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Mendonca P, Sunny SP, Mohan U, Birur N P, Suresh A, Kuriakose MA. Non-invasive imaging of oral potentially malignant and malignant lesions: A systematic review and meta-analysis. Oral Oncol 2022; 130:105877. [PMID: 35617750 DOI: 10.1016/j.oraloncology.2022.105877] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 04/09/2022] [Accepted: 04/18/2022] [Indexed: 12/19/2022]
Abstract
Non-invasive (NI) imaging techniques have been developed to overcome the limitations of invasive biopsy procedures, which is the gold standard in diagnosis of oral dysplasia and Oral Squamous Cell Carcinoma (OSCC). This systematic review and meta- analysis was carried out with an aim to investigate the efficacy of the NI-imaging techniques in the detection of dysplastic oral potentially malignant disorders (OPMDs) and OSCC. Records concerned in the detection of OPMDs, Oral Cancer were identified through search in PubMed, Science direct, Cochrane Library electronic database (January 2000 to October 2020) and additional manual searches. Out of 529 articles evaluated for eligibility, 56 satisfied the pre-determined inclusion criteria, including 13 varying NI-imaging techniques. Meta-analysis consisted 44 articles, wherein majority of the studies reported Autofluorescence (AFI-38.6%) followed by Chemiluminescence (CHEM), Narrow Band Imaging (NBI) (CHEM, NBI-15.9%), Fluorescence Spectroscopy (FS), Diffuse Reflectance Spectroscopy (DRS), (FS, DRS-13.6%) and 5aminolevulinic acid induced protoporphyrin IX fluorescence (5ALA induced PPIX- 6.8%). Higher sensitivities (Sen) and specificities (Spe) were obtained using FS (Sen:74%, Spe:96%, SAUC=0.98), DRS (Sen:79%, Spe:86%, SAUC = 0.91) and 5 ALA induced PPIX (Sen:91%, Spe:78%, SAUC = 0.98) in the detection of dysplastic OPMDs from non-dysplastic lesions(NDLs). AFI, FS, DRS, NBI showed higher sensitivities and SAUC (>90%) in differentiating OSCC from NDLs. Analysed NI-imaging techniques suggests the higher accuracy levels in the diagnosis of OSCC when compared to dysplastic OPMDs. 5 ALA induced PPIX, DRS and FS showed evidence of superior accuracy levels in differentiation of dysplastic OPMDs from NDLs, however results need to be validated in a larger number of studies.
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Affiliation(s)
- Pramila Mendonca
- Department of Head and Neck Surgical Oncology, Mazumdar Shaw Medical Center, NH Health City, Bangalore 99, India; Integrated Head and Neck Oncology Program, Mazumdar Shaw Medical Foundation, Narayana Health City, Bangalore 99, India.
| | - Sumsum P Sunny
- Department of Head and Neck Surgical Oncology, Mazumdar Shaw Medical Center, NH Health City, Bangalore 99, India; Integrated Head and Neck Oncology Program, Mazumdar Shaw Medical Foundation, Narayana Health City, Bangalore 99, India; Manipal Academy of Higher Education, Manipal, Karnataka, India.
| | - Uma Mohan
- Department of Head and Neck Surgical Oncology, Mazumdar Shaw Medical Center, NH Health City, Bangalore 99, India; Integrated Head and Neck Oncology Program, Mazumdar Shaw Medical Foundation, Narayana Health City, Bangalore 99, India.
| | - Praveen Birur N
- KLE Society's Institute of Dental Sciences, #20, Yeshwanthpur Suburb, II Stage, Tumkur Road, Bangalore 22, India.
| | - Amritha Suresh
- Integrated Head and Neck Oncology Program, Mazumdar Shaw Medical Foundation, Narayana Health City, Bangalore 99, India; Manipal Academy of Higher Education, Manipal, Karnataka, India.
| | - Moni A Kuriakose
- Department of Head and Neck Surgical Oncology, Mazumdar Shaw Medical Center, NH Health City, Bangalore 99, India; Integrated Head and Neck Oncology Program, Mazumdar Shaw Medical Foundation, Narayana Health City, Bangalore 99, India.
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Diffuse Reflectance Spectroscopy with Infrared Thermography for Accurate Prediction of Cellulitis. JID INNOVATIONS 2021; 1:100032. [PMID: 34909729 PMCID: PMC8659371 DOI: 10.1016/j.xjidi.2021.100032] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 04/22/2021] [Accepted: 04/29/2021] [Indexed: 11/24/2022] Open
Abstract
Cellulitis is frequently misdiagnosed owing to its clinical mimickers, collectively known as pseudocellulitis. This study investigated diffuse reflectance spectroscopy (DRS) alone and in combination with infrared thermography (IRT) for the differentiation of cellulitis from pseudocellulitis. A prospective cohort study at an urban academic hospital was conducted from March 2017 to March 2018. Patients presenting to the emergency department with presumed cellulitis were screened for eligibility, and 30 adult patients were enrolled. Dermatology consultation conferred a final diagnosis of cellulitis or pseudocellulitis. DRS measurements yielded a spectral ratio between 556 nm (deoxyhemoglobin peak) and 542 nm (oxyhemoglobin peak), and IRT measurements yielded temperature differentials between the affected and unaffected skin. Of the 30 enrolled patients, 30% were diagnosed with pseudocellulitis. DRS revealed higher spectral ratios in patients with cellulitis (P = 0.005). A single parameter model using logistic regression on DRS measurements alone demonstrated a classification accuracy of 77.0%. A dual parameter model using linear discriminant analysis on DRS and IRT measurements combined demonstrated a 95.2% sensitivity, 77.8% specificity, and 90.0% accuracy for cellulitis prediction. DRS and IRT combined diagnoses cellulitis with an accuracy of 90%. DRS and IRT are inexpensive and noninvasive, and their use may reduce cellulitis misdiagnosis.
