Objective Detection and Delineation of Oral Neoplasia Using Autofluorescence Imaging
- 1 May 2009
- journal article
- Published by American Association for Cancer Research (AACR) in Cancer Prevention Research
- Vol. 2 (5), 423-431
- https://doi.org/10.1158/1940-6207.capr-08-0229
Abstract
Although the oral cavity is easily accessible to inspection, patients with oral cancer most often present at a late stage, leading to high morbidity and mortality. Autofluorescence imaging has emerged as a promising technology to aid clinicians in screening for oral neoplasia and as an aid to resection, but current approaches rely on subjective interpretation. We present a new method to objectively delineate neoplastic oral mucosa using autofluorescence imaging. Autofluorescence images were obtained from 56 patients with oral lesions and 11 normal volunteers. From these images, 276 measurements from 159 unique regions of interest (ROI) sites corresponding to normal and confirmed neoplastic areas were identified. Data from ROIs in the first 46 subjects were used to develop a simple classification algorithm based on the ratio of red-to-green fluorescence; performance of this algorithm was then validated using data from the ROIs in the last 21 subjects. This algorithm was applied to patient images to create visual disease probability maps across the field of view. Histologic sections of resected tissue were used to validate the disease probability maps. The best discrimination between neoplastic and nonneoplastic areas was obtained at 405 nm excitation; normal tissue could be discriminated from dysplasia and invasive cancer with a 95.9% sensitivity and 96.2% specificity in the training set, and with a 100% sensitivity and 91.4% specificity in the validation set. Disease probability maps qualitatively agreed with both clinical impression and histology. Autofluorescence imaging coupled with objective image analysis provided a sensitive and noninvasive tool for the detection of oral neoplasia.Keywords
Other Versions
This publication has 39 references indexed in Scilit:
- Understanding the Biological Basis of Autofluorescence Imaging for Oral Cancer Detection: High-Resolution Fluorescence Microscopy in Viable TissueClinical Cancer Research, 2008
- Critical evaluation of diagnostic aids for the detection of oral cancerOral Oncology, 2008
- Multispectral optical imaging device for in vivo detection of oral neoplasiaJournal of Biomedical Optics, 2008
- Low-cost, multimodal, portable screening system for early detection of oral cancerJournal of Biomedical Optics, 2008
- Visualization and Other Emerging Technologies as Change Makers for Oral Cancer PreventionAnnals of the New York Academy of Sciences, 2007
- Endoscopic video-autofluorescence imaging followed by narrow band imaging for detecting early neoplasia in Barrett's esophagusGastrointestinal Endoscopy, 2006
- The status of in vivo autofluorescence spectroscopy and imaging for oral oncologyOral Oncology, 2005
- Vision enhancement system for detection of oral cavity neoplasia based on autofluorescenceHead & Neck, 2004
- Optimal visual perception and detection of oral cavity neoplasiaIEEE Transactions on Biomedical Engineering, 2003
- QUANTITATIVE OPTICAL SPECTROSCOPY FOR TISSUE DIAGNOSISAnnual Review of Physical Chemistry, 1996