Abstract
Diffuse reflectance spectroscopy (DRS) with a fiber-optic probe can noninvasively quantify the optical properties of epithelial tissues and has shown the potential as a cost-effective, fast and sensitive tool for diagnosis of early precancerous changes in the cervix and oral cavity. However, current DRS systems are susceptible to several sources of systematic and random errors, such as uncontrolled probe-to-tissue pressure and lack of a real-time calibration that can significantly impair the measurement accuracy, reliability and validity of this technology as well as its clinical utility. In addition, such systems use bulky, high power and expensive optical components which impede their widespread use in low- and middle-income countries (LMICs) where epithelial cancer related death is disproportionately high. In this paper we report a portable, easy-to-use and low cost, yet accurate and reliable DRS device that can aid in the screening and diagnosis of oral and cervical cancer. The device uses an innovative smart fiber-optic probe to eliminate operator bias, state-of-the-art photonics components to reduce size and power consumption, and automated software to reduce the need of operator training. The device showed a mean error of 1.4 ± 0.5% and 6.8 ± 1.7% for extraction of phantom absorption and reduced scattering coefficients, respectively. A clinical study on healthy volunteers indicated that a pressure below 1.0 psi is desired for oral mucosal tissues to minimize the probe effects on tissue physiology and morphology.
Highlights
Numerous studies have shown that epithelial cancers, such as oral and cervical cancers, if detected at early stages, have a better chance of being successfully treated with surgery
In developing countries epithelial cancer related death is disproportionately high due to the absence of appropriate medical infrastructure and resources to support the organized screening and diagnostic programs that are available in the developed world
We describe a smart fiber-optic probe based on a portable Diffuse reflectance spectroscopy (DRS) instrument that extends the capability of the SC probe by integrating a diaphragmbased fiber-optic interferometric (DFPI) pressure sensor with the self-calibration probe to eliminate operator bias and to reduce size and power consumption as
Summary
Numerous studies have shown that epithelial cancers, such as oral and cervical cancers, if detected at early stages, have a better chance of being successfully treated with surgery,#201629 - $15.00 USD Received 20 Nov 2013; revised 1 Feb 2014; accepted 5 Feb 2014; published 10 Feb 2014 radiation, chemotherapy, or a combination of the three, significantly improving the survival rates [1,2,3,4,5,6,7,8]. Numerous studies have shown that epithelial cancers, such as oral and cervical cancers, if detected at early stages, have a better chance of being successfully treated with surgery,. DRS in the visible wavelength range is sensitive to the absorption and scattering properties of epithelial tissue and has shown promise for early diagnosis of cancers in the cervix and oral cavity [9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24]. The absorption and scattering coefficients of epithelial tissues reflect their underlying physiological and morphological properties [25]. Visible DRS has a penetration depth that can be tuned to be comparable to the thickness of the epithelial layer or deeper to probe both the epithelial and stromal layers [17, 25, 31]
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