Oral squamous cell carcinoma (OSCC), one of the most common types of cancers worldwide, is diagnosed mainly through tissue biopsy. However, owing to the tumor heterogeneity and other drawbacks, such as the invasiveness of the biopsy procedure and high cost and limited usefulness of longitudinal surveillance, there has been a focus on adopting more rapid, economical, and noninvasive screening methods. Examples of these include liquid biopsy, optical detection systems, oral brush cytology, microfluidic detection, and artificial intelligence auxiliary diagnosis, which have their own strengths and weaknesses. Extensive research is being performed on various liquid biopsy biomarkers, including novel microbiome components, noncoding RNAs, extracellular vesicles, and circulating tumor DNA. The majority of these elements have demonstrated encouraging clinical outcomes in early OSCC detection. This review summarizes the screening methods for OSCC with a focus on providing new guiding strategies for the diagnosis of the disease. 

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Current advances in noninvasive methods for the diagnosis of oral squamous cell carcinoma: a review

Surgery is still the first choice to treat oral cancer, where it is important to detect surgical margins in order to reduce cancer recurrence and maintain oral-maxillofacial function simultaneously. As a non-invasive and in situ imaging technique, optical coherence tomography (OCT) can obtain images close to the resolution of histopathology, which makes it have great potential in intraoperative diagnosis. However, it is not enough to find surgical margins accurately just observing OCT images directly and qualitatively. The purpose of this study is to identify oral cancer in OCT images by investigating the quantitative difference of cancer and non-cancer tissue. Based on an available optical attenuation model and the axial confocal PSF of a home-made swept source OCT system, by using fresh ex vivo human oral tissues from 14 patients of oral squamous cell carcinoma (OSCC) as the samples, diagnosis with sensitivity (97.88%) and specificity (83.77%) was achieved at the attenuation threshold of 4.7 mm−1, and the accuracy of identification reached 91.15% in our study. Our preliminary results demonstrated that the oral cancer resection will be guided accurately and the clinical application of OCT will be further promoted by deeply mining the information hidden in OCT images.

Identification of oral cancer in OCT images based on an optical attenuation model.

Introduction Oral Squamous Cell Carcinoma (OSCC) poses a significant challenge in oncology due to the absence of precise diagnostic tools, leading to delays in identifying the condition. Current diagnostic methods for OSCC have limitations in accuracy and efficiency, highlighting the need for more reliable approaches. This study aims to explore the discriminative potential of histopathological images of oral epithelium and OSCC. By utilizing a database containing 1224 images from 230 patients, captured at varying magnifications and publicly available, a customized deep learning model based on EfficientNetB3 was developed. The model’s objective was to differentiate between normal epithelium and OSCC tissues by employing advanced techniques such as data augmentation, regularization, and optimization. Methods The research utilized a histopathological imaging database for Oral Cancer analysis, incorporating 1224 images from 230 patients. These images, taken at various magnifications, formed the basis for training a specialized deep learning model built upon the EfficientNetB3 architecture. The model underwent training to distinguish between normal epithelium and OSCC tissues, employing sophisticated methodologies including data augmentation, regularization techniques, and optimization strategies. Results The customized deep learning model achieved significant success, showcasing a remarkable 99% accuracy when tested on the dataset. This high accuracy underscores the model’s efficacy in effectively discerning between normal epithelium and OSCC tissues. Furthermore, the model exhibited impressive precision, recall, and F1-score metrics, reinforcing its potential as a robust diagnostic tool for OSCC. Discussion This research demonstrates the promising potential of employing deep learning models to address the diagnostic challenges associated with OSCC. The model’s ability to achieve a 99% accuracy rate on the test dataset signifies a considerable leap forward in earlier and more accurate detection of OSCC. Leveraging advanced techniques in machine learning, such as data augmentation and optimization, has shown promising results in improving patient outcomes through timely and precise identification of OSCC.

Oral squamous cell carcinoma detection using EfficientNet on histopathological images

Optical coherence tomography (OCT) is a noninvasive, high resolution, and real-time imaging technology that has been used in ophthalmology and other medical fields. Limited by the point spread function of OCT system, it is difficult to optimize its spatial resolution only based on hardware. Digital image processing methods, especially deep learning, provide great potential in super-resolving images. In this paper, the matched axial low resolution (LR) and high resolution OCT image pairs from actual OCT imaging are collected to generate the dataset by our home-made spectral domain OCT (SD-OCT) system. Several methods are selected to super-resolve LR OCT images. It is shown from the experimental results that the residual-in-residual dense block network (RRDBNet) trained with different loss functions performs the best super-resolution for OCT images, and it is demonstrated from the preliminary results that deep learning methods have good generalization and robustness between OCT systems. We believe deep learning methods have broad prospects in improving the quality of OCT images.

