Background Early detection is vital for improving the survival rate of oral cancer patients.
Materials and Methods Spectral data at 545 and 575 nm in diffuse reflectance (DR) spectra were imaged from oral lesions of 55 patients and 103 sites of 23 healthy volunteers with an electron multiplying charge coupled device (EMCCD) camera. A computer-generated algorithm based on pixel intensity of DR image ratio (R545/R575) was used for pseudo-colour mapping the entire oral lesion. Tissue biopsies of all patients were taken from selected sites with maximum malignant potential. Spectral data of ratio image were then compared against the histopathology results.
Results The mean age of patients and healthy volunteers were 55.7±12.0 yrs and 28±7.0 yrs, respectively. Majority of patients were tobacco users (43/55), while 23/55 were users of alcohol. The median pixel intensity value of the ratio-image was significantly lower (p<0.001) in the healthy group (0.87, IQR: 0.82–0.94) in comparison to pre-malignant (1.35, IQR: 1.13–1.67) and malignant group (2.44, IQR: 1.78–3.80). The area under the ROC curve (AUC) of healthy to pre-malignant, healthy to malignant, pre-malignant to malignant and healthy to pre-malignant/malignant comparisons were 0.94 (95% CI 0.86 to 1.00), 0.99 (95% CI 0.99 to 1.00), 0.84 (95% CI 0.73 to 0.95) and 0.97 (95% CI 0.94 to 1.00), respectively. The discriminant function analyses with leave-one-out classification differentiate healthy from pre-malignant/malignant lesions correctly in 84.2% occasions after cross-validation (Wilks' λ=0.744, χ2=45.97 with degree of freedom=1, p<0.001).
Conclusion DR spectral imaging efficiently discriminates healthy tissues from oral malignant and pre-malignant lesions.
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