1. Development of an integrated multimodal optical imaging system with real-time image analysis for the evaluation of oral premalignant lesions
- Author
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Alex Lang, Justin Jacob, Ann M. Gillenwater, Jessica Rodriguez, Rebecca Richards-Kortum, Michelle D. Williams, Eric C. Yang, Nancy Bass, Katelin D. Cherry, Hawraa Badaoui, Nadarajah Vigneswaran, Richard A. Schwarz, Imran Vohra, and Timothy Quang
- Subjects
Paper ,medicine.medical_specialty ,Biopsy ,Point-of-Care Systems ,Biomedical Engineering ,Image registration ,Image processing ,autofluorescence ,Multimodal Imaging ,01 natural sciences ,oral lesion ,fiber bundle ,Pattern Recognition, Automated ,010309 optics ,Biomaterials ,Biopsy Site ,0103 physical sciences ,Image Processing, Computer-Assisted ,medicine ,Humans ,General ,Leukoplakia ,OPLS ,medicine.diagnostic_test ,business.industry ,Optical Imaging ,Reproducibility of Results ,Endoscopy ,oral cancer ,medicine.disease ,Atomic and Molecular Physics, and Optics ,3. Good health ,Electronic, Optical and Magnetic Materials ,stomatognathic diseases ,Autofluorescence ,Cell Transformation, Neoplastic ,Microscopy, Fluorescence ,Dysplasia ,Mouth Neoplasms ,Radiology ,in vivo imaging ,Mouth Diseases ,business ,Precancerous Conditions ,Algorithms ,Software - Abstract
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.
- Published
- 2019