Application of Targeted Optical Coherence Tomography in Oral Cancer: A Cross-Sectional Preliminary Study

Area of Science:

• Oral Medicine and Pathology
• Biomedical Imaging
• Diagnostic Accuracy

Background:

• Diagnosing oral potentially malignant disorders (OPMDs) and oral squamous cell carcinoma (OSCC) is challenging.
• Optical coherence tomography (OCT) shows potential for oral tissue analysis but lacks standardized protocols for mucosal lesions.

Purpose of the Study:

• To evaluate the diagnostic accuracy of targeted biopsy-based and site-coded OCT protocols for OPMDs and OSCC.
• To compare OCT diagnostic accuracy before and after site registration with histological findings.

Main Methods:

• A cross-sectional observational study enrolled adult patients with clinically diagnosed OPMDs (OL, OLP) and OSCC.
• OCT evaluation and punch scalpel-site registration were performed before diagnostic biopsy.
• Blinded observers analyzed OCT scans; sensitivity, specificity, and accuracy were compared to histology.

Main Results:

• High sensitivity and specificity were achieved post-site registration for OSCC, OL, and OLP.
• Positive and negative predictive values were consistently high, ranging from 97.14% to 100.00%.
• Targeted OCT scans significantly improved diagnostic accuracy (p < 0.001) with strong inter-observer agreement for OSCC.

Conclusions:

• Site-targeted OCT scans combined with targeted punch biopsy enhance precision in diagnosing oral conditions.
• This approach provides a foundation for developing automated algorithms for oral cancer and pre-cancer diagnosis using OCT imaging.