Development of an integrated multimodal optical imaging system with real-time image analysis for the evaluation of oral premalignant lesions

Oral premalignant lesions (OPLs), such as leukoplakia, are at risk of malignant transformation to oral cancer. Clinicians can elect to biopsy OPLs and assess them for dysplasia, a marker of increased risk. However, it is challenging to decide which OPLs need a biopsy and to select a biopsy site. We...

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Bibliographic Details
Published in:Journal of biomedical optics 2019-02, Vol.24 (2), p.1
Main Authors: Yang, Eric C, Vohra, Imran S, Badaoui, Hawraa, Schwarz, Richard A, Cherry, Katelin D, Quang, Timothy, Jacob, Justin, Lang, Alex, Bass, Nancy, Rodriguez, Jessica, Williams, Michelle D, Vigneswaran, Nadarajah, Gillenwater, Ann M, Richards-Kortum, Rebecca R
Format: Article
Language:English
Subjects:
Algorithms
Biopsy
Cell Transformation, Neoplastic
Dysplasia
Endoscopy
Humans
Image analysis
Image processing
Image Processing, Computer-Assisted - methods
Image resolution
Interactive computer systems
Lesions
Leukokeratosis
Light
Medical imaging
Microscopy, Fluorescence - methods
Morphology
Mouth Diseases - diagnostic imaging
Mouth Neoplasms - diagnostic imaging
Mouth Neoplasms - pathology
Mouth Neoplasms - surgery
Multimodal Imaging - methods
Noninvasive evaluation
Optical Imaging - methods
Oral cancer
Patients
Pattern Recognition, Automated
Point-of-Care Systems
Precancerous Conditions - diagnostic imaging
Real time
Reproducibility of Results
Software
Universal Serial Bus
White light
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Summary:Oral premalignant lesions (OPLs), such as leukoplakia, are at risk of malignant transformation to oral cancer. Clinicians can elect to biopsy OPLs and assess them for dysplasia, a marker of increased risk. However, it is challenging to decide which OPLs need a biopsy and to select a biopsy site. We developed a multimodal optical imaging system (MMIS) that fully integrates the acquisition, display, and analysis of macroscopic white-light (WL), autofluorescence (AF), and high-resolution microendoscopy (HRME) images to noninvasively evaluate OPLs. WL and AF images identify suspicious regions with high sensitivity, which are explored at higher resolution with the HRME to improve specificity. Key features include a heat map that delineates suspicious regions according to AF images, and real-time image analysis algorithms that predict pathologic diagnosis at imaged sites. Representative examples from ongoing studies of the MMIS demonstrate its ability to identify high-grade dysplasia in OPLs that are not clinically suspicious, and to avoid unnecessary biopsies of benign OPLs that are clinically suspicious. The MMIS successfully integrates optical imaging approaches (WL, AF, and HRME) at multiple scales for the noninvasive evaluation of OPLs.
ISSN:1083-3668
1560-2281
1560-2281
DOI:10.1117/1.JBO.24.2.025003