Dynamic optical contrast imaging as a novel modality for rapidly distinguishing head and neck squamous cell carcinoma from surrounding normal tissue

Abstract

This study demonstrates the feasibility of using DOCI to rapidly and accurately distinguish HNSCC from surrounding normal tissue. An analysis of DOCI images revealed microscopic characterization sufficient for tissue-type identification consistent with histology. Such an intraoperative tool would be transformative by allowing the rapid delineation of tumor tissue from nontumor tissue and thus maximizing the efficacy of resection and improving patient outcomes. Cancer 2017;123:879-86. © 2016 American Cancer Society.

Dynamic optical contrast imaging (DOCI): system theory for rapid, wide-field, multispectral optical imaging using fluorescence lifetime contrast mechanism

“…Previous work have demonstrated the initial concept and promising human ex vivo pilot study image results have been demonstrated from the DOCI system. 17,18 Several mathematical expressions have been formulated to describe the behavior of the DOCI system and how the contrast mechanism is interpreted. Non-ideal models and assumptions are also provided when the illumination source contains a first-order decay because the illumination source cannot be experimentally turned off instantaneously.…”

Detection of surgical margins in oral cavity cancer: the role of dynamic optical contrast imaging

“…lifetime) is a fluorophore-specific characteristic that is not influenced by the local concentration of fluorophores, the optical path, the local excitation intensity, or the local fluorescence detection efficiency (which is not possible in autofluorescence imaging) [28]. The intrinsic contrast mechanism accessed by DOCI parallels fluorescence lifetime imaging microscopy (FLIM), in which the endogenous fluorophore lifetime of tissue is probed by illumination with a pulsed, long-wave ultraviolet light source [26]. In comparison to FLIM, DOCI produces pixel values that are proportional to the aggregate fluorophore of the probed tissue without the requirement of fitting acquired data to complex mathematical models through a unique image frame normalization scheme [26].…”

“…The intrinsic contrast mechanism accessed by DOCI parallels fluorescence lifetime imaging microscopy (FLIM), in which the endogenous fluorophore lifetime of tissue is probed by illumination with a pulsed, long-wave ultraviolet light source [26]. In comparison to FLIM, DOCI produces pixel values that are proportional to the aggregate fluorophore of the probed tissue without the requirement of fitting acquired data to complex mathematical models through a unique image frame normalization scheme [26]. The avoidance of mathematical complexity in calculations enables scalable mapping of fluorophore lifetimes over macroscopic (not microscopic) fields of view with high contrast to noise ratios in a relatively short time frame (<60 sec image acquisition time) with all pixels acquired simultaneously.…”

“…Recent investigations in both human ex vivo and in vivo specimens demonstrate the ability of this technique to generate statistically significant contrast between tumor tissue and surrounding normal tissue in biopsies taken from OSCC patients [26]. In addition, a recent in vivo pilot study suggests the capability of delineating differences between pre-cancerous and normal tissues (Figure 2).…”

“…Collectively, the preliminary data indicates the potential utility of DOCI for early OSCC screening. Furthermore, the DOCI images reveal detailed tissue characteristics that are confirmed by histology but not visible to the naked eye alone [26].…”