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Walsh T, Macey R, Kerr AR, Lingen MW, Ogden GR, Warnakulasuriya S. Diagnostic tests for oral cancer and potentially malignant disorders in patients presenting with clinically evident lesions. Cochrane Database Syst Rev 2021; 7:CD010276. [PMID: 34282854 PMCID: PMC8407012 DOI: 10.1002/14651858.cd010276.pub3] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Squamous cell carcinoma is the most common form of malignancy of the oral cavity, and is often proceeded by oral potentially malignant disorders (OPMD). Early detection of oral cavity squamous cell carcinoma (oral cancer) can improve survival rates. The current diagnostic standard of surgical biopsy with histology is painful for patients and involves a delay in order to process the tissue and render a histological diagnosis; other diagnostic tests are available that are less invasive and some are able to provide immediate results. This is an update of a Cochrane Review first published in 2015. OBJECTIVES Primary objective: to estimate the diagnostic accuracy of index tests for the detection of oral cancer and OPMD, in people presenting with clinically evident suspicious and innocuous lesions. SECONDARY OBJECTIVE to estimate the relative accuracy of the different index tests. SEARCH METHODS Cochrane Oral Health's Information Specialist searched the following databases: MEDLINE Ovid (1946 to 20 October 2020), and Embase Ovid (1980 to 20 October 2020). The US National Institutes of Health Ongoing Trials Register (ClinicalTrials.gov) and the World Health Organization International Clinical Trials Registry Platform were also searched for ongoing trials to 20 October 2020. No restrictions were placed on the language or date of publication when searching the electronic databases. We conducted citation searches, and screened reference lists of included studies for additional references. SELECTION CRITERIA We selected studies that reported the diagnostic test accuracy of the following index tests when used as an adjunct to conventional oral examination in detecting OPMD or oral cavity squamous cell carcinoma: vital staining (a dye to stain oral mucosa tissues), oral cytology, light-based detection and oral spectroscopy, blood or saliva analysis (which test for the presence of biomarkers in blood or saliva). DATA COLLECTION AND ANALYSIS Two review authors independently screened titles and abstracts for relevance. Eligibility, data extraction and quality assessment were carried out by at least two authors, independently and in duplicate. Studies were assessed for methodological quality using the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2). Meta-analysis was used to combine the results of studies for each index test using the bivariate approach to estimate the expected values of sensitivity and specificity. MAIN RESULTS This update included 63 studies (79 datasets) published between 1980 and 2020 evaluating 7942 lesions for the quantitative meta-analysis. These studies evaluated the diagnostic accuracy of conventional oral examination with: vital staining (22 datasets), oral cytology (24 datasets), light-based detection or oral spectroscopy (24 datasets). Nine datasets assessed two combined index tests. There were no eligible diagnostic accuracy studies evaluating blood or salivary sample analysis. Two studies were classed as being at low risk of bias across all domains, and 33 studies were at low concern for applicability across the three domains, where patient selection, the index test, and the reference standard used were generalisable across the population attending secondary care. The summary estimates obtained from the meta-analysis were: - vital staining: sensitivity 0.86 (95% confidence interval (CI) 0.79 to 0.90) specificity 0.68 (95% CI 0.58 to 0.77), 20 studies, sensitivity low-certainty evidence, specificity very low-certainty evidence; - oral cytology: sensitivity 0.90 (95% CI 0.82 to 0.94) specificity 0.94 (95% CI 0.88 to 0.97), 20 studies, sensitivity moderate-certainty evidence, specificity moderate-certainty evidence; - light-based: sensitivity 0.87 (95% CI 0.78 to 0.93) specificity 0.50 (95% CI 0.32 to 0.68), 23 studies, sensitivity low-certainty evidence, specificity very low-certainty evidence; and - combined tests: sensitivity 0.78 (95% CI 0.45 to 0.94) specificity 0.71 (95% CI 0.53 to 0.84), 9 studies, sensitivity very low-certainty evidence, specificity very low-certainty evidence. AUTHORS' CONCLUSIONS At present none of the adjunctive tests can be recommended as a replacement for the currently used standard of a surgical biopsy and histological assessment. Given the relatively high values of the summary estimates of sensitivity and specificity for oral cytology, this would appear to offer the most potential. Combined adjunctive tests involving cytology warrant further investigation. Potentially eligible studies of blood and salivary biomarkers were excluded from the review as they were of a case-control design and therefore ineligible. In the absence of substantial improvement in the tests evaluated in this updated review, further research into biomarkers may be warranted.
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Affiliation(s)
- Tanya Walsh
- Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Richard Macey
- Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Alexander R Kerr
- Department of Oral and Maxillofacial Pathology, Radiology and Medicine, New York University College of Dentistry, New York, USA
| | - Mark W Lingen
- Pritzker School of Medicine, Division of Biological Sciences, Department of Pathology, University of Chicago, Chicago, Illinois, USA
| | - Graham R Ogden
- Division of Oral and Maxillofacial Clinical Sciences, School of Dentistry, University of Dundee, Dundee, UK
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Brouwer de Koning SG, Baltussen EJM, Karakullukcu MB, Dashtbozorg B, Smit LA, Dirven R, Hendriks BHW, Sterenborg HJCM, Ruers TJM. Toward complete oral cavity cancer resection using a handheld diffuse reflectance spectroscopy probe. JOURNAL OF BIOMEDICAL OPTICS 2018; 23:1-8. [PMID: 30341837 DOI: 10.1117/1.jbo.23.12.121611] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2018] [Accepted: 09/26/2018] [Indexed: 05/15/2023]
Abstract
This ex-vivo study evaluates the feasibility of diffuse reflectance spectroscopy (DRS) for discriminating tumor from healthy tissue, with the aim to develop a technology that can assess resection margins for the presence of tumor cells during oral cavity cancer surgery. Diffuse reflectance spectra were acquired on fresh surgical specimens from 28 patients with oral cavity squamous cell carcinoma. The spectra (400 to 1600 nm) were detected after illuminating tissue with a source fiber at 0.3-, 0.7-, 1.0-, and 2.0-mm distances from a detection fiber, obtaining spectral information from different sampling depths. The spectra were correlated with histopathology. A total of 76 spectra were obtained from tumor tissue and 110 spectra from healthy muscle tissue. The first- and second-order derivatives of the spectra were calculated and a classification algorithm was developed using fivefold cross validation with a linear support vector machine. The best results were obtained by the reflectance measured with a 1-mm source-detector distance (sensitivity, specificity, and accuracy are 89%, 82%, and 86%, respectively). DRS can accurately discriminate tumor from healthy tissue in an ex-vivo setting using a 1-mm source-detector distance. Accurate validation methods are warranted for larger sampling depths to allow for guidance during oral cavity cancer excision.
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Affiliation(s)
- Susan G Brouwer de Koning
- Netherlands Cancer Institute, Antoni van Leeuwenhoek, Department of Surgery, Amsterdam, The Netherlands
| | - Elisabeth J M Baltussen
- Netherlands Cancer Institute, Antoni van Leeuwenhoek, Department of Surgery, Amsterdam, The Netherlands
| | - M Baris Karakullukcu
- Netherlands Cancer Institute, Antoni van Leeuwenhoek, Department of Surgery, Amsterdam, The Netherlands
| | - Behdad Dashtbozorg
- Netherlands Cancer Institute, Antoni van Leeuwenhoek, Department of Surgery, Amsterdam, The Netherlands
| | - Laura A Smit
- Netherlands Cancer Institute, Antoni van Leeuwenhoek, Department of Pathology, Amsterdam, The Netherlands
| | - Richard Dirven
- Netherlands Cancer Institute, Antoni van Leeuwenhoek, Department of Surgery, Amsterdam, The Netherlands
| | - Benno H W Hendriks
- Philips Research, Department of In-body Systems, Eindhoven, The Netherlands
- Delft University of Technology, Department of Biomechanical Engineering, Delft, The Netherlands
| | - Henricus J C M Sterenborg
- Netherlands Cancer Institute, Antoni van Leeuwenhoek, Department of Surgery, Amsterdam, The Netherlands
- Academic Medical Centre, Department of Biomedical Engineering and Physics, Amsterdam, The Netherlands
| | - Theo J M Ruers
- Netherlands Cancer Institute, Antoni van Leeuwenhoek, Department of Surgery, Amsterdam, The Netherlands
- University of Twente, MIRA Institute, Enschede, The Netherlands
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Swami MK, Gupta PK. Optical Spectroscopy for Biomedical Diagnosis. PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES INDIA SECTION A-PHYSICAL SCIENCES 2018. [DOI: 10.1007/s40010-018-0519-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Bogomolov A, Zabarylo U, Kirsanov D, Belikova V, Ageev V, Usenov I, Galyanin V, Minet O, Sakharova T, Danielyan G, Feliksberger E, Artyushenko V. Development and Testing of an LED-Based Near-Infrared Sensor for Human Kidney Tumor Diagnostics. SENSORS 2017; 17:s17081914. [PMID: 28825612 PMCID: PMC5579832 DOI: 10.3390/s17081914] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Revised: 08/07/2017] [Accepted: 08/15/2017] [Indexed: 11/29/2022]
Abstract
Optical spectroscopy is increasingly used for cancer diagnostics. Tumor detection feasibility in human kidney samples using mid- and near-infrared (NIR) spectroscopy, fluorescence spectroscopy, and Raman spectroscopy has been reported (Artyushenko et al., Spectral fiber sensors for cancer diagnostics in vitro. In Proceedings of the European Conference on Biomedical Optics, Munich, Germany, 21–25 June 2015). In the present work, a simplification of the NIR spectroscopic analysis for cancer diagnostics was studied. The conventional high-resolution NIR spectroscopic method of kidney tumor diagnostics was replaced by a compact optical sensing device constructively represented by a set of four light-emitting diodes (LEDs) at selected wavelengths and one detecting photodiode. Two sensor prototypes were tested using 14 in vitro clinical samples of 7 different patients. Statistical data evaluation using principal component analysis (PCA) and partial least-squares discriminant analysis (PLS-DA) confirmed the general applicability of the LED-based sensing approach to kidney tumor detection. An additional validation of the results was performed by means of sample permutation.
