Funded by an R01 grant from the National Cancer Institute, we developed combined macroscopic fluorescence lifetime imaging (FLIM) and high resolution confocal microscopy for early detection of epithelial precancer, specifically in the oral cavity in vivo.
This multi-modality, multi-scale system provides both macroscopic time-resolved autofluorescence surveillance at multiple emission wavelengths simultaneously and high resolution three dimensional imaging of cellular morphology to detect and evaluate suspicious lesions. Current clinical methods for detection of oral cancer lack the ability to delineate between benign and premalignant lesions with adequate sensitivity and specificity. The usual diagnostic mechanism involves visual inspection and palpation followed by tissue biopsy and histopathology, a process both invasive and time-intensive. A more sensitive and objective screening method can greatly facilitate the overall process of detection of early cancer. Oral precancer progression is associated with biochemical (increase in NADH fluorescence, decrease in collagen fluorescence) and morphological changes (increase in nuclear to cytoplasmic ratio) that can be characterized with FLIM and confocal microscopy, respectively. Different aspects of the project include the design and implementation of handheld endoscopes, clinical data acquisition, and development of image processing and classification strategies.