Value of Full‐Field Optical Coherence Tomography Imaging for the Histological Assessment of Head and Neck Cancer

Background and Objectives In head and neck surgery, intraoperative and postoperative evaluation of tumor margins is achieved by histopathological assessment, which is a multistep process. Intraoperative analysis of tumor margins to obtain a preliminary diagnosis is usually carried out on frozen sect...

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Published in:Lasers in surgery and medicine 2020-10, Vol.52 (8), p.768-778
Main Authors: De Leeuw, Frederic, Abbaci, Muriel, Casiraghi, Odile, Ben Lakhdar, Aïcha, Alfaro, Alexia, Breuskin, Ingrid, Laplace‐Builhé, Corinne
Format: Article
Language:English
Subjects:
Abnormalities
Biopsy
Coiling
Correlation analysis
Criteria
Diagnosis
Diagnostic systems
Differential diagnosis
Evaluation
full‐field optical coherence tomography
Head & neck cancer
head and neck cancer
head and neck squamous cell carcinoma
Histology
Keratinization
Lasers
Medical imaging
optical biopsy
Optical Coherence Tomography
pathology
Reliability analysis
Sensitivity
Squamous cell carcinoma
Surgery
Tissues
Tomography
Tumors
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Summary:Background and Objectives In head and neck surgery, intraoperative and postoperative evaluation of tumor margins is achieved by histopathological assessment, which is a multistep process. Intraoperative analysis of tumor margins to obtain a preliminary diagnosis is usually carried out on frozen sections. Analysis of frozen sections is challenging due to technical difficulties in processing. Full‐field optical coherence tomography (FFOCT) provides ex vivo images of fresh tissue samples at a microscopic scale without tissue processing. The objectives of our study were to define the diagnostic criteria required to interpret head and neck FFOCT images and to evaluate the reliability of a histological diagnosis made on an “optical biopsy” produced by head and neck FFOCT imaging compared with conventional histology. Study Design/Materials and Methods First, we established an atlas of comparative images (FFOCT/standard histology) and defined the diagnostic criteria based on FFOCT images. Two pathologists subsequently performed a blinded review on 57 FFOCT images (32 patients). Specificity and sensitivity were measured by comparison with the standard histological diagnosis. The primary endpoint was major concordance, defined as two classifications leading to the same therapeutic decision (treatment/no treatment). Results Pathologists identified four main criteria for tissue diagnosis on FFOCT images: heterogeneous cell distribution, stromal reaction, coiling, and keratinization abnormalities. The correlation study showed good results, with sensitivity from 88% to 90% and specificity from 81% to 87%, regardless of whether the FFOCT image review was performed by a pathologist with or without previous experience in optical imaging. Conclusions Our results demonstrate that FFOCT images can be used by pathologists for differential diagnosis, and that high‐resolution FFOCT imaging can provide an assessment of microscopic architecture in head and neck tissues without tissue processing requirements. Lasers Surg. Med. © 2020 Wiley Periodicals, Inc.
ISSN:0196-8092
1096-9101
DOI:10.1002/lsm.23223