Presented in part as a poster at the Annual Meeting of the American Academy of Otolaryngology-Head and Neck Surgery Foundation, Inc., San Antonio, Texas, September 13-16, 1998. The published abstract appears in the August 1998 Special Issue of Otolaryngology-Head and Neck Surgery on page P100.
Noninvasive Imaging of Human Oral Mucosa in Vivo by Confocal Reflectance Microscopy †
Version of Record online: 4 JAN 2009
Copyright © 1999 The Triological Society
Volume 109, Issue 10, pages 1709–1717, October 1999
How to Cite
White, W. M., Rajadhyaksha, M., González, S., Fabian, R. L. and Anderson, R. R. (1999), Noninvasive Imaging of Human Oral Mucosa in Vivo by Confocal Reflectance Microscopy . The Laryngoscope, 109: 1709–1717. doi: 10.1097/00005537-199910000-00029
This work was funded in part by a grant from the Department of Energy (grant No. DE-FG02-91ER61229) and a Whitaker Foundation grant to Milind Rajadhyaksha. Further instrument and human studies were supported by Lucid, Inc. (Henrietta, NY).
- Issue online: 4 JAN 2009
- Version of Record online: 4 JAN 2009
- Manuscript Accepted: 15 JUN 1999
- blood flow/microvasculature;
- mouth mucosa;
Objectives/Hypothesis: To study the microscopic anatomy of normal oral tissues in vivo using confocal reflectance microscopy (CRM). This novel and noninvasive imaging modality can define and characterize healthy oral mucosa and thus this work serves as the foundation for studying oral diseases in vivo.
Study Design: This was a pilot observational cohort study comparing noninvasive CRM images with histology.
Materials and Methods: Lip and tongue mucosa were imaged by CRM in six healthy human subjects. In CRM living tissue is illuminated by a laser source and backscattered (or reflected) light is collected by a detector. Image contrast is determined by natural differences in refractive indices of organelles and other subcellular structures within the tissues. Gray-scale images were displayed in real-time on a video monitor and represented horizontal (en face) optical sections through the tissue. Motion of the oral tissue relative to the objective lens was minimized with a tissue stabilizer. After imaging, biopsies were taken from the same site of lip mucosa to correlate noninvasive confocal images with conventional histology.
Results: Confocal images correlated well with conventional histology, both qualitatively (visual analysis) and quantitatively (stereology). Imaging was possible up to depths of 490 and 250 μm in the lip and tongue, respectively. Cells and organelles including nuclei, circulating blood cells, and extracellular matrix were clearly observed.
Conclusion: CRM provides details of normal human oral mucosa at the cellular level without the artifacts of histological processing, and thus has the potential for further development and use in clinical practice as a diagnostic tool for the early detection of oral cancer and precancer.