Objectives: The aim of this study is to search for suitable conditions in real-time imaging of oral/pharyngeal mucosa using a newly developed confocal micro-endoscopy (CME) and to identify features which could distinguish cancer tissue form normal mucosa for in vivo diagnosis (optical biopsy) using CME.
Materials and Methods: Patients with biopsy-proven HNSCC undergoing surgery consented to participate. Images were taken from resected tumor and adjacent normal tissue in different 3 conditions.
- 500-550 nm auto-fluorescence with 473nm laser excitation
- 500-550 nm emerged fluorescence with 473nm laser excitation after 0.01ug/ml acriflavine topical application
- 500-550nm and 570-630nm emerged fluorescence with 473nm and 561nm laser excitation after 0.01ug/ml acriflavine and eatable red dye #106 topical applications.
Results: Auto-fluorescence images showed lower signals in cancer tissue than in normal tissue with 473nm laser excitation (Figure a,b). After acriflavine application, the nuclei of the tissue were labeled and there existed a clear difference between tumor tissue and normal mucosa in the uniformity of nuclear size and shape (Figure c,d). In using acriflavine and red dye #106, images became more vivid because red dye staining cytoplasm emerged different wave length fluorescence (Figure e,f).
Conclusions: We demonstrated the possibility of real time in vivo imaging using newly developed CME and conditions which could distinguish cancer tissue from normal mucosa without invasive biopsy.