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Affiliation(s)
- Andrey Bogomolov
- Art Photonics GmbH, Rudower Chaussee 46, 12489 Berlin, Germany.
- Laboratory of Multivariate Analysis and Global Modeling, Samara State Technical University, Molodogvardeyskaya 244, 443100 Samara, Russia.
| | - Urszula Zabarylo
- Art Photonics GmbH, Rudower Chaussee 46, 12489 Berlin, Germany.
- Medical Physics & Optical Diagnostics, CC6 Campus Benjamin Franklin, Charité Universitätsmedizin Berlin, Hindenburgdamm 30, 12203 Berlin, Germany.
| | - Dmitry Kirsanov
- Institute of Chemistry, St. Petersburg State University, Universitetskaya nab. 7/9, 199034 St. Petersburg, Russia.
| | - Valeria Belikova
- Laboratory of Multivariate Analysis and Global Modeling, Samara State Technical University, Molodogvardeyskaya 244, 443100 Samara, Russia.
| | - Vladimir Ageev
- Art Photonics GmbH, Rudower Chaussee 46, 12489 Berlin, Germany.
| | - Iskander Usenov
- Art Photonics GmbH, Rudower Chaussee 46, 12489 Berlin, Germany.
- Institute of Optics and Atomic Physics, Technical University of Berlin, Straße des 17. Juni 135, 10623 Berlin, Germany.
| | - Vladislav Galyanin
- Laboratory of Multivariate Analysis and Global Modeling, Samara State Technical University, Molodogvardeyskaya 244, 443100 Samara, Russia.
| | - Olaf Minet
- Medical Physics & Optical Diagnostics, CC6 Campus Benjamin Franklin, Charité Universitätsmedizin Berlin, Hindenburgdamm 30, 12203 Berlin, Germany.
| | - Tatiana Sakharova
- General Physics Institute of Russian Academy of Sciences, Vavilova 38, 119991 Moscow, Russia.
| | - Georgy Danielyan
- General Physics Institute of Russian Academy of Sciences, Vavilova 38, 119991 Moscow, Russia.
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Stelzle F, Rohde M, Riemann M, Oetter N, Adler W, Tangermann-Gerk K, Schmidt M, Knipfer C. Autofluorescence spectroscopy for nerve-sparing laser surgery of the head and neck-the influence of laser-tissue interaction. Lasers Med Sci 2017; 32:1289-1300. [PMID: 28551764 DOI: 10.1007/s10103-017-2240-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2016] [Accepted: 05/18/2017] [Indexed: 11/30/2022]
Abstract
The use of remote optical feedback systems represents a promising approach for minimally invasive, nerve-sparing laser surgery. Autofluorescence properties can be exploited for a fast, robust identification of nervous tissue. With regard to the crucial step towards clinical application, the impact of laser ablation on optical properties in the vicinity of structures of the head and neck has not been investigated up to now. We acquired 24,298 autofluorescence spectra from 135 tissue samples (nine ex vivo tissue types from 15 bisected pig heads) both before and after ER:YAG laser ablation. Sensitivities, specificities, and area under curve(AUC) values for each tissue pair as well as the confusion matrix were statistically calculated for pre-ablation and post-ablation autofluorescence spectra using principal component analysis (PCA), quadratic discriminant analysis (QDA), and receiver operating characteristics (ROC). The confusion matrix indicated a highly successful tissue discrimination rate before laser exposure, with an average classification error of 5.2%. The clinically relevant tissue pairs nerve/cancellous bone and nerve/salivary gland yielded an AUC of 100% each. After laser ablation, tissue discrimination was feasible with an average classification accuracy of 92.1% (average classification error 7.9%). The identification of nerve versus cancellous bone and salivary gland performed very well with an AUC of 100 and 99%, respectively. Nerve-sparing laser surgery in the area of the head and neck by means of an autofluorescence-based feedback system is feasible even after ER-YAG laser-tissue interactions. These results represent a crucial step for the development of a clinically applicable feedback tool for laser surgery interventions in the oral and maxillofacial region.
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Affiliation(s)
- Florian Stelzle
- Department of Oral and Maxillofacial Surgery, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), University Hospital Erlangen, Glückstraße 11, 91054, Erlangen, Germany.,Graduate School in Advanced Optical Technologies (SAOT), Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Paul-Gordan-Str. 6, 91052, Erlangen, Germany
| | - Maximilian Rohde
- Department of Oral and Maxillofacial Surgery, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), University Hospital Erlangen, Glückstraße 11, 91054, Erlangen, Germany.,Graduate School in Advanced Optical Technologies (SAOT), Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Paul-Gordan-Str. 6, 91052, Erlangen, Germany
| | - Max Riemann
- Department of Oral and Maxillofacial Surgery, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), University Hospital Erlangen, Glückstraße 11, 91054, Erlangen, Germany
| | - Nicolai Oetter
- Department of Oral and Maxillofacial Surgery, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), University Hospital Erlangen, Glückstraße 11, 91054, Erlangen, Germany
| | - Werner Adler
- Department of Medical Informatics, Biometry and Epidemiology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Waldstraße 6, 91054, Erlangen, Germany
| | | | - Michael Schmidt
- Graduate School in Advanced Optical Technologies (SAOT), Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Paul-Gordan-Str. 6, 91052, Erlangen, Germany.,Bavarian Laser Center GmbH (blz), Konrad-Zuse-Straße 2-6, 91054, Erlangen, Germany.,Institute of Photonic Technologies, Friedrich-Alexander-University Erlangen-Nürnberg(FAU), Konrad-Zuse-Straße 3-5, 91052, Erlangen, Germany
| | - Christian Knipfer
- Graduate School in Advanced Optical Technologies (SAOT), Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Paul-Gordan-Str. 6, 91052, Erlangen, Germany. .,Department of Oral and Maxillofacial Surgery, University of Hamburg (UHH), University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany.
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8
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Shadfan A, Darwiche H, Blanco J, Gillenwater A, Richards-Kortum R, Tkaczyk TS. Development of a multimodal foveated endomicroscope for the detection of oral cancer. BIOMEDICAL OPTICS EXPRESS 2017; 8:1525-1535. [PMID: 28663847 PMCID: PMC5480562 DOI: 10.1364/boe.8.001525] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Revised: 02/06/2017] [Accepted: 02/06/2017] [Indexed: 05/11/2023]
Abstract
A multimodal endomicroscope was developed for cancer detection that combines hyperspectral and confocal imaging through a single foveated objective and a vibrating optical fiber bundle. Standard clinical examination has a limited ability to identify early stage oral cancer. Optical detection methods are typically restricted by either achievable resolution or a small field-of-view. By combining high resolution and widefield spectral imaging into a single probe, a device was developed that provides spectral and spatial information over a 5 mm field to locate suspicious lesions that can then be inspected in high resolution mode. The device was evaluated on ex vivo biopsies of human oral tumors.
