Enhanced detection of oral dysplasia by structured illumination fluorescence lifetime imaging microscopy

• Published in: Scientific reports Vol. 11; no. 1; pp. 4984 - 11
• Main Authors: Hinsdale, Taylor A., Malik, Bilal H., Cheng, Shuna, Benavides, Oscar R., Giger, Maryellen L., Wright, John M., Patel, Paras B., Jo, Javier A., Maitland, Kristen C.
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 02.03.2021; Nature Publishing Group; Nature Portfolio
• Subjects: 631/1647/245/2225; 631/67/1665; 639/624/1075; 639/624/1107/328; 692/4028/67/1665; Animals; Carcinogenesis; Cheek pouch; Cofactors; Dysplasia; Epithelium; Fluorescence; Humanities and Social Sciences; Illumination; Malignancy; Mesocricetus; Microscopy; Microscopy, Fluorescence; Mouth Neoplasms - metabolism; Mouth Neoplasms - pathology; Mucosa; multidisciplinary; NADH; NADP - metabolism; Oral squamous cell carcinoma; Science; Science (multidisciplinary); Squamous cell carcinoma; Squamous Cell Carcinoma of Head and Neck - metabolism; Squamous Cell Carcinoma of Head and Neck - pathology
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-021-84552-8

We demonstrate that structured illumination microscopy has the potential to enhance fluorescence lifetime imaging microscopy (FLIM) as an early detection method for oral squamous cell carcinoma. FLIM can be used to monitor or detect changes in the fluorescence lifetime of metabolic cofactors (e.g. NADH and FAD) associated with the onset of carcinogenesis. However, out of focus fluorescence often interferes with this lifetime measurement. Structured illumination fluorescence lifetime imaging (SI-FLIM) addresses this by providing depth-resolved lifetime measurements, and applied to oral mucosa, can localize the collected signal to the epithelium. In this study, the hamster model of oral carcinogenesis was used to evaluate SI-FLIM in premalignant and malignant oral mucosa. Cheek pouches were imaged in vivo and correlated to histopathological diagnoses. The potential of NADH fluorescence signal and lifetime, as measured by widefield FLIM and SI-FLIM, to differentiate dysplasia (pre-malignancy) from normal tissue was evaluated. ROC analysis was carried out with the task of discriminating between normal tissue and mild dysplasia, when changes in fluorescence characteristics are localized to the epithelium only. The results demonstrate that SI-FLIM (AUC = 0.83) is a significantly better (p-value = 0.031) marker for mild dysplasia when compared to widefield FLIM (AUC = 0.63).