Noninvasive imaging of oral neoplasia with a high-resolution fiber-optic microendoscope

BACKGROUND: The purpose of this study was to evaluate the ability of high-resolution microendoscopy to image and quantify changes in cellular and architectural features seen in early oral neoplasia in vivo. METHODS: A high-resolution microendoscope (HRME) was used to image intact, resected oral squamous carcinoma specimens. HRME images were reviewed and classified as non-neoplastic or neoplastic by expert clinicians. An algorithm based on quantitative morphologic features was also used to classify each image. Results were compared to the histopathologic diagnosis. RESULTS: HRME images were obtained from 141 sites in resected specimens from 13 patients. Subjective image interpretation yielded sensitivity and specificity of 85% to 90% and 80% to 85%, respectively, whereas the objective classification algorithm achieved sensitivity and specificity of 81% and 77%, respectively. CONCLUSION: High-resolution microendoscopy of intact oral mucosa can provide images with sufficient detail to classify oral lesions by both subjective image interpretation and objective image analysis. © 2011 Wiley Periodicals, Inc. Head Neck, 2011