineering, Nanjing University of Aeronautics and Astronautics, Nanjing 210016, China
| | - Yan-Fei Lu
- Department of Biomedical Engineering, Nanjing University of Aeronautics and Astronautics, Nanjing 210016, China
| | - Yuan Zhao
- Department of Biomedical Engineering, Nanjing University of Aeronautics and Astronautics, Nanjing 210016, China
| | - Xin-Yu Xu
- Department of Pathology, Jiangsu Cancer Hospital, Nanjing 210009, China
| | - Jian-Hua Yin
- Department of Biomedical Engineering, Nanjing University of Aeronautics and Astronautics, Nanjing 210016, China
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May VelScope Be Deemed an Opportunistic Oral Cancer Screening by General Dentists? A Pilot Study. J Clin Med 2020; 9:jcm9061754. [PMID: 32516953 PMCID: PMC7356111 DOI: 10.3390/jcm9061754] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Revised: 05/26/2020] [Accepted: 06/03/2020] [Indexed: 12/25/2022] Open
Abstract
Early diagnosis of oral cancer through visual inspection followed by histopathological confirmation is a pivotal step for reducing rates of morbidity and mortality. There are several auxiliary devices used to improve oral examination. The purpose of this cross-sectional pilot study is to evaluate the sensitivity and specificity of the Visually Enhance Lesion Scope (VelScope) system when it is used by the general dentist after a yearly oral medicine training. Thirty-five patients with oral lesions were evaluated with clinical and VelScope examination by two general dentists, one of which trained with a specific course. A comparison of the histopathological results, clinical examination, and VelScope made by both dentists was performed through statistical analysis. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for detecting oral potentially malignant disorders (OPMDs) are 53.3%, 65%, 53.3%, 76.5% for unskilled dentist, 73.3%, 65%, 61.1%, 76.5% for skilled clinician. When both examiners use VelScope the values are 53.3%, 70%, 57.1%, 66.7% for unskilled general dentist (u-GD), 86.7%, 90%, 86.7%, 90% for skilled general dentist (s-GD). Improvement of a skilled general dentist for detecting malignancies is higher than inexperienced examiner when using VelScope. VelScope alone is unable to improve the general dentist’s ability to detect malignancies, but it could be a useful adjunctive device for clinicians when a focused training program is performed.
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Kumar M, Quan X, Awatsuji Y, Tamada Y, Matoba O. Digital Holographic Multimodal Cross-Sectional Fluorescence and Quantitative Phase Imaging System. Sci Rep 2020; 10:7580. [PMID: 32415184 PMCID: PMC7228964 DOI: 10.1038/s41598-020-64028-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 04/03/2020] [Indexed: 12/29/2022] Open
Abstract
We present a multimodal imaging system based on simple off-axis digital holography, for simultaneous recording and retrieval of cross-sectional fluorescence and quantitative phase imaging of the biological specimen. Synergism in the imaging capabilities can be achieved by incorporating two off-axis digital holographic microscopes integrated to record different information at the same time. The cross-sectional fluorescence imaging is realized by a common-path configuration of the single-shot off-axis incoherent digital holographic system. The quantitative phase imaging, on the other hand, is achieved by another off-axis coherent digital holographic microscopy operating in transmission mode. The fundamental characteristics of the proposed multimodal system are confirmed by performing various experiments on fluorescent beads and fluorescent protein-labeled living cells of the moss Physcomitrella patens lying at different axial depth positions. Furthermore, the cross-sectional live fluorescence and phase imaging of the fluorescent beads are demonstrated by the proposed multimodal system. The experimental results presented here corroborate the feasibility of the proposed system and indicate its potential in the applications to analyze the functional and structural behavior of biological cells and tissues.
