Multiscale Optical Imaging with Real Time Projection of Cancer Risk and Biopsy Guidance Maps for Early Oral Cancer Diagnosis and Treatment

Abstract When detected early, oral precancer and cancer can be treated with surgical resection with successful long-term clinical outcomes. Despite easy accessibility of the oral cavity, conventional oral examination has limited sensitivity and specificity to detect early neoplastic changes. Several optical imaging tools have shown promise to improve early detection of oral neoplasia, but they do not provide visible guidance to help clinicians determine when and where to biopsy suspicious oral lesions. Here, we demonstrate a low-cost, portable Active Biopsy Guidance System (ABGS) that uses multi-scale optical imaging with deep learning algorithms to create and directly project cancer risk maps onto clinically visible oral potentially malignant disorders (OPMDs) to guide biopsy locations in real time. Representative patient examples highlight these clinically actionable visualizations that are provided in real-time during an imaging procedure through automated processing of imaging data. Results show multiscale optical imaging with cancer-risk map projection offers a versatile, quantitative and precise tool to guide biopsy site selection and improve the early detection of oral epithelial cancers and their precursors.