Anatomy-based algorithms for detecting oral cancer using reflectance and fluorescence spectroscopy.
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.
McGee
Sasha
S
G. R. Harrison Spectroscopy Laboratory, Massachusetts Institute of Technology, Cambridge 02139, USA.
Mardirossian
Vartan
V
Elackattu
Alphi
A
Mirkovic
Jelena
J
Pistey
Robert
R
Gallagher
George
G
Kabani
Sadru
S
Yu
Chung-Chieh
CC
Wang
Zimmern
Z
Badizadegan
Kamran
K
Grillone
Gregory
G
Feld
Michael S
MS
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*