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Affiliation(s)
- Manoj Kumar
- Graduate School of System Informatics, Kobe University, Rokkodai 1-1, Nada, Kobe, 657-8501, Japan.
| | - Xiangyu Quan
- Graduate School of System Informatics, Kobe University, Rokkodai 1-1, Nada, Kobe, 657-8501, Japan
| | - Yasuhiro Awatsuji
- Faculty of Electrical Engineering and Electronics, Kyoto Institute of Technology, Matsugasaki, Sakyo-ku, Kyoto, 606-8585, Japan
| | - Yosuke Tamada
- School of Engineering, Utsunomiya University, 7-1-2 Yoto, Utsunomiya, 321-8585, Japan
- National Institute for Basic Biology, 38 Nishigonaka, Myodaiji, Okazaki, 444-8585, Japan
- School of Life Science, SOKENDAI (The Graduate University for Advanced Studies), 38 Nishigonaka, Myodaiji, Okazaki, 444-8585, Japan
- Center for Optical Research and Education (CORE), Utsunomiya University, 7-1-2 Yoto, Utsunomiya, 321-8585, Japan
| | - Osamu Matoba
- Graduate School of System Informatics, Kobe University, Rokkodai 1-1, Nada, Kobe, 657-8501, Japan.
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A Sensitive Fibre Optic Probe for Autofluorescence Spectroscopy of Oral Tongue Cancer: Monte Carlo Simulation Study. BIOMED RESEARCH INTERNATIONAL 2020; 2020:1936570. [PMID: 32337228 PMCID: PMC7168752 DOI: 10.1155/2020/1936570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 03/11/2020] [Accepted: 03/25/2020] [Indexed: 11/17/2022]
Abstract
The objective of this paper is to determine the best optical probe configuration that would help to detect neoplastic lesions in oral tongue epithelial tissue. Three geometrical configurations are investigated. The first one is a single-fibre probe with different fibre diameters. The second one is a multitilted fibre probe that employs different tilting angles for emission and collection fibres. While the third one is a multidiameter probe that employs different fibre diameters and distances between the emission and the collection fibres. All probes were evaluated for their depth-limited sensitivity in the epithelium layer of the tongue. Probes that showed efficient sensitivities were then compared for their fluorescence intensities acquired from both tissue types. The sensitivity for the first two types of probes was found to be roughly comparable. However, the differentiation capability of the multitilted fibre probe between dysplastic and healthy tissue was found to be noticeably larger by 30% of that of the single-fibre probe. The third type showed more sensitivity to fluorescence emerging from deeper layers. Finally, the proposed configuration is presented and proved to achieve higher sensitivity for both superficial and deep layers.
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Duran-Sierra E, Cheng S, Cuenca-Martinez R, Malik B, Maitland KC, Lisa Cheng YS, Wright J, Ahmed B, Ji J, Martinez M, Al-Khalil M, Al-Enazi H, Jo JA. Clinical label-free biochemical and metabolic fluorescence lifetime endoscopic imaging of precancerous and cancerous oral lesions. Oral Oncol 2020; 105:104635. [PMID: 32247986 DOI: 10.1016/j.oraloncology.2020.104635] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 02/15/2020] [Accepted: 03/05/2020] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Incomplete head and neck cancer resection occurs in up to 85% of cases, leading to increased odds of local recurrence and regional metastases; thus, image-guided surgical tools for accurate, in situ and fast detection of positive margins during head and neck cancer resection surgery are urgently needed. Oral epithelial dysplasia and cancer development is accompanied by morphological, biochemical, and metabolic tissue and cellular alterations that can modulate the autofluorescence properties of the oral epithelial tissue. OBJECTIVE This study aimed to test the hypothesis that autofluorescence biomarkers of oral precancer and cancer can be clinically imaged and quantified by means of multispectral fluorescence lifetime imaging (FLIM) endoscopy. METHODS Multispectral autofluorescence lifetime images of precancerous and cancerous lesions from 39 patients were imaged in vivo using a novel multispectral FLIM endoscope and processed to generate widefield maps of biochemical and metabolic autofluorescence biomarkers of oral precancer and cancer. RESULTS Statistical analyses applied to the quantified multispectral FLIM endoscopy based autofluorescence biomarkers indicated their potential to provide contrast between precancerous/cancerous vs. healthy oral epithelial tissue. CONCLUSION To the best of our knowledge, this study represents the first demonstration of label-free biochemical and metabolic clinical imaging of precancerous and cancerous oral lesions by means of widefield multispectral autofluorescence lifetime endoscopy. Future studies will focus on demonstrating the capabilities of endogenous multispectral FLIM endoscopy as an image-guided surgical tool for positive margin detection during head and neck cancer resection surgery.
