Joseph Boadi, Robert Byers, Jon Fernandes, Shweta Mittar, Vanessa Hearnden, Zenghai Lu, Sheila MacNeil, Martin Thornhill, Craig Murdoch, Keith Hunter, Alasdair McKechnie, Stephen Matcher
OCT has demonstrated great potential to non-invasively detect oral epithelial cancers, potentially guiding biopsy and surgical resection. On non-ophthalmic tissues the preferred illumination wavelength is 1300 nm. Previous studies on skin have shown that useful image data can also be obtained at shorter wavelengths, with systems at 1060 nm and 820 nm offering reduced depth penetration but higher contrast. Here we apply a similar comparison to tissue engineered models of oral cancer and also to human biopsy samples, generally finding a similar trend. 1300 nm multi-beam OCT (Michelson Diagnostics EX1301) visualises stromal structures and surface keratin more clearly, providing useful image contrast down to around 1 mm. This system was compared with an ultra-high resolution home-built system operating at 890 nm (2.5 micron resolution vs 7.5 micron axial resolution for the EX1301). The UHR system reveals epithelial features more clearly, especially in the DOK pre-invasive cell line model and the biopsy samples. The relative effects of center wavelength vs axial resolution in generating the differential, wavelength-dependent contrast are assessed and the OCT biopsy images are compared with contemporary histology.
Cervical cancer is the eleventh most common cancer in the UK, especially for women under 35. In developed countries, cervical cancer is diagnosed by performing colposcopy. Contrast is enhanced by spraying dilute acetic acid onto the surface of the tissue. In the past decades, it has been shown that abnormal cervical epithelium turns opaque white upon contact with this weak acid whereas normal epithelium is generally not affected. This mechanism is known as aceto-whitening. However, the exact mechanism of this phenomenon is not fully known. In this study, OCT using near infrared light was used to quantify depth-resolved kinetics of aceto-whitening in a simple squamous epithelium model: rabbit cornea. We have found that both the epithelium and stroma brighten with approximately the same time course, reaching a peak reflectivity at about 50 seconds. The most significant increase in reflectivity was seen in the first 20 seconds upon the application of acid, and was measured to be 11dB. This result is compared with phosphate buffered saline solution, which was shown to exhibit no effect. Lactic acid, an alpha-hydroxy acid, has been reported as a negative control for aceto-whitening. However, our OCT results showed a significant epithelial brightening effect of approximately 8 dB in the first 20 seconds. The key difference with acetic acid is the lack of brightening in the corneal stroma. This could be due to inability to permeate through the basal lamina between corneal epithelium and stroma or lack of interaction with stromal keratocytes.
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