Optical coherence tomography of laryngeal cancer.
OBJECTIVE
Optical coherence tomography (OCT) is a high-resolution optical imaging technique that produces cross-sectional images of living tissues using light in a manner similar to ultrasound. This prospective study evaluated the ability of OCT to identify the characteristics of laryngeal cancer and measure changes in the basement membrane, tissue microstructure, and the transition zone at the edge of tumors.


METHODS
One hundred thirty-three patients underwent OCT examination during surgical endoscopy of the head and neck. Twenty-two patients with laryngeal cancer or a history of laryngeal cancer were imaged with a fiberoptic OCT system. Tumor and adjacent transition zones were imaged along with uninvolved subsites. OCT images were correlated with histopathology.


RESULTS
Twenty-six OCT examinations were performed in 22 patients. Basement membrane disruption was seen in 18 subjects, all of whom had histology showing classic features of cancer. A transition zone to uninvolved epithelium at the tumor periphery was also often observed. In six studies, benign or premalignant processes were histologically confirmed. In three thin, superficial lesions, an intact basement membrane was observed. The basement membrane could not be identified in three other bulky exophytic, premalignant lesions, primarily because of increased superficial signal backscattering observed in pathologic tissues.


CONCLUSIONS
OCT clearly identifies basement membrane violation from laryngeal cancer and can identify transition zones at the cancer margin. In bulky exophytic lesions, OCT signal may not penetrate deeply enough to show the basement membrane, but for many suspicious lesions that require exclusion of cancer, OCT shows potential for assisting in diagnostic assessment.
Armstrong
William B
WB
Department of Otolaryngology-Head and Neck Surgery, University of California Irvine, Orange, California 92868, USA. wbarmstr@uci.edu
Ridgway
James M
JM
Vokes
David E
DE
Guo
Shuguang
S
Perez
Jorge
J
Jackson
Ryan P
RP
Gu
Mai
M
Su
Jianping
J
Crumley
Roger L
RL
Shibuya
Terry Y
TY
Mahmood
Usama
U
Chen
Zhongping
Z
Wong
Brian J F
BJ
D000368:Aged; D000369:Aged, 80 and over; D001485:Basement Membrane / Q000648:ultrastructure; D001706:Biopsy; D002294:Carcinoma, Squamous Cell / Q000473:pathology* / Q000601:surgery; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007822:Laryngeal Neoplasms / Q000473:pathology* / Q000601:surgery; D007828:Laryngoscopy; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D041623:Tomography, Optical Coherence