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Affiliation(s)
- Elvis Duran-Sierra
- Department of Biomedical Engineering, Texas A&M University, College Station, TX, USA
| | - Shuna Cheng
- Department of Biomedical Engineering, Texas A&M University, College Station, TX, USA
| | - Rodrigo Cuenca-Martinez
- Department of Electrical and Computer Engineering, Texas A&M University at Qatar, Doha, Qatar
| | - Bilal Malik
- QT Ultrasound Labs, 3 Hamilton Landing, Suite 160, Novato, CA, USA
| | - Kristen C Maitland
- Department of Biomedical Engineering, Texas A&M University, College Station, TX, USA
| | | | - John Wright
- Texas A&M College of Dentistry, Dallas, TX, USA
| | - Beena Ahmed
- Department of Electrical and Computer Engineering, Texas A&M University at Qatar, Doha, Qatar
| | - Jim Ji
- Department of Electrical and Computer Engineering, Texas A&M University at Qatar, Doha, Qatar
| | - Mathias Martinez
- Department of Cranio-Maxillofacial Surgery, Hamad Medical Corporation, Doha, Qatar
| | - Moustafa Al-Khalil
- Department of Cranio-Maxillofacial Surgery, Hamad Medical Corporation, Doha, Qatar
| | - Hussain Al-Enazi
- Department of Otorhinolaryngology Head and Neck Surgery, Hamad Medical Corporation, Doha, Qatar
| | - Javier A Jo
- School of Electrical and Computer Engineering, University of Oklahoma, Norman, OK, USA.
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Shah S, Waknis P, Saha A, Setiya S, Ratra T, Vaswani V. The use of Velscope to assess cellular changes occuring in oral premalignancy. J Oral Biol Craniofac Res 2020; 10:99-103. [PMID: 32211285 DOI: 10.1016/j.jobcr.2020.03.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Accepted: 03/10/2020] [Indexed: 11/20/2022] Open
Abstract
Objectives To improve visualization of suspicious lesions of the oral mucosa and to assess the accuracy of Velscope in assessing cellular changes occurring in oral premalignancy for early diagnosis. Materials and methods In this prospective, randomized in-vivo clinical study a total of 250 patients who gave history of chewing tobacco were screened. The selection of the site of biopsy was taken based on the area of loss of fluorescence identified by the Velscope within the lesion. Routine blood investigations were done. A biopsy was performed to confirm the findings of clinical examination. The data was collected and analysed. Results Among 200 patients only 110 underwent incisional biopsy. Of these only 89 patients showed neoplastic changes. Of the control biopsies, none of them showed any dysplastic changes. Out of 106 who exhibited speckling under autofluorescence, only 89 showed dysplastic changes whereas only 17 showed no dysplastic changes. Out of these 17 specimens, the histopathological diagnosis of 5 was coated tongue, 3 were pigmented lesions, 3 were geographic tongue and 2 were mucositis. Of the remaining 4, the histopathological diagnosis of 1 was oral submucous fibrosis, 1 was lichen planus and 2 were frictional keratosis. Conclusion False positive findings are possible in presence of highly inflamed tissues, and it is possible that use of Velscope alone may result in failure to detect regions of dysplasia, but it has its use definitely to improve clinical decision making about the nature of oral lesions and aids in decisions to biopsy regions of concern. Use of the scope has allowed practitioners to identify the best region for biopsy. It is much better to occasionally sample tissue that turns out to be benign than to fail to diagnose dysplastic or malignant lesions. However, poor specificity is a major limitation for using it as a screening tool.
