Detection and diagnosis of oral neoplasia with an optical coherence microscope

University of Texas at Austin, Department of Biomedical Engineering, Austin, Texas 78712, USA.
Journal of Biomedical Optics (Impact Factor: 2.86). 01/2004; 9(6):1271-80. DOI: 10.1117/1.1805558
Source: PubMed


The use of high resolution, in vivo optical imaging may offer a clinically useful adjunct to standard histopathologic techniques. A pilot study was performed to investigate the diagnostic capabilities of optical coherence microscopy (OCM) to discriminate between normal and abnormal oral tissue. Our objective is to determine whether OCM, a technique combining the subcellular resolution of confocal microscopy with the coherence gating and heterodyne detection of optical coherence tomography, has the same ability as confocal microscopy to detect morphological changes present in precancers of the epithelium while providing superior penetration depths. We report our results using OCM to characterize the features of normal and neoplastic oral mucosa excised from 13 subjects. Specifically, we use optical coherence and confocal microscopic images obtained from human oral biopsy specimens at various depths from the mucosal surface to examine the optical properties that distinguish normal and neoplastic oral mucosa. An analysis of penetration depths achieved by the OCM and its associated confocal arm found that the OCM consistently imaged more deeply. Extraction of scattering coefficients from reflected nuclear intensity is successful in nonhyperkeratotic layers and shows differentiation between scattering properties of normal and dysplastic epithelium and invasive cancer.

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Available from: Rebecca Kortum, Aug 06, 2014
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    • "In addition to the mapping of structural changes, OCT in Doppler mode, i.e., Optical Doppler Tomography, is also capable of quantifying the velocity of blood flow, particularly useful in detecting vascular changes associated with carcinogenesis [84]. With the extended numerical aperture and penetration depth of this OCT configuration, it is feasible to determine the scattering coefficient of the nucleus, which was found to increase as the normal cells progress to invasive cancer stage [83]. Later, in vivo 3-D OCT was available to visualize the detailed histological features of the oral lesions with an imaging depth down to 2–3 mm. "
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    ABSTRACT: Oral cancer is among the most common malignancies worldwide, therefore early detection and treatment is imperative. The 5-year survival rate has remained at a dismal 50% for the past several decades. The main reason for the poor survival rate is the fact that most of the oral cancers, despite the general accessibility of the oral cavity, are not diagnosed until the advanced stage. Early detection of the oral tumors and its precursor lesions may be the most effective means to improve clinical outcome and cure most patients. One of the emerging technologies is the use of non-invasive in vivo tissue imaging to capture the molecular changes at high-resolution to improve the detection capability of early stage disease. This review will discuss the use of optical probes and highlight the role of optical imaging such as autofluorescence, fluorescence diagnosis (FD), laser confocal endomicroscopy (LCE), surface enhanced Raman spectroscopy (SERS), optical coherence tomography (OCT) and confocal reflectance microscopy (CRM) in early oral cancer detection. FD is a promising method to differentiate cancerous lesions from benign, thus helping in the determination of adequate resolution of surgical resection margin. LCE offers in vivo cellular imaging of tissue structures from surface to subsurface layers and has demonstrated the potential to be used as a minimally invasive optical biopsy technique for early diagnosis of oral cancer lesions. SERS was able to differentiate between normal and oral cancer patients based on the spectra acquired from saliva of patients. OCT has been used to visualize the detailed histological features of the oral lesions with an imaging depth down to 2-3 mm. CRM is an optical tool to noninvasively image tissue with near histological resolution. These comprehensive diagnostic modalities can also be used to define surgical margin and to provide a direct assessment of the therapeutic effectiveness.
    Pharmaceutics 12/2011; 3(3):354-378. DOI:10.3390/pharmaceutics3030354
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    • "OCM is a closely related technique that uses low coherence interferometry in addition to a confocal pinhole to filter back scattered light [18]. OCM has an advantage in imaging depth [19], although both OCM and confocal reflectance microscopy generate images of tissue reflectance. As such, the NLOM-OCM system is shown to be sensitive to cornea anatomical structures and hydration state without using exogenous markers or labels. "
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    ABSTRACT: A combined nonlinear optical microscopy (NLOM) and optical coherence microscopy (OCM) imaging system has been assembled in order to simultaneously capture co-registered volumetric images of corneal morphology and biochemistry. Tracking of cell nuclei visible in the OCM volume enabled the calculation of strain depth profile in response to changes in intraocular pressure for rabbit cornea stroma. Results revealed nonlinear responses with a depth dependent strain distribution, exhibiting smaller strains in the anterior and larger strains in the posterior stroma. Cross-sectional images of collagen lamellae, visible in NLOM, showed inhomogeneous collagen structure along the anterior-posterior direction that correlated well with the noted heterogeneous corneal mechanical responses.
    Biomedical Optics Express 05/2011; 2(5):1135-46. DOI:10.1364/BOE.2.001135 · 3.65 Impact Factor
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    • "Furthermore, by scanning an en face image plane with the coherence and confocal gates matched, OCM does not suffer from depth-of-field limitations present in standard depth scanning OCT and can achieve micron scale transverse image resolutions. Cellular imaging in human tissue has been demonstrated with OCM [5–7]. OCM can achieve cellular imaging in scattering tissues with lower numerical aperture compared to confocal microscopy because axial sectioning is performed with a combination of coherence and confocal gating. "
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    ABSTRACT: Optical coherence microscopy (OCM) is a promising technique for high resolution cellular imaging in human tissues. An OCM system for high-speed en face cellular resolution imaging was developed at 1060 nm wavelength at frame rates up to 5 Hz with resolutions of < 4 microm axial and < 2 microm transverse. The system utilized a novel polarization compensation method to combat wavelength dependent source polarization and achieve broadband electro-optic phase modulation compatible with ultrahigh axial resolution. In addition, the system incorporated an auto-focusing feature that enables precise, near real-time alignment of the confocal and coherence gates in tissue, allowing user-friendly optimization of image quality during the imaging procedure. Ex vivo cellular images of human esophagus, colon, and cervix as well as in vivo results from human skin are presented. Finally, the system design is demonstrated with a miniaturized piezoelectric fiber-scanning probe which can be adapted for laparoscopic and endoscopic imaging applications.
    Optics Express 03/2010; 18(5):4222-39. DOI:10.1364/OE.18.004222 · 3.49 Impact Factor
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