We report progress in development and feasibility testing of reflectance confocal microscopy (RCM) for imaging in
the oral cavity of humans. We adapted a small rigid relay telescope (120mm long x 14mm diameter) and a small
water immersion objective lens (12mm diameter, NA 0.7) to a commercial handheld RCM scanner (Vivascope
3000, Caliber ID, Rochester NY). This scanner is designed for imaging skin but we adapted the front end (the
objective lens and the stepper motor that axially translates) for intra-oral use. This adaption required a new approach
to address the loss of the automated stepper motor for acquisition of images in depth. A helical spring-like cap (with
a coverslip to contact tissue) was designed for approximately 150 um of travel. Additionally other methods for
focusing optics were designed and evaluated. The relay telescope optics is being tested in a clinical setting. With the
capture of video and “video-mosaicing”, extended areas can be imaged. The feasibility of imaging oral tissues was
initially investigated in volunteers. RCM imaging in buccal mucosa in vivo shows nuclear and cellular detail in the
epithelium and epithelial junction, and connective tissue and blood flow in the underlying lamina propria. Similar
detail, including filiform and fungiform papillae, can be seen on the tongue in vivo. Clinical testing during head and
neck surgery is now in progress and patients are being imaged for both normal tissue and cancerous margins in lip
and tongue mucosa.
Gary Peterson, Daniella Karassawa Zanoni, Jocelyn Migliacci, Miguel Cordova, Milind Rajadhyaksha, and Snehal Patel M.D., "Progress in reflectance confocal microscopy for imaging oral tissues in vivo," Proc. SPIE 9689, Photonic Therapeutics and Diagnostics XII, 96891X (Presented at SPIE BiOS: February 13, 2016; Published: 29 February 2016); https://doi.org/10.1117/12.2213692.
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