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Affiliation(s)
- Sonal Shah
- Dept. of Oral and Maxillofacial Surgery, Dr. D.Y. Patil Vidyapeeth, Pune, India
| | - Pushkar Waknis
- Dept. of Oral and Maxillofacial Surgery, Dr. D.Y. Patil Vidyapeeth, Pune, India
| | - Aditi Saha
- Dept. of Oral and Maxillofacial Surgery, Dr. D.Y. Patil Vidyapeeth, Pune, India
| | - Sneha Setiya
- Dept. of Oral and Maxillofacial Surgery, Dr. D.Y. Patil Vidyapeeth, Pune, India
| | - Tusha Ratra
- Dept. of Oral and Maxillofacial Surgery, Dr. D.Y. Patil Vidyapeeth, Pune, India
| | - Vibha Vaswani
- Dept. of Oral and Maxillofacial Surgery, Dr. D.Y. Patil Vidyapeeth, Pune, India
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Evaluation of autofluorescence and photodynamic diagnosis in assessment of bladder lesions. Photodiagnosis Photodyn Ther 2020; 30:101719. [PMID: 32165336 DOI: 10.1016/j.pdpdt.2020.101719] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 02/16/2020] [Accepted: 03/06/2020] [Indexed: 12/24/2022]
Abstract
The ability to detect and diagnose bladder cancer early and precisely is crucial for effective treatment. The aim of this study is to assess the utility of optical biopsy performed with autofluorescence cystoscopy (AFC) using the Onco-LIFE system with numerical color values (NCVs) and by ALA/PDD. Histopathological examination of material obtained during TURBT and/or biopsy of the bladder was carried out in 251 patients. In the case of 35 patients, the selection of the specimen collected for histopathological examination was based using ALA/PDD. In the remaining 216 patients, tissue was collected based on the findings of AFC with NCV. Using AFC, the observed NCV ranged from 0 to 3.86; the highest mean NCV was observed in neoplastic muscle invasive lesions and was equal to 3.18. Furthermore, non-muscle invasive tumors were characterized by a mean NCV equal to 1.54. Tissue with inflammation, metaplasia, and healthy tissue demonstrated significantly lower mean NCV values. The presence of a muscle-invasive tumor increased the NCV by approximately 2.86 compared to healthy tissue. The rates of postoperative complications depend on the examining operator and are observed more often, as much as 65.7 % during ALA/PDD. AFC with NCV using the Onco-LIFE system, as well as ALA/PDD are helpful tools for early diagnosis of bladder precancerous and cancer lesions and for performing targeted biopsies. A significant correlation was found between lesion NCV index and the grade of dysplasia or tumor malignancy. Tissue with inflammation, metaplasia, and healthy tissue demonstrated significantly lower mean NCV values. AFE with NCV have a significantly higher sensitivity than specificity. Low rates of postoperative complications are correlated to the experience of the endoscopist and with AFE/NCV in comparison of ALA/PDD.
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Li Y, Chen X, Watkins B, Saini N, Gannon S, Nadeau E, Reeves R, Gao B, Pelligrini V, Yao H, Mercuri J, Ye T. Nonlabeling and quantitative assessment of chondrocyte viability in articular cartilage with intrinsic nonlinear optical signatures. Exp Biol Med (Maywood) 2020; 245:348-359. [PMID: 31910653 DOI: 10.1177/1535370219896545] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Chondrocyte viability is a crucial factor for evaluating cartilage health. Most prevalent cell viability assays rely on dyes and are not applicable for in vivo or longitudinal studies. Here we demonstrated that the two-photon excited autofluorescence and second harmonic generation microscopy provided high-resolution imaging of cartilage tissue and distinguished live/dead chondrocytes by visual assessment. Furthermore, the normalized autofluorescence ratio was proposed as a quantitative indicator to determine chondrocyte viability. Based on the indicator, a curve fitting and simulated receiver operating characteristic method was proposed to identify the live/dead cell populations as well as the indicator threshold without dye labeling. Thus, it established the label-free imaging method for chondrocyte viability assay in cartilage tissue. Impact statement Chondrocytes are the only cellular component found in the cartilage, playing a critical role in maintaining the homeostasis of articular cartilage. The viability of chondrocytes is a crucial factor for evaluating cartilage health. However, the current prevalent cell viability assays rely on dye staining and thereby are not applicable in vivo or in longitudinal assessments. In this study, we demonstrate that the intrinsic signals such as two-photon excited autofluorescence and second harmonic generation can be used to classify live and dead chondrocytes in cartilage tissue. A quantitative measure is also proposed allowing development of automated assessment algorithms. The nonlabeling nature of this method suggests the potential applicability to nondestructive and in vivo assessment of cartilage health.
