In vivo optical coherence tomography for the diagnosis of oral malignancy

Petra Wilder‐Smith,Hamza Beydoun,Diana Messadi,Woong‐Gyu Jung,Kathryn Osann,Matthew Brenner,Zhongping Chen

doi:10.1002/lsm.20098

Abstract

Oral cancer results in 10,000 U.S. deaths annually. Improved highly sensitive diagnostics allowing early detection of oral cancer would benefit patient survival and quality of life. Objective was to investigate in vivo non-invasive optical coherence tomography (OCT) techniques for imaging and diagnosing neoplasia-related epithelial, sub-epithelial changes throughout carcinogenesis. In the standard hamster cheek pouch model for oral carcinogenesis (n = 36), in vivo OCT was used to image epithelial and sub-epithelial change. OCT- and histopathology-based diagnoses on a scale of 0 (healthy) to 6 (squamous cell carcinoma, SCC) were performed at all stages throughout carcinogenesis by two blinded investigators. Epithelial, sub-epithelial structures were clearly discernible using OCT. OCT diagnosis agreed with the histopathological gold standard in 80% of readings. In vivo OCT demonstrates excellent potential as a diagnostic tool in the oral cavity.

Highlights

According to the American Cancer Society, 1,220,100 patients were diagnosed with cancer in the year 2000
The in vivo optical coherence tomography (OCT) technology used in these investigations was able to image multiple epithelial and sub-epithelial layers throughout carcinogenesis in the hamster cheek pouch model (Figs. 3–5)
Sensitivity was excellent for the diagnosis of squamous cell carcinoma (SCC), and somewhat reduced for differentiating between different types of dysplasia

Summary

Introduction

According to the American Cancer Society, 1,220,100 patients were diagnosed with cancer in the year 2000. A modality for the direct, non-invasive early detection, diagnosis, and monitoring of oral dysplasia and malignancy and for the screening of high-risk populations is urgently required to identify treatment needs at early, more treatable stages of pathological development. Such multi-use clinical capabilities would be likely to produce a sharp drop in morbidity and mortality due to cancer, with substantial reductions in patient anxiety and suffering as well as treatment cost. Improved highly sensitive diagnostics allowing early detection of oral cancer would benefit patient survival and quality of life.

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Results

Conclusion