Evaluation of optical coherence tomography to discriminate lesions of the upper aerodigestive tract

Head Neck. 2013 Nov;35(11):1558-66. doi: 10.1002/hed.23189. Epub 2012 Oct 29.

Abstract

Background: This study evaluated the capability of optical coherence tomography (OCT) to differentiate premalignant and early malignant lesions of the upper aerodigestive tract (UADT).

Methods: An OCT screening was performed in 52 healthy volunteers. Epithelial thicknesses on 38 OCT images and histopathological slides were correlated. One hundred primary lesions were rated via OCT concerning invasiveness by an "unblinded" investigator, then biopsied, and the results correlated. All OCT images were evaluated by 3 "blinded" investigators. Forty-eight images underwent retrospective image analysis.

Results: Screening showed large differences concerning epithelial thicknesses, but good correlation (κ = 0.63) between OCT and histopathological slides. In the unblinded evaluation, noninvasive and invasive lesions could be distinguished with a sensitivity of 88.9% and specificity of 89.0% whereas the blinded evaluations led to sensitivities of 100%, 66.7%, and 77.8% and specificities of 75.8%, 71.4%, and 70.3%. The difference of mean intraepithelial intensity reductions in dysplasias (38.7%) and hyperplasias (18.9%) was statistically significant.

Conclusion: OCT complements visual inspection for differentiating UADT-lesions.

Keywords: erythroplasia; invasiveness; leukoplakia; optical coherence tomography; upper aerodigestive tract.

Publication types

  • Comparative Study
  • Evaluation Study

MeSH terms

  • Adult
  • Aged
  • Carcinoma, Squamous Cell / pathology*
  • Carcinoma, Squamous Cell / ultrastructure
  • Case-Control Studies
  • Diagnosis, Differential
  • Early Detection of Cancer
  • Female
  • Healthy Volunteers
  • Humans
  • Laryngeal Neoplasms / pathology*
  • Laryngeal Neoplasms / ultrastructure
  • Male
  • Middle Aged
  • Mouth Neoplasms / pathology*
  • Mouth Neoplasms / ultrastructure
  • Neoplasm Invasiveness / pathology
  • Neoplasm Staging
  • Observer Variation
  • Oropharyngeal Neoplasms / pathology*
  • Oropharyngeal Neoplasms / ultrastructure
  • Precancerous Conditions / pathology*
  • Prospective Studies
  • Reference Values
  • Sensitivity and Specificity
  • Statistics, Nonparametric
  • Tomography, Optical Coherence / methods*
  • Young Adult