Diffuse reflectance imaging: a tool for guided biopsy
2012
Accurate diagnosis of premalignant or malignant oral lesions depends on the quality of the biopsy, adequate clinical
information and correct interpretation of the biopsy results. The major clinical challenge is to precisely locate the biopsy
site in a clinically suspicious lesion. Dips due to oxygenated hemoglobin absorption have been noticed at 545 and 575
nm in the diffusely reflected white light spectra of oral mucosa and the intensity ratio R545/R575 has been found suited
for early detection of oral pre-cancers. A multi-spectral diffuse reflectance (DR) imaging system has been developed
consisting of an electron multiplying charge coupled device (EMCCD) camera and a liquid crystal tunable filter for
guiding the clinician to an optimal biopsy site. Towards this DR images were recorded from 27 patients with potentially
malignant lesions on their tongue (dorsal, lateral and ventral sides) and from 44 healthy controls at 545 and 575 nm with
the DR imaging system. False colored ratio image R545/R575 of the lesion provides a visual discerning capability that
helps in locating the most malignant site for biopsy. Histopathological report of guided biopsy showed that out of the 27
patients 16 were cancers, 9 pre-cancers and 2 lichen planus. In this clinical trial DR imaging has correctly guided 25
biopsy sites, yielding a sensitivity of 93% and a specificity of 98%, thereby establishing the potential of DR imaging as a
tool for guided biopsy.
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