Endogenous fluorescence lifetime imaging (FLIM) provides direct access to the concomitant functional and biochemical changes accompanying tissue transition from benign to precancerous and cancerous. Since FLIM can noninvasively measure different and complementary biomarkers of precancer and cancer, we hypothesize that it will aid in clinically detecting early oral epithelial cancer. Our group has recently demonstrated the detection of benign from premalignant and malignant lesions based on endogenous multispectral FLIM in the hamster cheek-pouch model. Encouraged by these positive preliminary results, we have developed a handheld endoscope capable of acquiring multispectral FLIM images in real time from the oral mucosa. This novel FLIM endoscope is being used for imaging clinically suspicious pre-malignant and malignant lesions from patients before undergoing tissue biopsy for histopathological diagnosis of oral epithelial cancer. Our preliminary results thus far are already suggesting the potential of endogenous FLIM for distinguishing a variety of benign lesions from advanced dysplasia and squamous cell carcinoma (SCC). To the best of out knowledge, this is the first in vivo human study aiming to demonstrate the ability to predict the true malignancy of clinically suspicious lesions using endogenous FLIM. If successful, the resulting clinical tool will allow noninvasive real-time detection of epithelial precancerous and cancerous lesions in the oral mucosa and could potentially be used to assist at every step involved on the clinical management of oral cancer patients, from early screening and diagnosis, to treatment and monitoring of recurrence.
Javier A. Jo, Dae Yon Hwang, Jorge Palma, Shuna Cheng, Rodrigo Cuenca, Bilal Malik, Joey Jabbour, Lisa Cheng, John Wright, and Kristen Maitland, "In vivo detection of oral epithelial cancer using endogenous fluorescence lifetime imaging: a pilot human study
(Conference Presentation)," Proc. SPIE 9698, Advanced Biomedical and Clinical Diagnostic and Surgical Guidance Systems XIV, 969805 (Presented at SPIE BiOS: February 14, 2016; Published: 3 May 2016); https://doi.org/10.1117/12.2213846.4828055414001.
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