title: Assessment of the sensitivity and specificity of tissue-specific-based and anatomical-based optical biomarkers for rapid detection of human head and neck squamous cell carcinoma.
abstract: OBJECTIVE
  We propose the use of morphological optical biomarkers for rapid detection of human head and neck squamous cell carcinoma (HNSCC) by leveraging the underlying tissue characteristics in aerodigestive tracts.
  
  
  METHODS
  Diffuse reflectance spectra were obtained from malignant and contra-lateral normal tissues of 57 patients undergoing panendoscopy and biopsy. Oxygen saturation, total hemoglobin concentration, and the reduced scattering coefficient were extracted. Differences in malignant and normal tissues were examined based on two different groupings: anatomical site and morphological tissue type.
  
  
  CONCLUSIONS
  Measurements were acquired from 252 sites, of which 51 were pathologically classified as SCC. Optical biomarkers exhibited statistical differences between malignant and normal samples. Contrast was enhanced when parsing tissues by morphological classification rather than anatomical subtype for unpaired comparisons. Corresponding linear discriminant models using multiple optical biomarkers showed improved predictive ability when accounting for morphological classification, particularly in node-positive lesions. The false-positive rate was retrospectively found to decrease by 34.2% in morphologically- vs. anatomically-derived predictive models. In glottic tissue, the surgeon exhibited a false-positive rate of 45.7% while the device showed a lower false-positive rate of 12.4%. Additionally, comparisons of optical parameters were made to further understand the physiology of tumor staging and potential causes of high surgeon false-positive rates. Optical spectroscopy is a user-friendly, non-invasive tool capable of providing quantitative information to discriminate malignant from normal head and neck tissues. Predictive models demonstrated promising results for real-time diagnostics. Furthermore, the strategy described appears to be well suited to reduce the clinical false-positive rate.
authors.affiliation: Duke University, Biomedical Engineering Department, Durham, NC, USA.
authors.forename: Fangyao
authors.initials: F
authors.lastname: Hu
authors.affiliation: Duke University, Biomedical Engineering Department, Durham, NC, USA.
authors.forename: Karthik
authors.initials: K
authors.lastname: Vishwanath
authors.affiliation: Division of Otolaryngology - Head and Neck Surgery, Duke University Medical Center, Durham, NC, USA.
authors.forename: H Wolfgang
authors.initials: HW
authors.lastname: Beumer
authors.affiliation: Division of Otolaryngology - Head and Neck Surgery, Duke University Medical Center, Durham, NC, USA.|Section of Otolaryngology - Head and Neck Surgery, Durham Veterans Administration Medical Center, Durham, NC, USA.
authors.forename: Liana
authors.initials: L
authors.lastname: Puscas
authors.affiliation: Dental Service, Durham Veterans Administration Medical Center, Durham, NC, USA.
authors.forename: Hamid R
authors.initials: HR
authors.lastname: Afshari
authors.affiliation: Division of Otolaryngology - Head and Neck Surgery, Duke University Medical Center, Durham, NC, USA.
authors.forename: Ramon M
authors.initials: RM
authors.lastname: Esclamado
authors.affiliation: Division of Otolaryngology - Head and Neck Surgery, Duke University Medical Center, Durham, NC, USA.
authors.forename: Richard
authors.initials: R
authors.lastname: Scher
authors.affiliation: Division of Otolaryngology - Head and Neck Surgery, Duke University Medical Center, Durham, NC, USA.
authors.forename: Samuel
authors.initials: S
authors.lastname: Fisher
authors.affiliation: Duke University, Biomedical Engineering Department, Durham, NC, USA.
authors.forename: Justin
authors.initials: J
authors.lastname: Lo
authors.affiliation: Duke University, Biomedical Engineering Department, Durham, NC, USA.
authors.forename: Christine
authors.initials: C
authors.lastname: Mulvey
authors.affiliation: Duke University, Biomedical Engineering Department, Durham, NC, USA.
authors.forename: Nirmala
authors.initials: N
authors.lastname: Ramanujam
authors.affiliation: Division of Otolaryngology - Head and Neck Surgery, Duke University Medical Center, Durham, NC, USA.|Section of Otolaryngology - Head and Neck Surgery, Durham Veterans Administration Medical Center, Durham, NC, USA.
authors.forename: Walter T
authors.initials: WT
authors.lastname: Lee
mesh_terms: D014408:Biomarkers, Tumor / Q000032:analysis*; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis*; D006258:Head and Neck Neoplasms / Q000175:diagnosis*; D006801:Humans; D012680:Sensitivity and Specificity; D013057:Spectrum Analysis / Q000379:methods
chemical_list: D014408:Biomarkers, Tumor
keywords: Cancer detection; Cancer screening; Diffuse reflectance; Global health; Head and neck cancer; Hypoxia