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Affiliation(s)
- Adam Shadfan
- Rice University, Bioengineering Department, 6100 Main Street, Houston, TX 77005, USA
| | - Hawraa Darwiche
- Department of Head and Neck Surgery, University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, USA
| | - Jesus Blanco
- Department of Head and Neck Surgery, University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, USA
| | - Ann Gillenwater
- Department of Head and Neck Surgery, University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, USA
| | | | - Tomasz S. Tkaczyk
- Rice University, Bioengineering Department, 6100 Main Street, Houston, TX 77005, USA
- Rice University, Electrical and Computer Engineering, 6100 Main Street, Houston, TX 77005, USA
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Shaikh R, Prabitha VG, Dora TK, Chopra S, Maheshwari A, Deodhar K, Rekhi B, Sukumar N, Krishna CM, Subhash N. A comparative evaluation of diffuse reflectance and Raman spectroscopy in the detection of cervical cancer. JOURNAL OF BIOPHOTONICS 2017; 10:242-252. [PMID: 26929106 DOI: 10.1002/jbio.201500248] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2015] [Revised: 01/13/2016] [Accepted: 01/25/2016] [Indexed: 05/09/2023]
Abstract
Optical spectroscopic techniques show improved diagnostic accuracy for non-invasive detection of cervical cancers. In this study, sensitivity and specificity of two in vivo modalities, i.e diffuse reflectance spectroscopy (DRS) and Raman spectroscopy (RS), were compared by utilizing spectra recorded from the same sites (67 tumor (T), 22 normal cervix (C), and 57 normal vagina (V)). Data was analysed using principal component - linear discriminant analysis (PC-LDA), and validated using leave-one-out-cross-validation (LOOCV). Sensitivity, specificity, positive predictive value and negative predictive value for classification between normal (N) and tumor (T) sites were 91%, 96%, 95% and 93%, respectively for RS and 85%, 95%, 93% and 88%, respectively for DRS. Even though DRS revealed slightly lower diagnostic accuracies, owing to its lower cost and portability, it was found to be more suited for cervical cancer screening in low resource settings. On the other hand, RS based devices could be ideal for screening patients with centralised facilities in developing countries.
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Affiliation(s)
- Rubina Shaikh
- Chilakapati Laboratory, ACTREC, Kharghar, Navi Mumbai, 410210, India
| | - Vasumathi G Prabitha
- Biophotonics Laboratory, National Centre for Earth Science Studies, Akkulam, Thiruvananthapuram, 695 031, Kerala, India
| | - Tapas Kumar Dora
- Tata Memorial Center, Radiation Oncology, ACTREC, Kharghar, Navi Mumbai, 410210, India
| | - Supriya Chopra
- Tata Memorial Center, Radiation Oncology, ACTREC, Kharghar, Navi Mumbai, 410210, India
| | - Amita Maheshwari
- Tata Memorial Hospital, Gynecology Oncology, Parel, Mumbai, 400012, India
| | - Kedar Deodhar
- Tata Memorial Hospital, Surgical Pathology, Cytopathology, Parel, Mumbai, 400012, India
| | - Bharat Rekhi
- Tata Memorial Hospital, Surgical Pathology, Cytopathology, Parel, Mumbai, 400012, India
| | - Nita Sukumar
- Biophotonics Laboratory, National Centre for Earth Science Studies, Akkulam, Thiruvananthapuram, 695 031, Kerala, India
| | - C Murali Krishna
- Chilakapati Laboratory, ACTREC, Kharghar, Navi Mumbai, 410210, India
| | - Narayanan Subhash
- Sascan Meditech Pvt Ltd, Centre for Innovation in Medical Electronics, BMS College of Engineering, Basavanagudi, Bangalore, 560019, India
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10
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Dinish US, Wong CL, Sriram S, Ong WK, Balasundaram G, Sugii S, Olivo M. Diffuse Optical Spectroscopy and Imaging to Detect and Quantify Adipose Tissue Browning. Sci Rep 2017; 7:41357. [PMID: 28145475 PMCID: PMC5286412 DOI: 10.1038/srep41357] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Accepted: 12/20/2016] [Indexed: 02/08/2023] Open
Abstract
Adipose (fat) tissue is a complex metabolic organ that is highly active and essential. In contrast to white adipose tissue (WAT), brown adipose tissue (BAT) is deemed metabolically beneficial because of its ability to burn calories through heat production. The conversion of WAT-resident adipocytes to “beige” or “brown-like” adipocytes has recently attracted attention. However, it typically takes a few days to analyze and confirm this browning of WAT through conventional molecular, biochemical, or histological methods. Moreover, accurate quantification of the overall browning process is not possible by any of these methods. In this context, we report the novel application of diffuse reflectance spectroscopy (DRS) and multispectral imaging (MSI) to detect and quantify the browning process in mice. We successfully demonstrated the time-dependent increase in browning of WAT, following its induction through β-adrenergic agonist injections. The results from these optical techniques were confirmed with those of standard molecular and biochemical assays, which measure gene and protein expression levels of UCP1 and PGC-1α, as well as with histological examinations. We envision that the reported optical methods can be developed into a fast, real time, cost effective and easy to implement imaging approach for quantification of the browning process in adipose tissue.
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Affiliation(s)
- U S Dinish
- Bio Optical Imaging Group, Singapore Bioimaging Consortium, Agency for Science Technology and Research (A*STAR), Singapore
| | - Chi Lok Wong
- Bio Optical Imaging Group, Singapore Bioimaging Consortium, Agency for Science Technology and Research (A*STAR), Singapore
| | - Sandhya Sriram
- Fat Metabolism and Stem Cell Group, Singapore Bioimaging Consortium, Agency for Science Technology and Research (A*STAR), Singapore
| | - Wee Kiat Ong
- Fat Metabolism and Stem Cell Group, Singapore Bioimaging Consortium, Agency for Science Technology and Research (A*STAR), Singapore
| | - Ghayathri Balasundaram
- Bio Optical Imaging Group, Singapore Bioimaging Consortium, Agency for Science Technology and Research (A*STAR), Singapore
| | - Shigeki Sugii
- Fat Metabolism and Stem Cell Group, Singapore Bioimaging Consortium, Agency for Science Technology and Research (A*STAR), Singapore.,Cardiovascular and Metabolic Disorders Program, Duke-NUS Medical School, Singapore
| | - Malini Olivo
- Bio Optical Imaging Group, Singapore Bioimaging Consortium, Agency for Science Technology and Research (A*STAR), Singapore.,School of Physics, National University of Ireland Galway, Ireland
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11
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Abookasis D, Volkov B, Shochat A, Kofman I. Noninvasive assessment of hemodynamic and brain metabolism parameters following closed head injury in a mouse model by comparative diffuse optical reflectance approaches. NEUROPHOTONICS 2016; 3:025003. [PMID: 27175372 PMCID: PMC4860005 DOI: 10.1117/1.nph.3.2.025003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Accepted: 04/12/2016] [Indexed: 05/03/2023]
Abstract
Optical techniques have gained substantial interest over the past four decades for biomedical imaging due to their unique advantages, which may suggest their use as alternatives to conventional methodologies. Several optical techniques have been successfully adapted to clinical practice and biomedical research to monitor tissue structure and function in both humans and animal models. This paper reviews the analysis of the optical properties of brain tissue in the wavelength range between 500 and 1000 nm by three different diffuse optical reflectance methods: spatially modulated illumination, orthogonal diffuse light spectroscopy, and dual-wavelength laser speckle imaging, to monitor changes in brain tissue morphology, chromophore content, and metabolism following head injury. After induction of closed head injury upon anesthetized mice by weight-drop method, significant changes in hemoglobin oxygen saturation, blood flow, and metabolism were readily detectible by all three optical setups, up to 1 h post-trauma. Furthermore, the experimental results clearly demonstrate the feasibility and reliability of the three methodologies, and the differences between the system performances and capabilities are also discussed. The long-term goal of this line of study is to combine these optical systems to study brain pathophysiology in high spatiotemporal resolution using additional models of brain trauma. Such combined use of complementary algorithms should fill the gaps in each system's capabilities, toward the development of a noninvasive, quantitative tool to expand our knowledge of the principles underlying brain function following trauma, and to monitor the efficacy of therapeutic interventions in the clinic.