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Affiliation(s)
- Yang Li
- Department of Bioengineering, Clemson University, Clemson, SC 29634, USA
| | - Xun Chen
- Department of Bioengineering, Clemson University, Clemson, SC 29634, USA
| | | | - Neal Saini
- College of Medicine, Medical University of South Carolina, Charleston, SC 29425, USA
| | - Steven Gannon
- Department of Bioengineering, Clemson University, Clemson, SC 29634, USA
| | - Elizabeth Nadeau
- College of Medicine, Medical University of South Carolina, Charleston, SC 29425, USA
| | - Russell Reeves
- College of Medicine, Medical University of South Carolina, Charleston, SC 29425, USA
| | - Bruce Gao
- Department of Bioengineering, Clemson University, Clemson, SC 29634, USA
| | - Vincent Pelligrini
- Department of Bioengineering, Clemson University, Clemson, SC 29634, USA.,Department of Orthopaedics, Medical University of South Carolina, Charleston, SC 29425, USA
| | - Hai Yao
- Department of Bioengineering, Clemson University, Clemson, SC 29634, USA
| | - Jeremy Mercuri
- Department of Bioengineering, Clemson University, Clemson, SC 29634, USA
| | - Tong Ye
- Department of Bioengineering, Clemson University, Clemson, SC 29634, USA.,Department of Regenerative Medicine and Cell Biology, Medical University of South Carolina, Charleston, SC 29425, USA
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Sriram G, Sudhaharan T, Wright GD. Multiphoton Microscopy for Noninvasive and Label-Free Imaging of Human Skin and Oral Mucosa Equivalents. Methods Mol Biol 2020; 2150:195-212. [PMID: 30941721 DOI: 10.1007/7651_2019_220] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Multiphoton microscopy has emerged as a powerful modality for noninvasive, spatial, and temporal imaging of biological tissues without the use of labels and/or dyes. It provides complimentary imaging modalities, which include two-photon excited fluorescence (2PEF) and second harmonic generation (SHG). 2PEF from endogenous chromophores such as nicotinamide adenine dinucleotides (NADH), flavins and keratin enable visualization of cellular and subcellular structures. SHG provides visualization of asymmetric macromolecular structures such as collagen. These modalities enable the visualization of biochemical and biological alterations within live tissues in their native state.Organotypic cultures of the skin and oral mucosa equivalents have been increasingly used across basic and translational research. However, assessment of the skin and oral mucosa equivalents is predominantly based on histological techniques which are not suited for real-time imaging and longitudinal studies of the tissues in their native state. 2PEF from endogenous chromophores and SHG from collagen can be effectively used as an imaging tool for noninvasive and label-free acquisition of cellular and matrix structures of live skin and oral mucosa cultures.In this chapter, the methods for noninvasive and label-free imaging of monolayer and organotypic cultures of the skin and oral mucosa using multiphoton microscopy are described.
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Affiliation(s)
- Gopu Sriram
- Faculty of Dentistry, National University of Singapore, Singapore, Singapore.
| | - Thankiah Sudhaharan
- Institute of Medical Biology, A*STAR, Singapore, Singapore
- Skin Research Institute of Singapore, A*STAR, Singapore, Singapore
| | - Graham D Wright
- Institute of Medical Biology, A*STAR, Singapore, Singapore
- Skin Research Institute of Singapore, A*STAR, Singapore, Singapore
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History and future perspectives for the use of fluorescence visualization to detect oral squamous cell carcinoma and oral potentially malignant disorders. Photodiagnosis Photodyn Ther 2019; 28:308-317. [DOI: 10.1016/j.pdpdt.2019.10.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Revised: 10/03/2019] [Accepted: 10/04/2019] [Indexed: 12/20/2022]
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Laser induced autofluorescence lifetime to identify larynx squamous cell carcinoma: Short series ex vivo study. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2019; 202:111724. [PMID: 31785446 DOI: 10.1016/j.jphotobiol.2019.111724] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 11/21/2019] [Accepted: 11/22/2019] [Indexed: 02/08/2023]
Abstract
Laser induced autofluorescence (LIAF) lifetime is useful to distinguish between normal laryngeal tissues and squamous cell carcinoma (SCC) based on variations of their biochemical composition and structure alterations. LIAF was collected from samples constituted by pairs of normal and malignant tissue, which were excised from three patients. Exclusion criteria for samples harvest were: (i) macroscopic changes of normal vocal cord observed during surgery; (ii) previous surgical intervention on vocal cord, (iii) patients treated only with chemotherapy or radiotherapy for carcinoma. Inclusion conditions: men, aged 57-68, non-smokers. A pulsed laser diode excited LIAF at 375 nm and 31 MHz repetition rate; beam full-time width at half-maximum was 87 ps at an average power of 0.49 mW. Mean LIAF lifetime for normal tissues was (3.75 ± 0.49) ns and for malignant (4.37 ± 0.85) ns: it is longer in malignant than in normal tissue. Variance analysis made with Fisher's test has shown no significant difference between patients for normal tissues; the same was true for malignant. Though, when malignant tissue was compared to normal for the same patients as well as between patients, a significant difference (significance level of 5%) was evidenced. Time-resolved LIAF may allow better differentiation between normal and malignant tissues in patients diagnosed with larynx SCC.
