In Vivo Multimodal Optical Imaging: Improved Detection of Oral Dysplasia in Low-Risk Oral Mucosal Lesions

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dc.citation.firstpage465
dc.citation.issueNumber8
dc.citation.journalTitleCancer Prevention Research
dc.citation.lastpage476
dc.citation.volumeNumber11
dc.contributor.authorYang, Eric C.
dc.contributor.authorSchwarz, Richard A.
dc.contributor.authorLang, Alexander K.
dc.contributor.authorBass, Nancy
dc.contributor.authorBadaoui, Hawraa
dc.contributor.authorVohra, Imran S.
dc.contributor.authorCherry, Katelin D.
dc.contributor.authorWilliams, Michelle D.
dc.contributor.authorGillenwater, Ann M.
dc.contributor.authorVigneswaran, Nadarajah
dc.contributor.authorRichards-Kortum, Rebecca R.
dc.date.accessioned2019-11-05T17:30:07Z
dc.date.available2019-11-05T17:30:07Z
dc.date.issued2018
dc.description.abstractEarly detection of oral cancer and oral premalignant lesions (OPL) containing dysplasia could improve oral cancer outcomes. However, general dental practitioners have difficulty distinguishing dysplastic OPLs from confounder oral mucosal lesions in low-risk populations. We evaluated the ability of two optical imaging technologies, autofluorescence imaging (AFI) and high-resolution microendoscopy (HRME), to diagnose moderate dysplasia or worse (ModDys+) in 56 oral mucosal lesions in a low-risk patient population, using histopathology as the gold standard, and in 46 clinically normal sites. AFI correctly diagnosed 91% of ModDys+ lesions, 89% of clinically normal sites, and 33% of benign lesions. Benign lesions with severe inflammation were less likely to be correctly diagnosed by AFI (13%) than those without (42%). Multimodal imaging (AFI+HRME) had higher accuracy than either modality alone; 91% of ModDys+ lesions, 93% of clinically normal sites, and 64% of benign lesions were correctly diagnosed. Photos of the 56 lesions were evaluated by 28 dentists of varied training levels, including 26 dental residents. We compared the area under the receiver operator curve (AUC) of clinical impression alone to clinical impression plus AFI and clinical impression plus multimodal imaging using k-Nearest Neighbors models. The mean AUC of the dental residents was 0.71 (range: 0.45–0.86). The addition of AFI alone to clinical impression slightly lowered the mean AUC (0.68; range: 0.40–0.82), whereas the addition of multimodal imaging to clinical impression increased the mean AUC (0.79; range: 0.61–0.90). On the basis of these findings, multimodal imaging could improve the evaluation of oral mucosal lesions in community dental settings.
dc.identifier.citationYang, Eric C., Schwarz, Richard A., Lang, Alexander K., et al.. "In Vivo Multimodal Optical Imaging: Improved Detection of Oral Dysplasia in Low-Risk Oral Mucosal Lesions." <i>Cancer Prevention Research,</i> 11, no. 8 (2018) AACR: 465-476. https://doi.org/10.1158/1940-6207.CAPR-18-0032.
dc.identifier.digitalnihms975538
dc.identifier.doihttps://doi.org/10.1158/1940-6207.CAPR-18-0032
dc.identifier.urihttps://hdl.handle.net/1911/107604
dc.language.isoeng
dc.publisherAACR
dc.rightsThis is an author's peer-reviewed final manuscript, as accepted by the publisher. The published article is copyrighted by AACR
dc.titleIn Vivo Multimodal Optical Imaging: Improved Detection of Oral Dysplasia in Low-Risk Oral Mucosal Lesions
dc.typeJournal article
dc.type.dcmiText
dc.type.publicationpost-print
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