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Affiliation(s)
- David Abookasis
- Ariel University, Department of Electrical and Electronics Engineering, Ariel 40700, Israel
- Address all correspondence to: David Abookasis, E-mail:
| | - Boris Volkov
- Ariel University, Department of Electrical and Electronics Engineering, Ariel 40700, Israel
| | - Ariel Shochat
- Ariel University, Department of Electrical and Electronics Engineering, Ariel 40700, Israel
| | - Itamar Kofman
- Ariel University, Department of Electrical and Electronics Engineering, Ariel 40700, Israel
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12
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Liu D, Zhao X, Zeng X, Dan H, Chen Q. Non-Invasive Techniques for Detection and Diagnosis of Oral Potentially Malignant Disorders. TOHOKU J EXP MED 2016; 238:165-77. [PMID: 26888696 DOI: 10.1620/tjem.238.165] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Dongjuan Liu
- State Key Laboratory of Oral Diseases, West China College of Stomatology, Sichuan University
| | - Xin Zhao
- State Key Laboratory of Oral Diseases, West China College of Stomatology, Sichuan University
| | - Xin Zeng
- State Key Laboratory of Oral Diseases, West China College of Stomatology, Sichuan University
| | - Hongxia Dan
- State Key Laboratory of Oral Diseases, West China College of Stomatology, Sichuan University
| | - Qianming Chen
- State Key Laboratory of Oral Diseases, West China College of Stomatology, Sichuan University
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13
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Macey R, Walsh T, Brocklehurst P, Kerr AR, Liu JLY, Lingen MW, Ogden GR, Warnakulasuriya S, Scully C. Diagnostic tests for oral cancer and potentially malignant disorders in patients presenting with clinically evident lesions. Cochrane Database Syst Rev 2015; 2015:CD010276. [PMID: 26021841 PMCID: PMC7087440 DOI: 10.1002/14651858.cd010276.pub2] [Citation(s) in RCA: 67] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Oral squamous cell carcinoma is the most common form of malignancy of the lip and oral cavity, often being proceeded by potentially malignant disorders (PMD). Early detection can reduce the malignant transformation of PMD and can improve the survival rate for oral cancer. The current standard of scalpel biopsy with histology is painful for patients and involves a delay whilst histology is completed; other tests are available that are unobtrusive and provide immediate results. OBJECTIVES PRIMARY OBJECTIVE To estimate the diagnostic accuracy of index tests for the detection of oral cancer and PMD of the lip and oral cavity, in people presenting with clinically evident lesions. SECONDARY OBJECTIVE To estimate the relative accuracy of the different index tests. SEARCH METHODS The electronic databases were searched on 30 April 2013. We searched MEDLINE (OVID) (1946 to April 2013) and four other electronic databases (the Cochrane Diagnostic Test Accuracy Studies Register, the Cochrane Oral Health Group's Trials Register, EMBASE (OVID) and MEDION (Ovid)). There were no restrictions on language in the searches of the electronic databases. We conducted citation searches and screened reference lists of included studies for additional references. SELECTION CRITERIA We selected studies that reported the diagnostic test accuracy of the following index tests when used as an adjunct to conventional oral examination in detecting PMD or oral squamous cell carcinoma of the lip or oral cavity: vital staining, oral cytology, light-based detection and oral spectroscopy, blood or saliva analysis (which test for the presence of biomarkers in blood or saliva). DATA COLLECTION AND ANALYSIS Two review authors independently screened titles and abstracts for relevance. Eligibility, data extraction and quality assessment were carried out by at least two authors, independently and in duplicate. Studies were assessed for methodological quality using QUADAS-2. Meta-analysis was used to combine the results of studies for each index test using the bivariate approach to estimate the expected values of sensitivity and specificity. MAIN RESULTS We included 41 studies, recruiting 4002 participants, in this review. These studies evaluated the diagnostic accuracy of conventional oral examination with: vital staining (14 studies), oral cytology (13 studies), light-based detection or oral spectroscopy (13 studies). Six studies assessed two combined index tests. There were no eligible diagnostic accuracy studies evaluating blood or salivary sample analysis.The summary estimates for vital staining obtained from the meta-analysis were sensitivity of 0.84 (95% CI 0.74 to 0.90) with specificity of 0.70 (0.59 to 0.79), with 14 studies were included in the meta-analysis. For cytology, sensitivity was 0.91 (0.81 to 0.96) and specificity was 0.91 (0.81 to 0.95) with 12 studies included in the meta-analysis. For light-based detection, sensitivity was 0.91 (0.77 to 0.97) and specificity was 0.58 (0.22 to 0.87) with 11 studies included in the meta-analysis. The relative test accuracy was assessed by adding covariates to the bivariate analysis, no difference in model fit was observed. AUTHORS' CONCLUSIONS The overall quality of the included studies was poor. None of the adjunctive tests can be recommended as a replacement for the currently used standard of a scalpel biopsy and histological assessment. Given the relatively high values of the summary estimates of sensitivity and specificity for cytology, this would appear to offer the most potential. Combined adjunctive tests involving cytology warrant further investigation.