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Rajput SK, Kumar M, Quan X, Morita M, Furuyashiki T, Awatsuji Y, Tajahuerce E, Matoba O. Three-dimensional fluorescence imaging using the transport of intensity equation. JOURNAL OF BIOMEDICAL OPTICS 2019; 25:1-7. [PMID: 31721541 PMCID: PMC7010985 DOI: 10.1117/1.jbo.25.3.032004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Accepted: 09/04/2019] [Indexed: 06/01/2023]
Abstract
We propose a nonscanning three-dimensional (3-D) fluorescence imaging technique using the transport of intensity equation (TIE) and free-space Fresnel propagation. In this imaging technique, a phase distribution corresponding to defocused fluorescence images with a point-light-source-like shape is retrieved by a TIE-based phase retrieval algorithm. From the obtained phase distribution, and its corresponding amplitude distribution, of the defocused fluorescence image, various images at different distances can be reconstructed at the desired plane after Fresnel propagation of the complex wave function. Through the proposed imaging approach, the 3-D fluorescence imaging can be performed in multiple planes. The fluorescence intensity images are captured with the help of an electrically tunable lens; hence, the imaging technique is free from motion artifacts. We present experimental results corresponding to microbeads and a biological sample to demonstrate the proposed 3-D fluorescence imaging technique.
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Affiliation(s)
- Sudheesh K. Rajput
- Kobe University, Graduate School of System Informatics, Department of Systems Science, Nada, Kobe, Japan
| | - Manoj Kumar
- Kobe University, Graduate School of System Informatics, Department of Systems Science, Nada, Kobe, Japan
| | - Xiangyu Quan
- Kobe University, Graduate School of System Informatics, Department of Systems Science, Nada, Kobe, Japan
| | - Mitsuhiro Morita
- Kobe University, Graduate School of Sciences, Department of Biology, Nada, Kobe, Japan
| | - Tomoyuki Furuyashiki
- Kobe University, Graduate School of Medicine, Division of Pharmacology, Chuo-ku, Kobe, Japan
- AMED-CREST, Chiyoda-ku, Tokyo, Japan
| | - Yasuhiro Awatsuji
- Kyoto Institute of Technology, Faculty of Electrical Engineering and Electronics, Matsugasaki, Sakyo-ku, Kyoto, Japan
| | - Enrique Tajahuerce
- Universitat Jaume I, Institute of New Imaging Technologies (INIT), Department of Physics, Castello, Spain
| | - Osamu Matoba
- Kobe University, Graduate School of System Informatics, Department of Systems Science, Nada, Kobe, Japan
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Weyers BW, Marsden M, Sun T, Bec J, Bewley AF, Gandour-Edwards RF, Moore MG, Farwell DG, Marcu L. Fluorescence lifetime imaging for intraoperative cancer delineation in transoral robotic surgery. TRANSLATIONAL BIOPHOTONICS 2019; 1. [PMID: 32656529 PMCID: PMC7351319 DOI: 10.1002/tbio.201900017] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
This study evaluates the potential for fluorescence lifetime imaging (FLIm) to enhance intraoperative decisionmaking during robotic-assisted surgery of oropharyngeal cancer. Using a custom built FLIm instrument integrated with the da Vinci robotic surgical platform, we first demonstrate that cancer in epithelial tissue diagnosed by histopathology can be differentiated from surrounding healthy epithelial tissue imaged in vivo prior to cancer resection and ex vivo on the excised specimen. Second, we study the fluorescence properties of tissue imaged in vivo at surgical resection margins (tumor bed). Fluorescence lifetimes and spectral intensity ratios were calculated for three spectral channels, producing a set of six FLIm parameters. Current results from 10 patients undergoing TORS procedures demonstrate that healthy epithelium can be resolved from cancer (P < .001) for at least one FLIm parameter. We also showed that a multiparameter linear discriminant analysis approach provides superior discrimination to individual FLIm parameters for tissue imaged both in vivo and ex vivo. Overall, this study highlights the potential for FLIm to be developed into a diagnostic tool for clinical cancer applications of the oropharynx. This technique could help to circumvent the issues posed by the lack of tactile feedback associated with robotic surgical platforms to better enable cancer delineation.
