Zaid Hamdoon1, Waseem Jerjes2, Gordon McKenzie3, Amrita Jay4, Colin Hopper5. 1. Unit of Oral and Maxillofacial Surgery, UCL Eastman Dental Institute, London, UK; Head and Neck Centre, University College London Hospitals, London, UK. Electronic address: zaid19772000@yahoo.com. 2. UCL Department of Surgery, London, UK. Electronic address: waseem_wk1@yahoo.co.uk. 3. UCL Department of Surgery, London, UK. Electronic address: gordon.mckenzie@md-ltd.co.uk. 4. Head and Neck Centre, University College London Hospitals, London, UK. Electronic address: amritajk@msn.com. 5. Unit of Oral and Maxillofacial Surgery, UCL Eastman Dental Institute, London, UK; Head and Neck Centre, University College London Hospitals, London, UK; UCL Department of Surgery, London, UK. Electronic address: c.hopper@ucl.ac.uk.
Abstract
BACKGROUND: Incomplete surgical removal of cancer is believed to be the main cause of local recurrence and high mortality. This study assessed the use of optical technology (namely optical coherence tomography [OCT]) in examining oral squamous cell carcinoma (OSCC) resection margins to assess if this modality could guide the surgeon during surgical resections. MATERIALS AND METHODS: Twenty-eight T1-T2 N0M0 oral squamous cell carcinoma patients participated in this study. Nineteen patients were males and nine were females. The majority of lesions were in the ventro-lateral tongue, floor of mouth, retromolar trigone and the buccal mucosa. Following tumour resection, the specimen resection margins were optically scanned in the immediate ex vivo phase. Two independent assessors commented on the four resection margins of each specimen. The findings were then compared to the corresponding gold standard histopathology. The average epithelial thickness for both tumor-free and tumor-involved margins was also calculated. RESULTS: The pathology reports of the 112 margins revealed 90 tumor-free margins and 22 tumor-involved margins. Examining the data from both senior operating surgeons (assessors), the overall sensitivity and specificity was found to be 81.5% and 87%, respectively. Whilst the positive predictive value was 61.5% and the negative predictive value was 95%. OCT accuracy for the first assessor was 88% and for the second assessor 84%. The assessors' inter-observer agreement was "very good" for superior, inferior and medial margins; while agreement on the lateral surgical margin status was "good". Using OCT, the mean epithelial thickness at the tumor-free resection margins was 360 μm; while, it was 567 μm for the tumour-involved margins. CONCLUSION: OCT is a valuable tool in the assessment of surgical margins. Tumour-involved margins can be identified by architectural changes and increase in epithelial layer thickness on the OCT image. Further studies are required to assess tumour margins in vivo.
BACKGROUND: Incomplete surgical removal of cancer is believed to be the main cause of local recurrence and high mortality. This study assessed the use of optical technology (namely optical coherence tomography [OCT]) in examining oral squamous cell carcinoma (OSCC) resection margins to assess if this modality could guide the surgeon during surgical resections. MATERIALS AND METHODS: Twenty-eight T1-T2 N0M0 oral squamous cell carcinomapatients participated in this study. Nineteen patients were males and nine were females. The majority of lesions were in the ventro-lateral tongue, floor of mouth, retromolar trigone and the buccal mucosa. Following tumour resection, the specimen resection margins were optically scanned in the immediate ex vivo phase. Two independent assessors commented on the four resection margins of each specimen. The findings were then compared to the corresponding gold standard histopathology. The average epithelial thickness for both tumor-free and tumor-involved margins was also calculated. RESULTS: The pathology reports of the 112 margins revealed 90 tumor-free margins and 22 tumor-involved margins. Examining the data from both senior operating surgeons (assessors), the overall sensitivity and specificity was found to be 81.5% and 87%, respectively. Whilst the positive predictive value was 61.5% and the negative predictive value was 95%. OCT accuracy for the first assessor was 88% and for the second assessor 84%. The assessors' inter-observer agreement was "very good" for superior, inferior and medial margins; while agreement on the lateral surgical margin status was "good". Using OCT, the mean epithelial thickness at the tumor-free resection margins was 360 μm; while, it was 567 μm for the tumour-involved margins. CONCLUSION: OCT is a valuable tool in the assessment of surgical margins. Tumour-involved margins can be identified by architectural changes and increase in epithelial layer thickness on the OCT image. Further studies are required to assess tumour margins in vivo.
Authors: Adam Shadfan; Hawraa Darwiche; Jesus Blanco; Ann Gillenwater; Rebecca Richards-Kortum; Tomasz S Tkaczyk Journal: Biomed Opt Express Date: 2017-02-14 Impact factor: 3.732
Authors: Oscar M Carrasco-Zevallos; Christian Viehland; Brenton Keller; Mark Draelos; Anthony N Kuo; Cynthia A Toth; Joseph A Izatt Journal: Biomed Opt Express Date: 2017-02-21 Impact factor: 3.732
Authors: Floris J Voskuil; Jasper Vonk; Bert van der Vegt; Schelto Kruijff; Vasilis Ntziachristos; Pieter J van der Zaag; Max J H Witjes; Gooitzen M van Dam Journal: Nat Biomed Eng Date: 2021-11-08 Impact factor: 25.671
Authors: G Tirelli; S Zacchigna; F Boscolo Nata; E Quatela; R Di Lenarda; M Piovesana Journal: Eur Arch Otorhinolaryngol Date: 2016-08-04 Impact factor: 2.503
Authors: Andrew E Heidari; Tiffany T Pham; Ibe Ifegwu; Ross Burwell; William B Armstrong; Tjoa Tjoson; Stephanie Whyte; Carmen Giorgioni; Beverly Wang; Brian J F Wong; Zhongping Chen Journal: J Biophotonics Date: 2020-01-12 Impact factor: 3.207
Authors: Mary J Coleman; Laura E Selmic; Jonathan P Samuelson; Ryan Jennings; Pin-Chieh Huang; Eric M McLaughlin; Vincent A Wavreille; Josephine A Dornbusch; Janis Lapsley; James Howard; Edward Cheng; Alex Kalamaras; Kendra Hearon; Megan Cray; Janet Grimes; Brandan Wustefeld-Janssens; Katie Kennedy; Owen Skinner; Pierre Amsellem; Stephen A Boppart Journal: Vet Comp Oncol Date: 2021-09-14 Impact factor: 2.613