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Affiliation(s)
- Richard Macey
- School of Dentistry, The University of ManchesterCoupland 3 BuildingOxford RoadManchesterUKM13 9PL
| | - Tanya Walsh
- School of Dentistry, The University of ManchesterCoupland 3 BuildingOxford RoadManchesterUKM13 9PL
| | - Paul Brocklehurst
- Bangor UniversityNWORTH CTUY Wern (Normal Site)Holyhead RoadBangorUKLL57 2PZ
| | - Alexander R Kerr
- New York University College of DentistryDepartment of Oral and Maxillofacial Pathology, Radiology and Medicine345 East 24th StreetSchwartz BuildingNew YorkUSA10010
| | - Joseph LY Liu
- Scottish Dental Clinical Effectiveness Programme, NHS Education for ScotlandUniversity of Dundee, Dental Health Services Research UnitFrankland Building, Small's WyndDundeeUKDD1 4HN
| | - Mark W Lingen
- University of ChicagoPritzker School of Medicine, Division of Biological Sciences, Department of Pathology5841 South Maryland AvenueChicagoIllinoisUSA60637‐1470
| | - Graham R Ogden
- University of DundeeDivision of Oral and Maxillofacial Clinical Sciences, School of DentistryPark PlaceDundeeScotlandUKDD1 4HR
| | - Saman Warnakulasuriya
- King's College LondonClinical and Diagnostic SciencesBessemer RoadDenmark Hill CampusLondonUKSE5 9RW
| | - Crispian Scully
- University College London256 Gray's Inn RoadLondonUKWC1X 8LD
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14
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Hu F, Vishwanath K, Beumer HW, Puscas L, Afshari HR, Esclamado RM, Scher R, Fisher S, Lo J, Mulvey C, Ramanujam N, Lee WT. Assessment of the sensitivity and specificity of tissue-specific-based and anatomical-based optical biomarkers for rapid detection of human head and neck squamous cell carcinoma. Oral Oncol 2014; 50:848-856. [PMID: 25037162 DOI: 10.1016/j.oraloncology.2014.06.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2013] [Revised: 05/22/2014] [Accepted: 06/19/2014] [Indexed: 11/29/2022]
Abstract
OBJECTIVES We propose the use of morphological optical biomarkers for rapid detection of human head and neck squamous cell carcinoma (HNSCC) by leveraging the underlying tissue characteristics in aerodigestive tracts. MATERIALS AND METHODS Diffuse reflectance spectra were obtained from malignant and contra-lateral normal tissues of 57 patients undergoing panendoscopy and biopsy. Oxygen saturation, total hemoglobin concentration, and the reduced scattering coefficient were extracted. Differences in malignant and normal tissues were examined based on two different groupings: anatomical site and morphological tissue type. RESULTS AND CONCLUSIONS Measurements were acquired from 252 sites, of which 51 were pathologically classified as SCC. Optical biomarkers exhibited statistical differences between malignant and normal samples. Contrast was enhanced when parsing tissues by morphological classification rather than anatomical subtype for unpaired comparisons. Corresponding linear discriminant models using multiple optical biomarkers showed improved predictive ability when accounting for morphological classification, particularly in node-positive lesions. The false-positive rate was retrospectively found to decrease by 34.2% in morphologically- vs. anatomically-derived predictive models. In glottic tissue, the surgeon exhibited a false-positive rate of 45.7% while the device showed a lower false-positive rate of 12.4%. Additionally, comparisons of optical parameters were made to further understand the physiology of tumor staging and potential causes of high surgeon false-positive rates. Optical spectroscopy is a user-friendly, non-invasive tool capable of providing quantitative information to discriminate malignant from normal head and neck tissues. Predictive models demonstrated promising results for real-time diagnostics. Furthermore, the strategy described appears to be well suited to reduce the clinical false-positive rate.
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Affiliation(s)
- Fangyao Hu
- Duke University, Biomedical Engineering Department, Durham, NC, USA
| | | | - H Wolfgang Beumer
- Division of Otolaryngology - Head and Neck Surgery, Duke University Medical Center, Durham, NC, USA
| | - Liana Puscas
- Division of Otolaryngology - Head and Neck Surgery, Duke University Medical Center, Durham, NC, USA.,Section of Otolaryngology - Head and Neck Surgery, Durham Veterans Administration Medical Center, Durham, NC, USA
| | - Hamid R Afshari
- Dental Service, Durham Veterans Administration Medical Center, Durham, NC, USA
| | - Ramon M Esclamado
- Division of Otolaryngology - Head and Neck Surgery, Duke University Medical Center, Durham, NC, USA
| | - Richard Scher
- Division of Otolaryngology - Head and Neck Surgery, Duke University Medical Center, Durham, NC, USA
| | - Samuel Fisher
- Division of Otolaryngology - Head and Neck Surgery, Duke University Medical Center, Durham, NC, USA
| | - Justin Lo
- Duke University, Biomedical Engineering Department, Durham, NC, USA
| | - Christine Mulvey
- Duke University, Biomedical Engineering Department, Durham, NC, USA
| | | | - Walter T Lee
- Division of Otolaryngology - Head and Neck Surgery, Duke University Medical Center, Durham, NC, USA.,Section of Otolaryngology - Head and Neck Surgery, Durham Veterans Administration Medical Center, Durham, NC, USA
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15
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Fuller C, Camilon R, Nguyen S, Jennings J, Day T, Gillespie MB. Adjunctive diagnostic techniques for oral lesions of unknown malignant potential: Systematic review with meta-analysis. Head Neck 2014; 37:755-62. [PMID: 24596227 DOI: 10.1002/hed.23667] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2013] [Revised: 02/12/2014] [Accepted: 03/01/2014] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND The purpose of this study was to critically review the published evidence concerning adjunctive diagnostic techniques in the diagnosis of oral lesions of unknown malignant potential. METHODS We conducted a systematic literature review with meta-analysis using PubMed to search for articles published from June 1993 through June 2013 to identify prospective studies evaluating any diagnostic method, with tissue biopsy confirmation, in clinically evident oral lesions of unknown malignant potential. Aggregate weighted totals and SEs for true, false-positive, false-negative, and inadequate results were calculated and compared among subgroups. RESULTS Forty-eight articles satisfying inclusion criteria were identified. Twenty-five were included in quantitative synthesis. CONCLUSION Oral cytology holds higher diagnostic value than specialist's oral examination, which holds higher value than in vivo toluidine blue staining. This study does not support the use of computer-aided or liquid-based cytology. Future studies should be designed to test multiple methods in the same patient population to allow direct comparison among various techniques.
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Affiliation(s)
- Colin Fuller
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina
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16
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Stephen MM, Jayanthi JL, Unni NG, Kolady PE, Beena VT, Jeemon P, Subhash N. Diagnostic accuracy of diffuse reflectance imaging for early detection of pre-malignant and malignant changes in the oral cavity: a feasibility study. BMC Cancer 2013; 13:278. [PMID: 23738507 PMCID: PMC3679752 DOI: 10.1186/1471-2407-13-278] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2012] [Accepted: 05/30/2013] [Indexed: 11/27/2022] Open
Abstract
Background Diffusely reflected light is influenced by cytologic and morphologic changes that take place during tissue transformation, such as, nuclear changes, extracellular matrix structure and composition as well as blood flow. Albeit with varying degree of sensitivity and specificity, the properties of diffusely reflected light in discriminating a variety of oral lesions have been demonstrated by our group in multiple studies using point monitoring systems. However, the point monitoring system could not identify the region with the most malignant potential in a single sitting. Methods In order to scan the entire lesion, we developed a multi-spectral imaging camera system that records diffuse reflectance (DR) images of the oral lesion at 545 and 575 nm with white light illumination. The diagnostic accuracy of the system for 2-dimensional DR imaging of pre-malignant and malignant changes in the oral cavity was evaluated through a clinical study in 55 patients and 23 healthy volunteers. The DR imaging data were compared with gold standard tissue biopsy and histopathology results. Results In total 106- normal/clinically healthy sites, 20- pre-malignant and 29- malignant (SCC) sites were compared. While the median pixel value of the R545/R575 image ratio for normal/clinically healthy tissue was 0.87 (IQR = 0.82-0.94), they were 1.35 (IQR = 1.13-1.67) and 2.44 (IQR = 1.78-3.80) for pre-malignant and malignant lesions, respectively. Area under the ROC curve to differentiate malignant from normal/clinically healthy [AUC = 0.99 (95% CI: 0.99-1.00)], pre-malignant from normal/clinically healthy [AUC = 0.94 (95% CI: 0.86-1.00)], malignant from pre-malignant [AUC = 0.84 (95% CI: 0.73-0.95)] and pre-malignant and malignant from normal/clinically healthy [AUC = 0.97 (95% CI: 0.94-1.00)] lesions were desirable. Conclusion We find DR imaging to be very effective as a screening tool in locating the potentially malignant areas of oral lesions with relatively good diagnostic accuracy while comparing it to the gold standard histopathology.
