title: Anatomy-based algorithms for detecting oral cancer using reflectance and fluorescence spectroscopy.
abstract: OBJECTIVE
  We used reflectance and fluorescence spectroscopy to noninvasively and quantitatively distinguish benign from dysplastic/malignant oral lesions. We designed diagnostic algorithms to account for differences in the spectral properties among anatomic sites (gingiva, buccal mucosa, etc).
  
  
  METHODS
  In vivo reflectance and fluorescence spectra were collected from 71 patients with oral lesions. The tissue was then biopsied and the specimen evaluated by histopathology. Quantitative parameters related to tissue morphology and biochemistry were extracted from the spectra. Diagnostic algorithms specific for combinations of sites with similar spectral properties were developed.
  
  
  RESULTS
  Discrimination of benign from dysplastic/malignant lesions was most successful when algorithms were designed for individual sites (area under the receiver operator characteristic curve [ROC-AUC],0.75 for the lateral surface of the tongue) and was least accurate when all sites were combined (ROC-AUC, 0.60). The combination of sites with similar spectral properties (floor of mouth and lateral surface of the tongue) yielded an ROC-AUC of 0.71.
  
  
  CONCLUSIONS
  Accurate spectroscopic detection of oral disease must account for spectral variations among anatomic sites. Anatomy-based algorithms for single sites or combinations of sites demonstrated good diagnostic performance in distinguishing benign lesions from dysplastic/malignant lesions and consistently performed better than algorithms developed for all sites combined.
authors.affiliation: G. R. Harrison Spectroscopy Laboratory, Massachusetts Institute of Technology, Cambridge 02139, USA.
authors.forename: Sasha
authors.initials: S
authors.lastname: McGee
authors.forename: Vartan
authors.initials: V
authors.lastname: Mardirossian
authors.forename: Alphi
authors.initials: A
authors.lastname: Elackattu
authors.forename: Jelena
authors.initials: J
authors.lastname: Mirkovic
authors.forename: Robert
authors.initials: R
authors.lastname: Pistey
authors.forename: George
authors.initials: G
authors.lastname: Gallagher
authors.forename: Sadru
authors.initials: S
authors.lastname: Kabani
authors.forename: Chung-Chieh
authors.initials: CC
authors.lastname: Yu
authors.forename: Zimmern
authors.initials: Z
authors.lastname: Wang
authors.forename: Kamran
authors.initials: K
authors.lastname: Badizadegan
authors.forename: Gregory
authors.initials: G
authors.lastname: Grillone
authors.forename: Michael S
authors.initials: MS
authors.lastname: Feld
mesh_terms: D000465:Algorithms; D006801:Humans; D008875:Middle Aged; D009055:Mouth / Q000033:anatomy & histology; D009062:Mouth Neoplasms / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology; D013050:Spectrometry, Fluorescence; D013057:Spectrum Analysis / Q000379:methods*