Optical coherence tomography (OCT) is a powerful imaging modality capable of detecting subtle abnormalities at histological definition. OCT is extremely useful in the detection of epithelial cancers like oral squamous cell carcinoma. Oral squamous cell carcinomas (OSCC) not only demonstrate architectural loss, but also display strong accumulations of keratin, a major tissue biomolecular scatterrer. Our preliminary observations of A-scan intensity data in a contrasting set of oral precancerous, and cancerous tissues have revealed a striking correlation with degree-of-keratinization and histological differentiation grade. This led us to formulate a study aiming to decipher the ‘high-intensity’ data in A-scan plots of normal, oral precancerous and cancerous human tissues. Our further observations in 600 A-scans (300 malignant and 300 non-malignant) suggested a pertinent link between the high-intensity data occurring in A-scan intensity profile and overall distribution of keratin in OSCC.
Conventional cytology is a rapid chair-side method for diagnosis, but it relies on laborious fixing and staining protocols. As cytology specimens are transparent, it is very hard to visualize them under a bright-field microscope without staining. Quantitative phase imaging techniques have opened up an interesting and potential diagnostic method for volumetric three-dimensional (3-D) visualization of the transparent specimens without any need for sample preparations. We explore the use of digital holographic microscopy in clinical application of oral cytology for the 3-D visualization of buccal cells with high contrast without any additional sample preparations. We also propose nuclear to cytoplasmic (N / C) volumes as a much more accurate parameter for identification of multinucleate and actively dividing cells. We quantify the cellular volumes, and N / C ratios for 203 buccal cells taken from five healthy volunteers to clinically validate the technique and compare them with the traditional N / C area ratios as well as the histology standards. The mean N / C area and volume ratios are found to be 0.0322 ± 0.0149 and 0.0648 ± 0.0286, respectively. Our approach highlights the dawn of a new method for a label-free/nondestructive volumetric oral cytology evaluation, with high potential for exploration of suspicious oral lesions, in subjects with chronic habits such as alcoholism and tobacco use.
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