/pdf/axial-super-resolution-study-for-optical-coherence-1oddena91n.pdf

Axial Super-Resolution Study for Optical Coherence Tomography Images Via Deep Learning

Despite the substantial progress achieved in the development and integration of augmented reality (AR) in surgical robotic and autonomous systems (RAS), the center of focus in most devices remains on improving end-effector dexterity and precision, as well as improved access to minimally invasive surgeries. This paper aims to provide a systematic review of different types of state-of-the-art surgical robotic platforms while identifying areas for technological improvement. We associate specific control features, such as haptic feedback, sensory stimuli, and human–robot collaboration, with AR technology to perform complex surgical interventions for increased user perception of the augmented world. Current researchers in the field have, for long, faced innumerable issues with low accuracy in tool placement around complex trajectories, pose estimation, and difficulty in depth perception during two-dimensional medical imaging. A number of robots described in this review, such as Novarad and SpineAssist, are analyzed in terms of their hardware features, computer vision systems (such as deep learning algorithms), and the clinical relevance of the literature. We attempt to outline the shortcomings in current optimization algorithms for surgical robots (such as YOLO and LTSM) whilst providing mitigating solutions to internal tool-to-organ collision detection and image reconstruction. The accuracy of results in robot end-effector collisions and reduced occlusion remain promising within the scope of our research, validating the propositions made for the surgical clearance of ever-expanding AR technology in the future.

/pdf/augmented-reality-ar-for-surgical-robotic-and-autonomous-2rq7qpy2.pdf

Augmented Reality (AR) for Surgical Robotic and Autonomous Systems: State of the Art, Challenges, and Solutions

Early detection and diagnosis of oral cancer are critical for a better prognosis, but accurate and automatic identification is difficult using the available technologies. Optical coherence tomography (OCT) can be used as diagnostic aid due to the advantages of high resolution and non-invasion. We aim to evaluate deep-learning-based algorithms for OCT images to assist clinicians in oral cancer screening and diagnosis. An OCT data set was first established, including normal mucosa, precancerous lesion, and oral squamous cell carcinoma. Then, three kinds of convolutional neural networks (CNNs) were trained and evaluated by using four metrics (accuracy, precision, sensitivity, and specificity). Moreover, the CNN-based methods were compared against machine learning approaches through the same dataset. The results show the performance of CNNs, with a classification accuracy of up to 96.76%, is better than the machine-learning-based method with an accuracy of 92.52%. Moreover, visualization of lesions in OCT images was performed and the rationality and interpretability of the model for distinguishing different oral tissues were evaluated. It is proved that the automatic identification algorithm of OCT images based on deep learning has the potential to provide decision support for the effective screening and diagnosis of oral cancer.

/pdf/deep-learning-based-automated-identification-and-2vt4bduo.pdf

Deep-Learning-Based Automated Identification and Visualization of Oral Cancer in Optical Coherence Tomography Images

Histopathological examination is still the gold standard for diagnoses of oral-maxillofacial lesions, but it is invasive and time-consuming. Optical coherence tomography (OCT) provides a kind of no...

https://www.worldscientific.com/doi/pdf/10.1142/S1793545820500108

Intraoperative imaging of oral-maxillofacial lesions using optical coherence tomography

Background and objectives Distinguishing cancer from precancerous lesions is critical and challenging in oral medicine. As a noninvasive method, optical coherence tomography (OCT) has the advantages of real-time, in vivo, and large-depth imaging. Texture information hidden in OCT images can provide an important auxiliary effect for improving diagnostic accuracy. The aim of this study is to explore a reliable and accurate OCT-based method for the screening and diagnosis of human oral diseases, especially oral cancer. Materials and methods Fresh ex vivo oral tissues including normal mucosa, leukoplakia with epithelial hyperplasia (LEH), and oral squamous cell carcinoma (OSCC) were imaged intraoperatively by a homemade OCT system, and 58 texture features were extracted to create computational models of these tissues. A principal component analysis algorithm was employed to optimize the combination of texture feature vectors. The identification based on artificial neural network (ANN) was proposed and the sensitivity/specificity was calculated statistically to evaluate the classification performance. Results A total of 71 sites of three types of oral tissues were measured, and 5176 OCT images of three types of oral tissues were used in this study. The superior classification result based on ANN was obtained with an average accuracy of 98.17%. The sensitivity and specificity of normal mucosa, LEH, and OSCC are 98.17% / 98.38%, 93.81% / 98.54%, and 98.11% / 99.04%, respectively. Conclusion It is demonstrated from the high accuracies, sensitivities, and specificities that texture-based analysis can be used to identify oral precancerous and cancerous tissue in OCT images, and it has the potential to help surgeons in diseases screening and diagnosis effectively.

Identification of oral precancerous and cancerous tissue by swept source optical coherence tomography.

Currently, the diagnoses of oral diseases primarily depend on the visual recognition of experienced clinicians. It has been proven that automatic recognition based on images can support clinical decision-making by extracting and analyzing objective hidden information. In recent years, optical coherence tomography (OCT) has become a powerful optical imaging technique with the advantages of high resolution and non-invasion. In our study, a dataset composed of four kinds of oral salivary gland tumors (SGTs) was obtained from a homemade swept-source OCT, including two benign and two malignant tumors. Seventy-six texture features were extracted from OCT images to create computational models of diseases. It was demonstrated that the artificial neural network (ANN) based on principal component analysis (PCA) can obtain high diagnostic sensitivity and specificity (higher than 99%) for these four kinds of tumors. The classification accuracy of each tumor is larger than 99%. In addition, the performances of two classifiers (ANN and support vector machine) were quantitatively evaluated based on SGTs. It was proven that the texture features in OCT images provided objective information to classify oral tumors.

Classification of oral salivary gland tumors based on texture features in optical coherence tomography images

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