title: Multimodal nonlinear microscopic investigations on head and neck squamous cell carcinoma: toward intraoperative imaging.
abstract: BACKGROUND
  Prognosis and appropriate treatment of head and neck squamous cell carcinoma (HNSCC) depend on the tumor type routinely derived by invasive histopathology. A promising noninvasive alternative is nonlinear optical imaging, which is capable of in vivo tissue visualization for tumor typing and grading.
  
  
  RESULTS
  Thin tissue sections from 3 patients aged 56 to 60 years presenting advanced carcinoma of the hypopharynx, larynx, and left tonsil were investigated by coherent anti-Stokes Raman scattering (CARS), second-harmonic generation (SHG), and 2 photon excited fluorescence (TPEF) to study the morphochemistry of the tissues. Morphologic alterations of prognostic significance, such as cell density, nuclear to cytoplasm ratio, and keratinization as well as the underlying compositional changes during malignant transformation were determined, such as the distributions of lipids, collagen, and autofluorophors.
  
  
  CONCLUSIONS
  Nonlinear imaging provides a noninvasive optical biopsy of the epithelial layer comparable to staining microscopy. By integration into an operational microscope, routine screening of suspicious lesions and surgical guidance can be realized.
authors.affiliation: Institute of Photonic Technology, Jena, Germany.
authors.forename: Tobias
authors.initials: T
authors.lastname: Meyer
authors.forename: Orlando
authors.initials: O
authors.lastname: Guntinas-Lichius
authors.forename: Ferdinand
authors.initials: F
authors.lastname: von Eggeling
authors.forename: Günther
authors.initials: G
authors.lastname: Ernst
authors.forename: Denis
authors.initials: D
authors.lastname: Akimov
authors.forename: Michael
authors.initials: M
authors.lastname: Schmitt
authors.forename: Benjamin
authors.initials: B
authors.lastname: Dietzek
authors.forename: Jürgen
authors.initials: J
authors.lastname: Popp
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000473:pathology*; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000473:pathology*; D007822:Laryngeal Neoplasms / Q000473:pathology*; D008297:Male; D008853:Microscopy / Q000379:methods*; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods*; D013059:Spectrum Analysis, Raman / Q000379:methods; D014067:Tonsillar Neoplasms / Q000473:pathology*