The goal of this proposal is to develop a promising new approach for non-invasive early detection and diagnosis of oral neoplasia based on fluorescence and reflectance spectroscopy and imaging. Oral cancer is a major global health problem. Early detection and diagnosis is the best way to improve survival and reduce morbidity from oral cancer;yet no method currently exists to accomplish this goal. Fluorescence and reflectance spectroscopy can non-invasively probe biochemical and architectural changes in tissue that occur during carcinogenesis, and mathematical models can relate some of these changes, such as increased metabolic activity and angiogenesis, to observe optical spectra. Over the last four years, we have shown that fluorescence and reflectance spectroscopy can non-invasively and objectively discriminate between normal and abnormal oral mucosa with good sensitivity and specificity - similar to that of oral cancer specialists. The goal of this proposal is to leverage these advances to develop, evaluate and optimize an oral cancer screening approach using fluorescence and reflectance spectroscopy in a community setting to facilitate detection and diagnosis of oral lesions. As part of this competitive renewal, we are now poised to integrate the knowledge gained in these studies to achieve four important goals: (1) to translate these research findings to develop a simplified, non-invasive and objective device to be used in the community;(2) to implement real time data analysis software to provide a clinically meaningful diagnosis at the point-of-care;(3) to test the performance of this device to detect oral dysplasia and early carcinoma in various clinical settings and optimize its integration with existing diagnostic methods;and (4) to investigate the ability of optical spectroscopy as a new biomarker of risk of malignant conversion that can be measured in vivo without the need for biopsy. Successful completion of this research program will provide a portable objective device to screen for oral neoplasia that can be implemented in primary care dental and medical environments where oral cancer expertise is limited and screening is most urgently needed. Knowledge gained through this proposal will facilitate optimal integration of new diagnostic technologies to optimize oral cancer screening and surveillance in diverse patient populations. Further, results will show whether detectable optical features can serve as biomarkers to better identify which patients are at high risk to progress to invasive cancer. The use of this approach, if successful, could significantly improve the survival and quality of life of people worldwide who are likely to suffer from oral malignancies

Public Health Relevance

Oral cancer is a major health problem worldwide. To improve outcomes we must improve detection and diagnosis of early neoplastic changes. A simple, automated method to enable community healthcare workers to screen high risk individuals for suspicious oral lesions and a way to determine risk of malignant conversion in individuals with suspicious oral lesions is required. Our goal is to develop such an approach to oral detection and diagnosis based on optical spectroscopy and imaging. Over the last four years, we have shown that fluorescence and reflectance spectroscopy can non-invasively and objectively discriminate between normal and abnormal oral mucosa with good sensitivity and specificity - similar to that of oral cancer specialists. Our improved understanding of the biological basis for differences in reflectance and fluorescence of neoplastic oral lesions suggests that we can use depth-selectivity to enhance diagnostic performance. As part of this competitive renewal, we are now poised to integrate the knowledge gained in these studies to achieve four important goals: (1) to translate these research findings to develop a simplified, non-invasive and objective device to be used in the community;(2) to implement real time data analysis software to provide a clinically meaningful diagnosis at the point-of-care;(3) to test the performance of this device to detect oral dysplasia and early carcinoma in various clinical settings and optimize its integration with existing diagnostic methods;and (4) to investigate the ability of optical spectroscopy as a new biomarker of risk of malignant conversion that can be measured in vivo without the need for biopsy. Successful completion of this research program will provide a portable objective device to screen for oral neoplasia that can be implemented in primary care dental and medical environments where oral cancer expertise is limited and screening is most urgently needed. Further, knowledge gained through this proposal will facilitate optimal integration of new diagnostic technologies to optimize oral cancer screening and surveillance in diverse patient populations. The use of this approach could significantly improve the survival and quality of life of people worldwide who are likely to suffer from oral malignancies. .

Agency
National Institute of Health (NIH)
Institute
National Cancer Institute (NCI)
Type
Research Project (R01)
Project #
5R01CA095604-09
Application #
8461693
Study Section
Oral, Dental and Craniofacial Sciences Study Section (ODCS)
Program Officer
Kim, Kelly Y
Project Start
2002-04-01
Project End
2014-04-30
Budget Start
2013-05-01
Budget End
2014-04-30
Support Year
9
Fiscal Year
2013
Total Cost
$250,213
Indirect Cost
$46,475
Name
University of Texas MD Anderson Cancer Center
Department
Surgery
Type
Other Domestic Higher Education
DUNS #
800772139
City
Houston
State
TX
Country
United States
Zip Code
77030
Schwarz, Richard A; Gao, Wen; Redden Weber, Crystal et al. (2009) Noninvasive evaluation of oral lesions using depth-sensitive optical spectroscopy. Cancer 115:1669-79
Roblyer, Darren; Kurachi, Cristina; Stepanek, Vanda et al. (2009) Objective detection and delineation of oral neoplasia using autofluorescence imaging. Cancer Prev Res (Phila Pa) 2:423-31
Pavlova, Ina; Weber, Crystal Redden; Schwarz, Richard A et al. (2009) Fluorescence spectroscopy of oral tissue: Monte Carlo modeling with site-specific tissue properties. J Biomed Opt 14:014009
Pavlova, Ina; Williams, Michelle; El-Naggar, Adel et al. (2008) Understanding the biological basis of autofluorescence imaging for oral cancer detection: high-resolution fluorescence microscopy in viable tissue. Clin Cancer Res 14:2396-404
Schwarz, Richard A; Gao, Wen; Daye, Dania et al. (2008) Autofluorescence and diffuse reflectance spectroscopy of oral epithelial tissue using a depth-sensitive fiber-optic probe. Appl Opt 47:825-34
Pavlova, Ina; Weber, Crystal Redden; Schwarz, Richard A et al. (2008) Monte Carlo model to describe depth selective fluorescence spectra of epithelial tissue: applications for diagnosis of oral precancer. J Biomed Opt 13:064012
Carlson, Alicia L; Gillenwater, Ann M; Williams, Michelle D et al. (2007) Confocal microscopy and molecular-specific optical contrast agents for the detection of oral neoplasia. Technol Cancer Res Treat 6:361-74
Carlson, Alicia L; Coghlan, Lezlee G; Gillenwater, Ann M et al. (2007) Dual-mode reflectance and fluorescence near-video-rate confocal microscope for architectural, morphological and molecular imaging of tissue. J Microsc 228:11-24
Arifler, Dizem; Pavlova, Ina; Gillenwater, Ann et al. (2007) Light scattering from collagen fiber networks: micro-optical properties of normal and neoplastic stroma. Biophys J 92:3260-74
Hsu, Elizabeth R; Gillenwater, Ann M; Hasan, M Qasim et al. (2006) Real-time detection of epidermal growth factor receptor expression in fresh oral cavity biopsies using a molecular-specific contrast agent. Int J Cancer 118:3062-71

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