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17
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Evers D, Nachabé R, Hompes D, van Coevorden F, Lucassen G, Hendriks B, van Velthuysen ML, Wesseling J, Ruers T. Optical sensing for tumor detection in the liver. Eur J Surg Oncol 2013; 39:68-75. [DOI: 10.1016/j.ejso.2012.08.005] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2012] [Revised: 07/25/2012] [Accepted: 08/13/2012] [Indexed: 12/14/2022] Open
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18
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Evers D, Hendriks B, Lucassen G, Ruers T. Optical spectroscopy: current advances and future applications in cancer diagnostics and therapy. Future Oncol 2012; 8:307-20. [PMID: 22409466 DOI: 10.2217/fon.12.15] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Optical spectroscopy (OS) is a tissue-sensing technique that could enhance cancer diagnosis and treatment in the near future. With OS, tissue is illuminated with a selected light spectrum. Different tissue types can be distinguished from each other based on specific changes in the reflected light spectrum that are a result of differences on a molecular level between compared tissues. Therefore, OS has the potential to become an important optical tool for cancer diagnosis and treatment monitoring. In recent years, significant progress has been made in the discriminating abilities of OS techniques between normal and cancer tissues of multiple human tissue types. This article provides an overview of the advances made with diffuse reflectance, fluorescence and Raman spectroscopy techniques in the field of clinical oncology, and focuses on the different clinical applications that OS could enhance.
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Affiliation(s)
- Dj Evers
- Department of Surgery, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands.
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19
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Sekhar PC, Betsy J, Presanthila J, Subhash N. Discrimination of periodontal diseases using diffuse reflectance spectral intensity ratios. JOURNAL OF BIOMEDICAL OPTICS 2012; 17:027001. [PMID: 22463048 DOI: 10.1117/1.jbo.17.2.027001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
This clinical study was to demonstrate the applicability of diffuse reflectance (DR) intensity ratio R620/R575 in the quantification and discrimination of periodontitis and gingivitis from healthy gingiva. DR spectral measurements were carried out with white-light illumination from 70 healthy sites in 30 healthy volunteers, and 63 gingivitis- and 58 periodontitis-infected sites in 60 patients. Clinical parameters such as probing pocket depth, clinical attachment level, and gingival index were recorded in patient population. Diagnostic accuracies for discrimination of gingivitis and periodontitis from healthy gingiva were determined by comparison of spectral signatures with clinical parameters. Divergence of average DR spectral intensity ratio between control and test groups was studied using analysis of variance. The mean DR spectrum on normalization at 620 nm showed marked differences between healthy tissue, gingivitis, and periodontitis. Hemoglobin concentration and apparent SO(2) (oxygen saturation) were also calculated for healthy, gingivitis, and periodontitis sites. DR spectral intensities at 545 and 575 nm showed a decreasing trend with progression of disease. Among the various DR intensity ratios studied, the R620/R575 ratio provided a sensitivity of 90% and specificity of 94% for discrimination of healthy tissues from gingivitis and a sensitivity of 91% and specificity of 100% for discrimination of gingivitis from periodontitis.
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Affiliation(s)
- Prasanth Chandra Sekhar
- Centre for Earth Science Studies, Biophotonics Laboratory, P. O. Box 7250, Thiruvananthapuram 695031, Kerala, India
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20
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Jayanthi JL, Subhash N, Stephen M, Philip EK, Beena VT. Comparative evaluation of the diagnostic performance of autofluorescence and diffuse reflectance in oral cancer detection: a clinical study. JOURNAL OF BIOPHOTONICS 2011; 4:696-706. [PMID: 21905236 DOI: 10.1002/jbio.201100037] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2011] [Revised: 07/28/2011] [Accepted: 08/22/2011] [Indexed: 05/31/2023]
Abstract
Autofluorescence (AF) and diffuse reflectance (DR) spectroscopic techniques have shown good diagnostic accuracies for noninvasive detection of oral cavity cancer. In the present study, AF and DR spectra recorded in vivo from the same set of sites in 65 patients were analyzed using Principal component analysis (PCA) and linear discriminant analysis (LDA). The effectiveness of these two techniques was assessed by comparison with gold standard and their discrimination efficiency was determined from the area under the receiver operator characteristic (AUC-ROC) curve. Analysis using a DR technique shows a higher AUC-ROC of 0.991 as against 0.987 for AF spectral data.
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Affiliation(s)
- Jayaraj L Jayanthi
- Biophotonics Laboratory, Centre for Earth Science Studies, Akkulam, Trivandrum, India
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21
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Jayanthi JL, Nisha GU, Manju S, Philip EK, Jeemon P, Baiju KV, Beena VT, Subhash N. Diffuse reflectance spectroscopy: diagnostic accuracy of a non-invasive screening technique for early detection of malignant changes in the oral cavity. BMJ Open 2011; 1:e000071. [PMID: 22021749 PMCID: PMC3191415 DOI: 10.1136/bmjopen-2011-000071] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Strong proof-of-principle for utilisation of diffuse reflectance spectroscopy, a non-invasive tool for early detection of malignant changes, has emerged recently. The potential of this technique in distinguishing normal tissue from hyperplastic and dysplastic tissues was explored. METHODS Diffuse reflectance (DR) spectra in the 400-700 nm region were obtained from the buccal mucosa of 96 patients and 34 healthy volunteers. The DR spectral data were compared against the gold standard biopsy and histopathology results. A principal-component analysis was performed for dimensional reduction in the normalised spectral data with linear discriminant analysis as the classifying technique. The receiver operator characteristic curve technique was employed for evaluating the performance of the diagnostic test. RESULTS DR spectral features for different lesions, such as normal/healthy, hyperplastic, dysplastic and squamous cell carcinoma (SCC), varied significantly according to the intensity of oxygenated haemoglobin absorption. While the classification based on discriminant scores provided an overall sensitivity of 98.5% and specificity of 96.0% for distinguishing SCC from dysplasia, they were 100.0% and 95.0%, respectively, for distinguishing dysplasia from hyperplasia. Similarly, the analysis yielded a sensitivity of 95.0% and specificity of 100.0% for distinguishing hyperplasia from healthy tissue. The areas under the receiver operator characteristic curves were 0.98 (95% CI 0.95 to 1.00) and 0.95 (95% CI 0.90 to 1.00) for distinguishing dysplasia from SCC and hyperplasia from dysplasia, respectively. CONCLUSION DR spectral data efficiently discriminate healthy tissue from oral malignant lesions. Diagnostic accuracies obtained in this study highlight the potential use of this method for routine clinical practice.
