Department of Biomedical Engineering, Texas A&M University, College Station, TX, USA.
Department of Electrical and Computer Engineering, Texas A&M University at Qatar, Doha, Qatar.
Oral Oncol. 2020 Jun;105:104635. doi: 10.1016/j.oraloncology.2020.104635. Epub 2020 Apr 2.
Incomplete head and neck cancer resection occurs in up to 85% of cases, leading to increased odds of local recurrence and regional metastases; thus, image-guided surgical tools for accurate, in situ and fast detection of positive margins during head and neck cancer resection surgery are urgently needed. Oral epithelial dysplasia and cancer development is accompanied by morphological, biochemical, and metabolic tissue and cellular alterations that can modulate the autofluorescence properties of the oral epithelial tissue.
This study aimed to test the hypothesis that autofluorescence biomarkers of oral precancer and cancer can be clinically imaged and quantified by means of multispectral fluorescence lifetime imaging (FLIM) endoscopy.
Multispectral autofluorescence lifetime images of precancerous and cancerous lesions from 39 patients were imaged in vivo using a novel multispectral FLIM endoscope and processed to generate widefield maps of biochemical and metabolic autofluorescence biomarkers of oral precancer and cancer.
Statistical analyses applied to the quantified multispectral FLIM endoscopy based autofluorescence biomarkers indicated their potential to provide contrast between precancerous/cancerous vs. healthy oral epithelial tissue.
To the best of our knowledge, this study represents the first demonstration of label-free biochemical and metabolic clinical imaging of precancerous and cancerous oral lesions by means of widefield multispectral autofluorescence lifetime endoscopy. Future studies will focus on demonstrating the capabilities of endogenous multispectral FLIM endoscopy as an image-guided surgical tool for positive margin detection during head and neck cancer resection surgery.
头颈部癌症切除术的不完全切除发生率高达 85%，这增加了局部复发和区域转移的可能性；因此，迫切需要图像引导手术工具，以便在头颈部癌症切除手术中准确、原位和快速地检测阳性边缘。口腔上皮异型增生和癌症的发展伴随着形态、生化和代谢组织以及细胞的改变，这些改变可以调节口腔上皮组织的自发荧光特性。
本研究旨在验证假设，即口腔癌前病变和癌症的自发荧光生物标志物可以通过多光谱荧光寿命成像（FLIM）内窥镜进行临床成像和定量。
使用新型多光谱 FLIM 内窥镜对 39 名患者的癌前病变和癌症病变进行多光谱自发荧光寿命成像，并对其进行处理，以生成口腔癌前病变和癌症的生化和代谢自发荧光生物标志物的宽场图谱。
应用于定量多光谱 FLIM 内窥镜的统计分析表明，这些基于自发荧光的生物标志物具有在癌前病变/癌症与健康口腔上皮组织之间提供对比的潜力。
据我们所知，本研究首次通过宽场多光谱自发荧光寿命内窥镜证明了对癌前和癌症口腔病变进行无标记生化和代谢临床成像的能力。未来的研究将集中于证明内源性多光谱 FLIM 内窥镜作为头颈部癌症切除术中阳性边缘检测的图像引导手术工具的能力。
