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Archives of Otolaryngology - Head and Neck Surgery

Year: 2010  |  Volume: 136  |  Issue: 2  |  Page No.: 126 - 133

Time-Resolved Fluorescence Spectroscopy as a Diagnostic Technique of Oral Carcinoma: Validation in the Hamster Buccal Pouch Model

D. G Farwell, J. D Meier, J Park, Y Sun, H Coffman, B Poirier, J Phipps, S Tinling, D. J Enepekides and L. Marcu


Objective  To investigate the benefit of using time-resolved, laser-induced fluorescence spectroscopy for diagnosing malignant and premalignant lesions of the oral cavity.

Design  The carcinogen 7,12-dimethylbenz[a]anthracene (DMBA) was applied to 1 cheek pouch of 19 hamsters. The contralateral pouch and the cheek pouches of 3 hamsters without DMBA exposure served as controls.

Setting  University of California, Davis.

Participants  Twenty-two golden/Syrian hamsters.

Intervention  A nitrogen pulse laser was used to induce tissue autofluorescence between the wavelengths of 360 and 650 nm.

Main Outcome Measures  Spectral intensities and time-domain measurements were obtained and compared with the histopathologic findings at each corresponding site.

Results  Spectral intensities and lifetime values at 3 spectral bands (SBs; SB1 = 380 ± 10 nm; SB2 = 460 ± 10 nm, and SB3 = 635 ± 10 nm) allowed for discrimination among healthy epithelium, dysplasia, carcinoma in situ, and invasive carcinoma. The lifetime values at SB2 were the most important when distinguishing the lesions using only time-resolved parameters. An algorithm combining spectral fluorescence parameters derived from both spectral and time-domain parameters (peak intensities, average fluorescence lifetimes, and the Laguerre coefficient [zero-order]) for healthy epithelium, dysplasia, carcinoma in situ, and invasive carcinoma provided the best diagnostic discrimination, with 100%, 100%, 69.2%, and 76.5% sensitivity and 100%, 92.2%, 97.1%, and 96.2% specificity, respectively.

Conclusions  The addition of time-resolved fluorescence-derived parameters significantly improves the capability of fluorescence spectroscopy–based diagnostics in the hamster buccal pouch. This technique provides a potential noninvasive diagnostic instrument for head and neck cancer.

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