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Affiliation(s)
- Brent W Weyers
- Department of Biomedical Engineering, University of California, Davis, California
| | - Mark Marsden
- Department of Biomedical Engineering, University of California, Davis, California
| | - Tianchen Sun
- Department of Computer Science, University of California, Davis, California
| | - Julien Bec
- Department of Biomedical Engineering, University of California, Davis, California
| | - Arnaud F Bewley
- Department of Otolaryngology, University of California, Davis, California
| | | | - Michael G Moore
- Department of Otolaryngology, University of California, Davis, California
| | - D Gregory Farwell
- Department of Otolaryngology, University of California, Davis, California
| | - Laura Marcu
- Department of Biomedical Engineering, University of California, Davis, California
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Jo JA, Cheng S, Cuenca-Martinez R, Duran-Sierra E, Malik B, Ahmed B, Maitland K, Cheng YSL, Wright J, Reese T. Endogenous Fluorescence Lifetime Imaging (FLIM) Endoscopy For Early Detection Of Oral Cancer And Dysplasia. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2019; 2018:3009-3012. [PMID: 30441030 DOI: 10.1109/embc.2018.8513027] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
We have performed a pilot clinical study, in which multispectral endogenous fluorescence (or autofluorescence) lifetime imaging (FLIM) was performed on clinically suspicious oral lesions of 73 patients undergoing tissue biopsy for oral dysplasia and cancer diagnosis. The results from this pilot study indicated that mild-dysplasia and early stage oral cancer could be detected from benign lesions using a computed aided diagnosis system developed based on biochemical and metabolic biomarkers derived from the endogenous FLIM images. The diagnostic performance of this novel FLIM clinical tool was estimated using a leave-onepatient-out cross-validation approach, which reported levels of sensitivity >90%, specificity >85%, and Area Under the Receiving Operating Curve (ROC-AUC) >0.9.
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Yang EC, Vohra IS, Badaoui H, Schwarz RA, Cherry KD, Jacob J, Rodriguez J, Williams MD, Vigneswaran N, Gillenwater AM, Richards-Kortum RR. Prospective evaluation of oral premalignant lesions using a multimodal imaging system: a pilot study. Head Neck 2019; 42:171-179. [PMID: 31621979 PMCID: PMC7003735 DOI: 10.1002/hed.25978] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 09/03/2019] [Accepted: 09/17/2019] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Multimodal optical imaging, incorporating reflectance and fluorescence modalities, is a promising tool to detect oral premalignant lesions in real-time. METHODS Images were acquired from 171 sites in 66 patient visits for clinical evaluation of oral lesions. An automated algorithm was used to classify lesions as high- or low-risk for neoplasia. Biopsies were acquired at clinically indicated sites and those classified as high-risk by imaging, at the surgeon's discretion. RESULTS Twenty sites were biopsied based on clinical examination or imaging. Of these, 12 were indicated clinically and by imaging; 58% were moderate dysplasia or worse. Four biopsies were indicated by imaging evaluation only; 75% were moderate dysplasia or worse. Finally, four biopsies were indicated by clinical evaluation only; 75% were moderate dysplasia or worse. CONCLUSION Multimodal imaging identified more cases of high-grade dysplasia than clinical evaluation, and can improve detection of high grade precancer in patients with oral lesions.
