Advances in fluorescence imaging techniques to detect oral cancer and its precursors

Rice University, Department of Bioengineering, 6500 Main St., Houston, TX 77030, USA.
Future Oncology (Impact Factor: 2.48). 07/2010; 6(7):1143-54. DOI: 10.2217/fon.10.79
Source: PubMed


Oral cancer is a significant health problem in the USA and throughout the world. Most oral cancer patients are diagnosed at a late stage, when treatment is less successful and treatment-associated morbidity is more severe. A number of new diagnostic aids to conventional oral examination have recently been introduced to assist in the early detection of oral neoplasia. In particular, autofluorescence imaging has emerged as a promising adjunctive technique to improve early identification of oral premalignant lesions. Direct visual inspection of tissue autofluorescence has shown encouraging results in high-prevalence populations, but the technique requires subjective interpretation and depends on the visual recognition skills of the examiner. Capturing and analyzing digital fluorescence images can reduce subjectivity and potentially improve sensitivity of detection of precancerous changes. Recent studies of wide-field autofluorescence imaging in low-prevalence populations suggest that benign lesions such as inflammation may give rise to false-positive results. High-resolution fluorescence imaging is a new modality that can be used in conjunction with wide-field imaging to improve specificity by imaging subcellular detail of neoplastic tissues. The combination of wide-field and high-resolution fluorescence imaging systems with automated image analysis should be investigated to maximize overall diagnostic performance for early detection of oral neoplasia.

Download full-text


Available from: Rebecca Kortum, Mar 07, 2014
  • Source
    • "only as an adjunct to conventional white light examination not as a ''stand alone'' tool, largely due to issues of specificity. In this context, the evolution of optical technology is ongoing with several modifications in development to improve both the diagnostic sensitivity and to reduce confounding associated with change in inflammatory conditions [34] [35] [36] [37]. These improvements, together with lowering costs of this technology, will further facilitate the use of these approaches in regular clinical practice. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Worldwide, oral cancer is responsible for 170,000 deaths per year. Intervention to prevent this disease is a long sought after goal. Chemoprevention studies have focused on clinicopathological features of potentially malignant lesions (PML) in an effort to prevent their progression to cancer. However, prediction of future behavior for such lesions is difficult and remains a major challenge to such intervention. Different approaches to this problem have been tested in the past 20years. Early genetic progression models identified critical regions of allelic imbalance at 3p and 9p, and provided the basis for molecular markers to identify progressing PMLs. Subsequently, technological advances, such as genome-wide high-throughput array platforms, computer imaging, visualization technology and next generation sequencing, have broadened the scope for marker development and have the potential of further improving our ability to identify high-risk lesions in the near future either alone or in combination. In this article, we examine the milestones in the development of markers for PML progression. We emphasize the critical importance of networks among scientists, health professionals and community to facilitate the validation and application of putative markers into clinical practice. With a growing number of new agents to validate, it is necessary to coordinate the design and implementation of strategies for patient recruitment, integration of marker assessment, and the final translation of such approaches into clinical use.
    Full-text · Article · Sep 2014 · Oral Oncology
  • [Show abstract] [Hide abstract]
    ABSTRACT: With increasing evidence of a role for cancer stem cells (CSC) in tumor initiation, proliferation, and metastasis, and a multitude of advanced imaging technologies being developed for noninvasive in vivo cell tracking, the need for imaging studies with a focus on monitoring the fate of CSCs in vivo appears clear. Preclinical investigations of CSCs would benefit from techniques that could dynamically monitor cells from their earliest appearance in tissues and throughout the processes of tumor development and metastasis in entire organs or animals. Traditionally, the assays used to identify and examine CSC are labor-intensive, time-consuming, invasive, and provide little information on the dynamics of cancer cells in vivo. CSC studies should take advantage of advanced imaging technology to increase our understanding of the CSC model, dormancy, tumor growth, and metastasis. With the ability to reliably track the metastasis and proliferation of small numbers of cancer cells, and specific subsets of cancer cells, will come new knowledge of the behavior of these cells in a relatively undisturbed environment.
    No preview · Chapter · Dec 2010
  • [Show abstract] [Hide abstract]
    ABSTRACT: Wide-filed autofluorescence examination is currently considered as a standard of care for screening and diagnostic evaluation of early neoplastic changes of the skin, cervix, lung, bladder, gastrointestinal tract and oral cavity. Naturally occurring fluorophores within the tissue absorb UV and visible light and can re-emit some of this light at longer wavelengths in the form of fluorescence. This non-invasive tissue autofluorescence imaging is used in optical diagnostics, especially in the early detection of cancer. Usually, malignant transformation is associated with thickening of the epithelium, enhanced cellular density due to increased nuclear cytoplasmic ratio which may attenuate the excitation leading to a decrease in collagen autofluorescence. Hence, dysplastic and cancerous tissues often exhibit decreased blue-green autofluorescence and appear darker compared to uninvolved mucosa. Currently, there are three commercially available devices to examine tissue autofluorescence in the oral cavity. In this study we used the oral cancer screening device IdentafiTM 3000 to examine the tissue reflectance and autofluorescence of PML and confounding lesions of the oral cavity. Wide-field autofluorescence imaging enables rapid inspection of large mucosal surfaces, to aid in recognition of suspicious lesions and may also help in discriminate the PML (class 1) from some of the confounding lesions (class II). However, the presence of inflammation or pigments is also associated with loss of stromal autofluorescence, and may give rise to false-positive results with widefield fluorescence imaging. Clinicians who use these autofluorescence based oral cancer screening devices should be aware about the benign oral mucosal lesions that may give false positivity so that unnecessary patient's anxiety and the need for scalpel biopsy can be eliminated.
    No preview · Article · Feb 2011 · Proceedings of SPIE - The International Society for Optical Engineering
Show more