Bio-Optical Imaging: An Advanced Cancer Detection Modality

Pramod John, Jayasree VM

Abstract


Oral cancer is one of the most common malignancies that affect human beings across the world, mainly because of the wide-spread consumption of tobacco and its products. Tobacco and its products have been implicated as predisposing factors in the etiology of oral cancer. The commonest type of oral cancer is oral squamous cell carcinoma. Early detection is very important in the management of oral cancer. However, when the lesion is detected in the oral cavity, it is very much advanced for effective management with minimum morbidity and mortality. It is clearly known that cancer and cancer treatment are always associated with considerable morbidity and mortality, especially because of the late detection. In order to improve the clinical outcome, early detection is very important. Though the oral cavity is easily accessible for direct visual examination, medical practitioners mostly neglect this area in the general examination of the patient. The general dental practitioners also do not give much importance to the oral mucosal changes while carrying out dental treatment. One of the emerging technologies in the early detection of oral cancer is the use of non-invasive in vivo tissue imaging that capture the molecular changes at high-resolution to improve the detection capability of early stage oral cancer.Various newer cancer detection methods currently available are the use of optical imaging such as autofluorescence, fluorescence diagnosis, laser confocal endomicroscopy, surface enhanced Raman spectroscopy, optical coherence tomography and confocal reflectance microscopy in the early oral cancer. Fluorescence diagnosis is emerging as a promising method in the differentiation of cancerous lesions from benign lesions, thus helping in the determination of resolution for the surgical resection of affected area of malignancy very accurately. Laser confocal endomicroscopy offers in vivo cellular imaging of tissue structures from surface to subsurface layers and can be used as a minimally invasive biopsy technique for the early detection of the lesion. Based on the pattern of the spectrum obtained from the saliva, the detection of the lesion is possible in surface enhanced Raman spectroscopy. Optical coherence tomography can be used in the imaging of histopathological features of oral lesions. The above mentioned techniques can help in defining the surgical margin and in the assessment of successful management of the lesion. The review process was carried out by literature search using appropriate key words for articles published between 1995 1nd 2015. Out of 4,46,000 articles obtained, 1480 articles were selected. In the final review process, 179 articles were selected. After subjecting the articles to systematic review, finally 19 articles were selected. The study designs in the articles were interventional experimental studies.


Keywords


Confocal Endomicroscopy; Confocal Reflectance Microscopy; Flourescence; Malignancy; Oral Cancer; Optical Imaging; Optical Coherence Tomography; Raman Spectroscopy.

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