title: Spectroscopic detection and evaluation of morphologic and biochemical changes in early human oral carcinoma.
abstract: BACKGROUND
  Understanding the development and progression of head and neck squamous cell carcinoma is key in the quest for the early diagnosis and prevention of this type of malignancy. The current study correlated early biochemical and histologic changes in oral tissue with spectral features in fluorescence, reflectance, and light scattering spectra acquired in vivo to diagnose early stages of oral malignancies.
  
  
  METHODS
  A total of 91 tissue sites from 15 patients with varying degrees of malignancy (normal, dysplastic, and cancerous sites) and 8 healthy volunteers were analyzed with 3 spectroscopic techniques. Direct biochemical information regarding oral tissue native fluorophores was obtained with intrinsic fluorescence spectroscopy by fitting a linear combination of collagen and the reduced form of nicotinamide adenine dinucleotide (NADH) fluorescence spectra to the intrinsic tissue fluorescence spectra excited with 337 nanometer (nm) and 358-nm laser light. Diffuse reflectance spectroscopy was used to provide information regarding tissue absorption and structure, such as hemoglobin concentration and stroma density, by measuring the wavelength-dependent absorption and scattering coefficients. By subtracting the diffusely reflected component from the measured reflectance, light scattering spectroscopy (LSS) information resulting from single backscattering from epithelial cell nuclei was obtained. LSS provides information concerning the size distribution of cell nuclei.
  
  
  RESULTS
  These optically extracted tissue parameters provide biochemical or structural information in vivo without the need for tissue excision, and can be used to diagnose tissue abnormalities. By combining the information provided by the three techniques, a method known as trimodal spectroscopy, a sensitivity and specificity of 96% and 96%, respectively, in distinguishing cancerous/dysplastic (mild, moderate, and severe) from normal tissue was achieved. In addition, the authors were able to distinguish dysplastic from cancerous tissue with a sensitivity of 64% and a specificity of 90%.
  
  
  CONCLUSIONS
  The results of the current study demonstrated that Trimodal spectroscopy is a highly sensitive and specific technique with which to diagnose tissue abnormalities.
authors.affiliation: G. R. Harrison Spectroscopy Laboratory, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA.
authors.forename: Markus G
authors.initials: MG
authors.lastname: Müller
authors.forename: Tulio A
authors.initials: TA
authors.lastname: Valdez
authors.forename: Irene
authors.initials: I
authors.lastname: Georgakoudi
authors.forename: Vadim
authors.initials: V
authors.lastname: Backman
authors.forename: Cesar
authors.initials: C
authors.lastname: Fuentes
authors.forename: Sadru
authors.initials: S
authors.lastname: Kabani
authors.forename: Nora
authors.initials: N
authors.lastname: Laver
authors.forename: Zimmern
authors.initials: Z
authors.lastname: Wang
authors.forename: Charles W
authors.initials: CW
authors.lastname: Boone
authors.forename: Ramachandra R
authors.initials: RR
authors.lastname: Dasari
authors.forename: Stanley M
authors.initials: SM
authors.lastname: Shapshay
authors.forename: Michael S
authors.initials: MS
authors.lastname: Feld
mesh_terms: D002277:Carcinoma / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology; D018450:Disease Progression; D006801:Humans; D009062:Mouth Neoplasms / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology; D012542:Scattering, Radiation; D013050:Spectrometry, Fluorescence; D013057:Spectrum Analysis / Q000379:methods*