Two-channel autofluorescence analysis for oral cancer.

Dong-Yuan Wu,Chih-Yang Chen,Ming-Hsuan Chang,Jehn-Shyun Huang,Teng-Yi Huang,Wang-Ch Chen,Shoko Nioka,Pau-Choo Chung,Ken-Chung Chen,Yi-Chun Chen,Tze-Ta Huang,Tung-Yiu Wong

doi:10.1117/1.jbo.24.5.051402

Abstract

We created a two-channel autofluorescence test to detect oral cancer. The wavelengths 375 and 460nm, with filters of 479 and 525nm, were designed to excite and detect reduced-form nicotinamide adenine dinucleotide (NADH) and flavin adenine dinucleotide (FAD) autofluorescence. Patients with oral cancer or with precancerous lesions, and a control group with healthy oral mucosae, were enrolled. The lesion in the autofluorescent image was the region of interest. The average intensity and heterogeneity of the NADH and FAD were calculated. The redox ratio [(NADH)/(NADH + FAD)] was also computed. A quadratic discriminant analysis (QDA) was used to compute boundaries based on sensitivity and specificity. We analyzed 49 oral cancer lesions, 34 precancerous lesions, and 77 healthy oral mucosae. A boundary (sensitivity: 0.974 and specificity: 0.898) between the oral cancer lesions and healthy oral mucosae was validated. Oral cancer and precancerous lesions were also differentiated from healthy oral mucosae (sensitivity: 0.919 and specificity: 0.755). The two-channel autofluorescence detection device and analyses of the intensity and heterogeneity of NADH, and of FAD, and the redox ratio combined with a QDA classifier can differentiate oral cancer and precancerous lesions from healthy oral mucosae.

Highlights

Oral squamous cell carcinoma (OSCC) is the most common malignant disease of oral mucosae.[1]
We introduced using the standard deviation of the intensity of an autofluorescence image to determine the heterogeneity of a lesion.[7]
The redox ratio has always been difficult to verify because the NADH and flavin adenine dinucleotide (FAD) autofluorescence images must be taken at the same time

Summary

Introduction

Oral squamous cell carcinoma (OSCC) is the most common malignant disease of oral mucosae.[1] The average 5-year survival rate is ∼60%.2. The incidence and severity of OSCC are increasing worldwide, especially in Taiwan.[3] The diagnosis of oral cancer has relied heavily on lesion biopsies, which are time-consuming and uncomfortable for patients.[4] In view of these disadvantages, noninvasive oral cancer detection methods, such as a brush biopsy,[5] autofluorescence imaging,[6,7] and toluidine blue staining[8,9] have been used. The physician’s experience is critical when using current methods. Developing the visual detection of chemoluminescence and tissue fluorescence for diagnosing oral cancer might improve detection and allow us to earlier identify potentially malignant lesions.[7]

Methods

Results

Discussion

Conclusion