title: In vivo optical coherence tomography-based scoring of oral mucositis in human subjects: a pilot study.
abstract: A preliminary study to assess noninvasive optical coherence tomography (OCT) for early detection and evaluation of chemotherapy-induced oral mucositis in five patients. In five patients receiving neoadjuvant chemotherapy for primary breast cancer, oral mucositis was assessed clinically, and imaged using noninvasive OCT. Imaging was scored using a novel imaging-based scoring system. Conventional clinical assessment using the Oral Mucositis Assessment Scale was used as the gold standard. Patients were evaluated on days 0, 2, 4, 7, and 11 after commencement of chemotherapy. OCT images were visually examined by one blinded investigator. The following events were identified using OCT: (1) change in epithelial thickness and subepithelial tissue integrity (beginning on day 2), (2) loss of surface keratinized layer continuity (beginning on day 4), (3) loss of epithelial integrity (beginning on day 4). Imaging data gave higher scores compared to clinical scores earlier in treatment, suggesting that the imaging-based diagnostic scoring was more sensitive to early mucositic change than the clinical scoring system. Once mucositis was established, imaging and clinical scores converged. Chemotherapy-induced oral changes were identified prior to their clinical manifestation using OCT, and the proposed scoring system for oral mucositis was validated for the semiquantification of mucositic change.
authors.affiliation: University of California, Irvine, Beckman Laser Institute, 1002 Health Sciences Road East, Irvine, California 92612, USA.
authors.forename: Hilari
authors.initials: H
authors.lastname: Kawakami-Wong
authors.forename: Shuguang
authors.initials: S
authors.lastname: Gu
authors.forename: Marie J
authors.initials: MJ
authors.lastname: Hammer-Wilson
authors.forename: Joel B
authors.initials: JB
authors.lastname: Epstein
authors.forename: Zhongping
authors.initials: Z
authors.lastname: Chen
authors.forename: Petra
authors.initials: P
authors.lastname: Wilder-Smith
mesh_terms: D000970:Antineoplastic Agents / Q000009:adverse effects*; D001943:Breast Neoplasms / Q000188:drug therapy; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D010865:Pilot Projects; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D016037:Single-Blind Method; D013280:Stomatitis / Q000139:chemically induced* / Q000473:pathology*; D041623:Tomography, Optical Coherence / Q000379:methods*
chemical_list: D000970:Antineoplastic Agents