Advances toward fully automated in vivo assessment of oral epithelial dysplasia by nuclear endomicroscopy-A pilot study.

Background: Uncertainties in detection of oral epithelial dysplasia (OED) frequently result from sampling error especially in inflammatory oral lesions. Endomicroscopy allows non-invasive, "en face" imaging of upper oral epithelium, but parameters of OED are unknown.Methods: Mucosal nuclei were imag...

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Publicado en:Journal of Oral Pathology & Medicine Vol. 46; no. 10; pp. 911 - 921
Autores principales: Liese, Jan, Winter, Karsten, Glass, Änne, Bertolini, Julia, Kämmerer, Peer Wolfgang, Frerich, Bernhard, Schiefke, Ingolf, Remmerbach, Torsten W.
Formato: pictorial research tables/charts Journal Article
Publicado: Wiley-Blackwell Nov2017
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Nov2017
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      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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        atl: Advances toward fully automated in vivo assessment of oral epithelial dysplasia by nuclear endomicroscopy-A pilot study.
      aug:
        au:
          Liese, Jan
          Winter, Karsten
          Glass, Änne
          Bertolini, Julia
          Kämmerer, Peer Wolfgang
          Frerich, Bernhard
          Schiefke, Ingolf
          Remmerbach, Torsten W.
          Glass, Änne
          Kämmerer, Peer Wolfgang
        affil: Department of Oral, Maxillofacial and Facial Plastic Surgery, University Medical Center Rostock, Rostock Germany
      sug:
        subj:
          Cell Nucleus Pathology
          Mouth Pathology
          Mouth Neoplasms Pathology
          Carcinoma in Situ Pathology
          Image Processing, Computer Assisted
          Pilot Studies
          Middle Age
          Endoscopy
          Female
          Automation
          Aged, 80 and Over
          Aged
          Epithelium Pathology
          Male
          Microscopy
          Human
          Middle Aged: 45-64 years
          Aged, 80 & over
          Aged: 65+ years
          Female
          Male
      ab: Background: Uncertainties in detection of oral epithelial dysplasia (OED) frequently result from sampling error especially in inflammatory oral lesions. Endomicroscopy allows non-invasive, "en face" imaging of upper oral epithelium, but parameters of OED are unknown.Methods: Mucosal nuclei were imaged in 34 toluidine blue-stained oral lesions with a commercial endomicroscopy. Histopathological diagnosis showed four biopsies in "dys-/neoplastic," 23 in "inflammatory," and seven in "others" disease groups. Strength of different assessment strategies of nuclear scoring, nuclear count, and automated nuclear analysis were measured by area under ROC curve (AUC) to identify histopathological "dys-/neoplastic" group. Nuclear objects from automated image analysis were visually corrected.Results: Best-performing parameters of nuclear-to-image ratios were the count of large nuclei (AUC=0.986) and 6-nearest neighborhood relation (AUC=0.896), and best parameters of nuclear polymorphism were the count of atypical nuclei (AUC=0.996) and compactness of nuclei (AUC=0.922). Excluding low-grade OED, nuclear scoring and count reached 100% sensitivity and 98% specificity for detection of dys-/neoplastic lesions. In automated analysis, combination of parameters enhanced diagnostic strength. Sensitivity of 100% and specificity of 87% were seen for distances of 6-nearest neighbors and aspect ratios even in uncorrected objects. Correction improved measures of nuclear polymorphism only. The hue of background color was stronger than nuclear density (AUC=0.779 vs 0.687) to detect dys-/neoplastic group indicating that macroscopic aspect is biased.Conclusions: Nuclear-to-image ratios are applicable for automated optical in vivo diagnostics for oral potentially malignant disorders. Nuclear endomicroscopy may promote non-invasive, early detection of dys-/neoplastic lesions by reducing sampling error.
      pubtype: Academic Journal
      doctype:
        pictorial
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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