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Affiliation(s)
- J L Jayanthi
- Biophotonics Laboratory, Centre for Earth Science Studies, Akkulam, Trivandrum, India
| | - G U Nisha
- Biophotonics Laboratory, Centre for Earth Science Studies, Akkulam, Trivandrum, India
| | - S Manju
- Department of Oral & Maxillofacial Pathology, Government Dental College, Trivandrum, India
| | - E K Philip
- Department of Oral & Maxillofacial Pathology, Government Dental College, Trivandrum, India
| | - P Jeemon
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - K V Baiju
- Department of Statistics, Sree Narayana College, Chempazhanthy, Trivandrum, India
| | - V T Beena
- Department of Oral & Maxillofacial Pathology, Government Dental College, Trivandrum, India
| | - N Subhash
- Biophotonics Laboratory, Centre for Earth Science Studies, Akkulam, Trivandrum, India
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22
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Stelzle F, Zam A, Adler W, Tangermann-Gerk K, Douplik A, Nkenke E, Schmidt M. Optical nerve detection by diffuse reflectance spectroscopy for feedback controlled oral and maxillofacial laser surgery. J Transl Med 2011; 9:20. [PMID: 21310023 PMCID: PMC3042403 DOI: 10.1186/1479-5876-9-20] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2010] [Accepted: 02/10/2011] [Indexed: 11/29/2022] Open
Abstract
Background Laser surgery lacks haptic feedback, which is accompanied by the risk of iatrogenic nerve damage. It was the aim of this study to investigate diffuse reflectance spectroscopy for tissue differentiation as the base of a feedback control system to enhance nerve preservation in oral and maxillofacial laser surgery. Methods Diffuse reflectance spectra of nerve tissue, salivary gland and bone (8640 spectra) of the mid-facial region of ex vivo domestic pigs were acquired in the wavelength range of 350-650 nm. Tissue differentiation was performed using principal component (PC) analysis followed by linear discriminant analysis (LDA). Specificity and sensitivity were calculated using receiver operating characteristic (ROC) analysis and the area under curve (AUC). Results Five PCs were found to be adequate for tissue differentiation with diffuse reflectance spectra using LDA. Nerve tissue could be differed from bone as well as from salivary gland with AUC results of greater than 88%, sensitivity of greater than 83% and specificity in excess of 78%. Conclusions Diffuse reflectance spectroscopy is an adequate technique for nerve identification in the vicinity of bone and salivary gland. The results set the basis for a feedback system to prevent iatrogenic nerve damage when performing oral and maxillofacial laser surgery.
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Affiliation(s)
- Florian Stelzle
- Department of Oral and Maxillofacial Surgery, Erlangen University Hospital, Erlangen, Germany.
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23
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van Brakel R, Noordmans HJ, Frenken J, de Roode R, de Wit GC, Cune MS. The effect of zirconia and titanium implant abutments on light reflection of the supporting soft tissues. Clin Oral Implants Res 2011; 22:1172-1178. [PMID: 21251080 DOI: 10.1111/j.1600-0501.2010.02082.x] [Citation(s) in RCA: 86] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To determine the difference in light reflection of oral mucosa covering titanium (Ti) or zirconia (ZrO(2)) abutments as it relates to the thickness of the covering mucosa. MATERIAL AND METHODS Fifteen anterior implants (Astra Osseo speed(®)) in 11 patients were fitted with a Ti or a ZrO(2) abutment (cross-over, within-subject comparison). Hyper-spectral images were taken with a camera fitted on a surgical microscope. High-resolution images with 70 nm interval between 440 and 720 nm were obtained within 30 s (1392 × 1024 pixels). Black- and white-point reference was used for spatial and spectral normalization as well as correction for motion during exposure. Reflection spectra were extracted from the image on a line mid-buccal of the implant, starting 1 mm above the soft tissue continuing up to 3 mm apically. RESULTS Median soft tissue height is 2.3 mm (min: 1.2 mm and max: 3.1 mm). The buccal mucosa rapidly increases in the thickness, when moving apically. At 2.2 mm, thickness is 3 mm. No perceivable difference between the Ti and ZrO(2) abutment can be observed when the thickness of the mucosa is 2±0.1 mm (95% confidence interval) or more. CONCLUSION It is expected that the difference in light reflection of soft tissue covering Ti or ZrO(2) abutments is no longer noticeable for the human eye when the mucosa thickness exceeds 2 mm. Haemoglobin peaks in the reflection spectrum can be observed and make hyper-spectral imaging a practical and useful tool for measuring soft tissue health.
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Affiliation(s)
- Ralph van Brakel
- Department of Oral-Maxillofacial Surgery, Prosthodontics and Special Dental Care, University Medical Centre, Utrecht, The NetherlandsDepartment of Medical Technology, University Medical Center, Utrecht, The NetherlandsDepartment of Oral-Maxillofacial Surgery, Prosthodontics and Special Dental Care, St Antonius Hospital, Nieuwegein, The NetherlandsBartiméus, Zeist, The NetherlandsDepartment of Fixed and Removable Prosthodontics, University Medical Center Groningen/Center for Dentistry and Oral Hygiene, Groningen, The Netherlands
| | - Herke Jan Noordmans
- Department of Oral-Maxillofacial Surgery, Prosthodontics and Special Dental Care, University Medical Centre, Utrecht, The NetherlandsDepartment of Medical Technology, University Medical Center, Utrecht, The NetherlandsDepartment of Oral-Maxillofacial Surgery, Prosthodontics and Special Dental Care, St Antonius Hospital, Nieuwegein, The NetherlandsBartiméus, Zeist, The NetherlandsDepartment of Fixed and Removable Prosthodontics, University Medical Center Groningen/Center for Dentistry and Oral Hygiene, Groningen, The Netherlands
| | - Joost Frenken
- Department of Oral-Maxillofacial Surgery, Prosthodontics and Special Dental Care, University Medical Centre, Utrecht, The NetherlandsDepartment of Medical Technology, University Medical Center, Utrecht, The NetherlandsDepartment of Oral-Maxillofacial Surgery, Prosthodontics and Special Dental Care, St Antonius Hospital, Nieuwegein, The NetherlandsBartiméus, Zeist, The NetherlandsDepartment of Fixed and Removable Prosthodontics, University Medical Center Groningen/Center for Dentistry and Oral Hygiene, Groningen, The Netherlands
| | - Rowland de Roode
- Department of Oral-Maxillofacial Surgery, Prosthodontics and Special Dental Care, University Medical Centre, Utrecht, The NetherlandsDepartment of Medical Technology, University Medical Center, Utrecht, The NetherlandsDepartment of Oral-Maxillofacial Surgery, Prosthodontics and Special Dental Care, St Antonius Hospital, Nieuwegein, The NetherlandsBartiméus, Zeist, The NetherlandsDepartment of Fixed and Removable Prosthodontics, University Medical Center Groningen/Center for Dentistry and Oral Hygiene, Groningen, The Netherlands
| | - Gerard C de Wit
- Department of Oral-Maxillofacial Surgery, Prosthodontics and Special Dental Care, University Medical Centre, Utrecht, The NetherlandsDepartment of Medical Technology, University Medical Center, Utrecht, The NetherlandsDepartment of Oral-Maxillofacial Surgery, Prosthodontics and Special Dental Care, St Antonius Hospital, Nieuwegein, The NetherlandsBartiméus, Zeist, The NetherlandsDepartment of Fixed and Removable Prosthodontics, University Medical Center Groningen/Center for Dentistry and Oral Hygiene, Groningen, The Netherlands
| | - Marco S Cune
- Department of Oral-Maxillofacial Surgery, Prosthodontics and Special Dental Care, University Medical Centre, Utrecht, The NetherlandsDepartment of Medical Technology, University Medical Center, Utrecht, The NetherlandsDepartment of Oral-Maxillofacial Surgery, Prosthodontics and Special Dental Care, St Antonius Hospital, Nieuwegein, The NetherlandsBartiméus, Zeist, The NetherlandsDepartment of Fixed and Removable Prosthodontics, University Medical Center Groningen/Center for Dentistry and Oral Hygiene, Groningen, The Netherlands
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