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Affiliation(s)
- Eric C Yang
- MD/PhD Medical Scientist Training Program, Baylor College of Medicine, Houston, Texas, USA
| | - Imran S Vohra
- Department of Bioengineering, Rice University, Houston, Texas, USA
| | - Hawraa Badaoui
- Department of Head and Neck Surgery, The University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | | | - Katelin D Cherry
- Department of Bioengineering, Rice University, Houston, Texas, USA
| | - Justin Jacob
- Department of Head and Neck Surgery, The University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Jessica Rodriguez
- Department of Head and Neck Surgery, The University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Michelle D Williams
- Department of Pathology, The University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Nadarajah Vigneswaran
- Department of Diagnostic and Biomedical Sciences, The University of Texas Health Science Center at Houston School of Dentistry, Houston, Texas
| | - Ann M Gillenwater
- Department of Head and Neck Surgery, The University of Texas M.D. Anderson Cancer Center, Houston, Texas
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Svoradová A, Makarevich A, Vašíček J, Olexiková L, Dragin S, Chrenek P. Microscopic Assessment of Dead Cell Ratio in Cryopreserved Chicken Primordial Germ Cells. MICROSCOPY AND MICROANALYSIS : THE OFFICIAL JOURNAL OF MICROSCOPY SOCIETY OF AMERICA, MICROBEAM ANALYSIS SOCIETY, MICROSCOPICAL SOCIETY OF CANADA 2019; 25:1257-1262. [PMID: 31530326 DOI: 10.1017/s1431927619014934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
This study aimed to compare three methods of cell death assessment [trypan blue exclusion (TBE), propidium iodide viability assay (PIVA), and transmission electron microscopy] to evaluate fresh and frozen-thawed chicken primordial germ cells (PGCs). For this study, chicken PGCs were collected from ROSS 908 and Oravka breed hens, cryopreserved-thawed according to the protocol, and submitted for different cell death assessments. We observed significant differences between TBE and PIVA techniques in the detectable proportion of dead cells in fresh (14.14 ± 1.27 versus 7.16 ± 1.02%, respectively) and frozen-thawed (44.00 ± 2.11 versus 33.33 ± 1.67%, respectively) samples of the Oravka breed. Moreover, significant differences (p < 0.05) between TBE and PIVA techniques in the detectable proportion of dead cells in fresh (9.20 ± 0.60 versus 5.37 ± 0.51%) samples of ROSS 908 breed were recorded. Differences may be due to methodological, sensitivity, and toxicity features of each technique tested, where TB stains cell cytoplasm of dead cells and PI penetrates and intercalates into DNA of dead cells. Therefore, we suggest using a more precise and sensitive PIVA for viability evaluation of PGCs. Further research is needed to apply various fluorochromes for more detailed cell viability evaluation.
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Affiliation(s)
- Andrea Svoradová
- Faculty of Natural Sciences, Constantine the Philosopher University, Trieda A. Hlinku 1, 949 79 Nitra, Slovakia
| | - Alexander Makarevich
- Research Institute for Animal Production in Nitra, National Agricultural and Food Centre, Hlohovecká 2, 951 41 Lužianky, Slovakia
| | - Jaromír Vašíček
- Research Institute for Animal Production in Nitra, National Agricultural and Food Centre, Hlohovecká 2, 951 41 Lužianky, Slovakia
- Faculty of Biotechnology and Food Science, Slovak University of Agriculture, Trieda A. Hlinku 2, 949 76 Nitra, Slovakia
| | - Lucia Olexiková
- Research Institute for Animal Production in Nitra, National Agricultural and Food Centre, Hlohovecká 2, 951 41 Lužianky, Slovakia
| | - Sasa Dragin
- Faculty of Agriculture, University of Novi Sad, Trg Dositeja Obradovića 8, Novi Sad, Serbia
| | - Peter Chrenek
- Research Institute for Animal Production in Nitra, National Agricultural and Food Centre, Hlohovecká 2, 951 41 Lužianky, Slovakia
- Faculty of Biotechnology and Food Science, Slovak University of Agriculture, Trieda A. Hlinku 2, 949 76 Nitra, Slovakia
- Department of Animal Biochemistry and Biotechnology, University of Science and Technology, Al. prof. S. Kaliskiego 7, 85-796 Bydgoszcz, Poland
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