Modern noninvasive imaging techniques are used in many areas of medical research, particularly where an additional modality is required to support close monitoring during pre- or post-care. In oral medicine, the combination of an experienced clinician and supporting noninvasive optical devices for oral imaging, such as optical coherence tomography (OCT), may ensure improved diagnosis. In this study, the pathological features of lichenoid oral mucosa were noninvasively imaged with our miniaturized pen-like OCT probe and compared to adjacent healthy areas. The non-homogeneous epithelial (EP) layer, increased cornification of the EP surface and unidentifiable basement membrane are the most important features recorded.
We present a miniaturized handheld OCT probe (9 grams weight), approximately the size of a small pen (10 mm x 140 mm), developed for use inside a patient’s mouth for examination of the oral mucosa. The probe operates in common-path mode and uses a magnetic scanning system to actuate a lensed fibre, achieving 50 B-scans per second. The system is demonstrated with OCT imaging of the buccal and alveolar mucosa of six patients with oral lichen planus (OLP) during clinical routine examination, and showed pathological changes in the tissue microarchitecture.
Concerning the usage of non-invasive optical techniques for oral cancer detection, the presented study dealt with the manual and semi-automatic measurement of oral epithelial thickness by means of optical coherence tomography (OCT). Here, a total of 3,510 OCT images out of seven areas of the oral cavity was analyzed. In the result, epithelial thickness varied from 77 µm to 704 µm. Beyond that, there was a good correlation between both methods (ρ = 0.71-0.96). With regard to clinical routine use, manual epithelial thickness measurement could be beneficial due to a currently lower time investment with comparable precision.
To date, there is still a lack of reliable imaging modalities to improve the quality of medical examinations of the oral mucosa in dentistry. One promising imaging technologies is optical coherence tomography (OCT). The present study provides in vivo intensity-based OCT cross sections of the human oral mucosa of the anterior and posterior oral cavity as well as the oropharynx of 47 disease-free adult volunteers. The randomized blinded image analysis was performed by means of 3,560 OCT cross sections using a set of seven qualitative and quantitative criteria to assess the epithelium and the lamina propria.
For future non-invasive optical biopsy by OCT, there is a demand to relate the obtained scans with histological cross sections, which represent the diagnostic gold standard. For this reason, the aim of the performed study was the qualitative matching of OCT cross-sectional images with histological pictures from various image databases. Therefore, the human oral mucosa of forty-seven healthy volunteers was investigated at ten different regions, e.g. lip, floor of mouth, hard and soft palate, by using the recently proposed in vivo endoscopic rigid handheld OCT system (central wavelength: λ = 840 nm, spatial resolution: 11.6 μm axial and 17.4 μm lateral). The results allow answering the question, whether OCT imaging is able to detect sublayers of mucosa and to clearly identify tissue structures by using a qualitative scoring system. In fact, depiction of epithelium, lamina propria and configurations like blood vessels and salivary glands, respectively, is possible, whereas a sufficient visualization of deep submucosa or epithelial sublayers cannot be achieved with the used wavelength range. Despite a well-defined surface profile, evaluating the level of keratinization is challenging. In contrast to histological cross sections impaired by fixation, orientation and organisation of collagen fiber bundles are highlighted better in OCT cross sections due to the in vivo situation. With regard to future clinical studies, correct interpretation of tissue structure in healthy individuals forms the basis to identify and assess pathomorphological changes related to various kinds of oral diseases by means of OCT.
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