title: Evaluation of a low-cost, portable imaging system for early detection of oral cancer.
abstract: BACKGROUND
  There is an important global need to improve early detection of oral cancer. Recent reports suggest that optical imaging technologies can aid in the identification of neoplastic lesions in the oral cavity; however, there is little data evaluating the use of optical imaging modalities in resource limited settings where oral cancer impacts patients disproportionately. In this article, we evaluate a simple, low-cost optical imaging system that is designed for early detection of oral cancer in resource limited settings. We report results of a clinical study conducted at Tata Memorial Hospital (TMH) in Mumbai, India using this system as a tool to improve detection of oral cancer and its precursors.
  
  
  METHODS
  Reflectance images with white light illumination and fluorescence images with 455 nm excitation were obtained from 261 sites in the oral cavity from 76 patients and 90 sites in the oral cavity from 33 normal volunteers. Quantitative image features were used to develop classification algorithms to identify neoplastic tissue, using clinical diagnosis of expert observers as the gold standard.
  
  
  RESULTS
  Using the ratio of red to green autofluorescence, the algorithm identified tissues judged clinically to be cancer or clinically suspicious for neoplasia with a sensitivity of 90% and a specificity of 87%.
  
  
  CONCLUSIONS
  Results suggest that the performance of this simple, objective low-cost system has potential to improve oral screening efforts, especially in low-resource settings.
authors.affiliation: Department of Bioengineering, Rice University, Houston, 77005, USA.|Head and Neck Surgery, Tata Memorial Hospital, Mumbai, 400012, India.
authors.forename: Mohammed S
authors.initials: MS
authors.lastname: Rahman
authors.affiliation: Head and Neck Surgery, Tata Memorial Hospital, Mumbai, 400012, India.
authors.forename: Nilesh
authors.initials: N
authors.lastname: Ingole
authors.affiliation: Department of Bioengineering, Rice University, Houston, 77005, USA.|Department of Head and Neck Surgery, University of Texas M.D. Anderson Cancer Center, Houston, 77030, USA.
authors.forename: Darren
authors.initials: D
authors.lastname: Roblyer
authors.affiliation: Department of Bioengineering, Rice University, Houston, 77005, USA.|Department of Head and Neck Surgery, University of Texas M.D. Anderson Cancer Center, Houston, 77030, USA.
authors.forename: Vanda
authors.initials: V
authors.lastname: Stepanek
authors.affiliation: Department of Bioengineering, Rice University, Houston, 77005, USA.|Department of Head and Neck Surgery, University of Texas M.D. Anderson Cancer Center, Houston, 77030, USA.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Richards-Kortum
authors.affiliation: Department of Bioengineering, Rice University, Houston, 77005, USA.|Department of Head and Neck Surgery, University of Texas M.D. Anderson Cancer Center, Houston, 77030, USA.
authors.forename: Ann
authors.initials: A
authors.lastname: Gillenwater
authors.affiliation: Head and Neck Surgery, Tata Memorial Hospital, Mumbai, 400012, India.
authors.forename: Surendra
authors.initials: S
authors.lastname: Shastri
authors.affiliation: Head and Neck Surgery, Tata Memorial Hospital, Mumbai, 400012, India.
authors.forename: Pankaj
authors.initials: P
authors.lastname: Chaturvedi
mesh_terms: D003952:Diagnostic Imaging / Q000191:economics / Q000295:instrumentation / Q000379:methods*; D055088:Early Detection of Cancer / Q000191:economics / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D009062:Mouth Neoplasms / Q000175:diagnosis* / Q000473:pathology
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