Feasibility of a Video-Mosaicking Approach to Extend the Field-of-View For Reflectance Confocal Microscopy in the Oral Cavity In Vivo
Feasibility of a Video-Mosaicking Approach to Extend the Field-of-View For Reflectance Confocal Microscopy in the Oral Cavity In Vivo
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DOI：
10.1002/lsm.23090
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发表时间：
2019-07-01
影响因子：
2.4
通讯作者：
Rajadhyaksha, Milind
中科院分区：
文献类型：
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作者：
Peterson, Gary;Zanoni, Daniella Karassawa;Rajadhyaksha, Milind
背景反射共聚焦显微镜（RCM）是一种发展中的无标记对比度和细胞水平分辨率的口腔病变无创检测方法。为了进入口腔，共焦显微镜被配置有小直径的伸缩探头和小物镜。然而，小探头和物镜透镜允许相对于为了诊断而必须检查的大面积组织的相当小的视场。为了扩展口内RCM成像的视野，我们正在研究一种视频镶嵌方法。方法在现有的共聚焦显微镜上安装中继望远镜和物镜透镜，以进入口腔。使用具有盖玻片窗口的金属三维打印物镜透镜前端盖进行成像，以接触和稳定组织并设置深度。四名健康志愿者（正常口腔粘膜），一名患者（汞合金纹身）在临床环境中，和20名麻醉患者（口腔鳞状细胞癌[OSCC]）在手术环境中进行了成像。而不是通常的静止RCM图像，视频记录，然后处理成视频马赛克。30个视频马赛克阅读和定性评估的专家读者的RCM图像的口腔粘膜。结果尽管物镜透镜的原始视野为0.75 mm x 0.75 mm，但视频拼接显示的区域更大，范围从2 mm x 2 mm到4 mm x 2 mm，分辨率、形态细节和图像质量相对于原始视频（单个图像）中观察到的图像质量得以保留。健康志愿者和患者图像的视频拼接显示了下上皮和上皮连接处的细胞形态学模式，以及结缔组织沿着毛细血管环路和固有层深层的血流。在口腔鳞状细胞癌中，肿瘤巢可以沿着边缘区域的正常粘膜观察到。结论视频拼接技术是一种快速有效的扩展RCM成像视野的方法，可以在一定程度上克服口内探头小视野的固有局限性。阅读视频拼接可以模拟检查病理学的过程：肿瘤的空间细胞和形态学模式以及肿瘤边缘在病变较大区域的扩散的初始可视化，然后进行数字缩放（放大）以更仔细地检查可疑区域。然而，将视频更快地处理成视频马赛克将是必要的，以允许在床边实时检查视频马赛克。激光外科医学51：439-451，2019。(c)2019 Wiley Periodicals，Inc.
Background Reflectance confocal microscopy (RCM) is a developing approach for noninvasive detection of oral lesions with label-free contrast and cellular-level resolution. For access into the oral cavity, confocal microscopes are being configured with small-diameter telescopic probes and small objective lenses. However, a small probe and objective lens allows for a rather small field-of-view relative to the large areas of tissue that must be examined for diagnosis. To extend the field-of-view for intraoral RCM imaging, we are investigating a video-mosaicking approach. Methods A relay telescope and objective lens were adapted to an existing confocal microscope for access into the oral cavity. Imaging was performed using metal three-dimensional-printed objective lens front-end caps with coverslip windows to contact and stabilize the tissue and set depth. Four healthy volunteers (normal oral mucosa), one patient (with an amalgam tattoo) in a clinical setting, and 20 anesthetized patients (with oral squamous cell carcinoma [OSCC]) in a surgical setting were imaged. Instead of the usual still RCM images, videos were recorded and then processed into video-mosaics. Thirty video-mosaics were read and qualitatively assessed by an expert reader of RCM images of the oral mucosa. Results Whereas the objective lens' native field-of-view is 0.75 mm x 0.75 mm, the video-mosaics display larger areas, ranging from 2 mm x 2 mm to 4 mm x 2 mm, with resolution, morphologic detail, and image quality that is preserved relative to that observed in the original videos (individual images). Video-mosaics in healthy volunteers' and the patients' images showed cellular morphologic patterns in the lower epithelium and at the epithelial junction, and connective tissue along with capillary loops and blood flow in the deeper lamina propria. In OSCC, tumor nests could be observed along with normal looking mucosa in margin areas. Conclusions Video-mosaicking is a reasonably quick and efficient approach for extending the field-of-view of RCM imaging, which can, to some extent, overcome the inherent limitation of an intraoral probe's small field-of-view. Reading video-mosaics can mimic the procedure for examining pathology: initial visualization of the spatial cellular and morphologic patterns of the tumor and the spread of tumor margins over larger areas of the lesion, followed by digitally zooming (magnifying) for closer inspection of suspicious areas. However, faster processing of videos into video-mosaics will be necessary, to allow examination of video-mosaics in real-time at the bedside. Lasers Surg. Med. 51:439-451, 2019. (c) 2019 Wiley Periodicals, Inc.