Noninvasive evaluation of oral lesions using depth‐sensitive optical spectroscopy

Schwarz, Richard A.; Gao, Wen; Weber, Crystal Redden; Kurachi, Cristina; Lee, John; El‐Naggar, Adel K.; Richards‐Kortum, Rebecca; Gillenwater, Ann M.

doi:10.1002/cncr.24177

“…According to Schwarz et al [18], during carcinogenesis in the oral cavity, structural and biochemical changes in the epithelium and stroma may alter the optical properties of dysplastic and cancerous tissues. Increased nuclear size and cytoplasm/nucleus ratio, microvascular changes, degradation of collagen fibers, increased of hemoglobin, and changes in mitochondrial concentration of NADH and FAD, leading to changes in the optical scattering, absorption and intrinsic characteristics of tissue autofluorescence.…”

Section: Discussionmentioning

confidence: 99%

“…This finding is particularly visible in the excitation at 406 nm. Epithelial fluorophores such as NADH also play a role in the features of the spectra of shallow depths and stromal fluorophores, such as collagen, contribute to the measured signal from deeper regions [8,18,19].…”

Section: Discussionmentioning

confidence: 99%

“…Schwarz et al [34] suggest that short wavelengths may be more sensitive than the profound changes in the uptake of optical scattering properties, where occur the initial changes detected in epithelium, such as nuclear size and nucleus/cytoplasm ratio, and in the stromal surface region. In non-keratinized tissue diagnostic performance was achieved using only optical spectra short and medium depths.…”

Section: Discussionmentioning

confidence: 99%

“…As inflammation primarily affects the stroma while the dysplastic epithelium changes occur, the depth sensitive spectral data, particularly obtained from superficial layers may provide more useful information for discriminating benign lesions from malignant or dysplastic lesions [18].…”

Section: Discussionmentioning

confidence: 99%

“…Based on the tissue optical properties and diagnostic sensitivity to capture the fluorescence emitted by native fluorophores, these optical techniques have been indicated to differentiate endogenous tissue variations [14][15][16]. The fluorescence spectroscopy has become an important tool in detecting potentially malignant and malignant lesions in the oral mucosa [17,18]. The biochemical composition and tissue architecture can be assessed by the emitted fluorescence spectrum, which will be modified in the presence of tissue alterations [19].…”

Section: Introductionmentioning

confidence: 99%

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BackgroundOral squamous cell carcinoma is the most common form of malignancy of the lip and oral cavity, often being proceeded by potentially malignant disorders (PMD). Early detection can reduce the malignant transformation of PMD and can improve the survival rate for oral cancer. The current standard of scalpel biopsy with histology is painful for patients and involves a delay whilst histology is completed; other tests are available that are unobtrusive and provide immediate results. ObjectivesPrimary objective: To estimate the diagnostic accuracy of index tests for the detection of oral cancer and PMD of the lip and oral cavity, in people presenting with clinically evident lesions.Secondary objective: To estimate the relative accuracy of the different index tests. Search methodsThe electronic databases were searched on 30 April 2013. We searched MEDLINE (OVID) (1946 to April 2013) and four other electronic databases (the Cochrane Diagnostic Test Accuracy Studies Register, the Cochrane Oral Health Group's Trials Register, EMBASE (OVID) and MEDION (Ovid)). There were no restrictions on language in the searches of the electronic databases. We conducted citation searches and screened reference lists of included studies for additional references. Selection criteriaWe selected studies that reported the diagnostic test accuracy of the following index tests when used as an adjunct to conventional oral examination in detecting PMD or oral squamous cell carcinoma of the lip or oral cavity: vital staining, oral cytology, light-based detection and oral spectroscopy, blood or saliva analysis (which test for the presence of biomarkers in blood or saliva). Data collection and analysisTwo review authors independently screened titles and abstracts for relevance. Eligibility, data extraction and quality assessment were carried out by at least two authors, independently and in duplicate. Studies were assessed for methodological quality using QUADAS-2. Meta-analysis was used to combine the results of studies for each index test using the bivariate approach to estimate the expected values of sensitivity and specificity. Main resultsWe included 41 studies, recruiting 4002 participants, in this review. These studies evaluated the diagnostic accuracy of conventional oral examination with: vital staining (14 studies), oral cytology (13 studies), light-based detection or oral spectroscopy (13 studies). Six studies assessed two combined index tests. There were no eligible diagnostic accuracy studies evaluating blood or salivary sample analysis.The summary estimates for vital staining obtained from the meta-analysis were sensitivity of 0.84 (95% CI 0.74 to 0.90) with specificity of 0.70 (0.59 to 0.79), with 14 studies were included in the meta-analysis. For cytology, sensitivity was 0.91 (0.81 to 0.96) and specificity was 0.91 (0.81 to 0.95) with 12 studies included in the meta-analysis. For light-based detection, sensitivity was 0.91 (0.77 to 0.97) and specificity was 0.58 (0.22 to 0.87) with 11 studies included in the meta-analysis. Th...

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BackgroundOral squamous cell carcinoma is the most common form of malignancy of the lip and oral cavity, often being proceeded by potentially malignant disorders (PMD). Early detection can reduce the malignant transformation of PMD and can improve the survival rate for oral cancer. The current standard of scalpel biopsy with histology is painful for patients and involves a delay whilst histology is completed; other tests are available that are unobtrusive and provide immediate results. ObjectivesPrimary objective: To estimate the diagnostic accuracy of index tests for the detection of oral cancer and PMD of the lip and oral cavity, in people presenting with clinically evident lesions.Secondary objective: To estimate the relative accuracy of the different index tests. Search methodsThe electronic databases were searched on 30 April 2013. We searched MEDLINE (OVID) (1946 to April 2013) and four other electronic databases (the Cochrane Diagnostic Test Accuracy Studies Register, the Cochrane Oral Health Group's Trials Register, EMBASE (OVID) and MEDION (Ovid)). There were no restrictions on language in the searches of the electronic databases. We conducted citation searches and screened reference lists of included studies for additional references. Selection criteriaWe selected studies that reported the diagnostic test accuracy of the following index tests when used as an adjunct to conventional oral examination in detecting PMD or oral squamous cell carcinoma of the lip or oral cavity: vital staining, oral cytology, light-based detection and oral spectroscopy, blood or saliva analysis (which test for the presence of biomarkers in blood or saliva). 1 Diagnostic tests for oral cancer and potentially malignant disorders in patients presenting with clinically evident lesions (Review)

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Noninvasive evaluation of oral lesions using depth‐sensitive optical spectroscopy

Abstract: BACKGROUND: Optical spectroscopy is a noninvasive technique with potential applications for diagnosis of oral dysplasia and early cancer. In this study, we evaluated the diagnostic performance of a depth-sensi-

Cited by 97 publications

References 33 publications

Fluorescence spectroscopy for the detection of potentially malignant disorders and squamous cell carcinoma of the oral cavity

Fluorescence spectroscopy for the detection of potentially malignant disorders and squamous cell carcinoma of the oral cavity

Diagnostic tests for oral cancer and potentially malignant disorders in patients presenting with clinically evident lesions

Diagnostic tests for oral cancer and potentially malignant disorders in patients presenting with clinically evident lesions

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