Differentiation of oral precancerous stages with optical coherence tomography based on the evaluation of optical scattering properties of oral mucosae

Optical coherence tomography (OCT) has been demonstrated to be a powerful tool for noninvasive, real-time oral cancer diagnosis. However, in previous reports, OCT has still been found to be difficult to use in the diagnosis of oral precancerous stages, including mild dysplasia and moderate dysplasia. In clinical applications, early diagnosis and treatment of oral cancer can greatly improve the survival rate. Therefore, in this study, we propose a new approach to differentiate the oral precancerous stages based on the evaluation of the optical scattering properties of the epithelial layer, which is where the dysplastic cells start to develop in the precancerous stages. Instead of using exponential decay fitting to evaluate the scattering properties of mucosal tissues based on the Beer-Lambert law, linear fitting of the OCT depth intensity is used to evaluate the scattering properties of normal and dysplastic cells. From the statistical results of the linear fitting, the slope, a, can be an effective indicator to discriminate healthy mucosa and moderate dysplasia when an a value equal to zero is the threshold value, and the intercept, b, can be used to differentiate healthy and dysplastic mucosae, as well as mild and moderate dysplasia, when b values of 0.15 and 0.18 are used as the threshold values, respectively. Furthermore, this approach is also applied to the determination of the safe margin between normal and abnormal mucosae, making it possible to provide real-time, in vivo inspection during oral maxillofacial surgery.