Objectives

Evaluating structural changes in oral epithelium can assist with the diagnosis of cancerous lesions. Two-dimensional (2D) non-invasive optical coherence tomography (OCT) is an established technique for this purpose. The objective of this study was to develop and test the diagnostic accuracy of a three-dimensional (3D) evaluation method.

Methods

The oral lip mucosa of 10 healthy volunteers was scanned using an 870-nm spectral-domain OCT device (SD-OCT) with enhanced depth imaging (EDI). Four raters semi-automatically segmented the epithelial layer twice. Thus, eighty 3D datasets were created and analyzed for epithelial thickness. To provide a reference standard for comparison, the raters took cross-sectional 2D measurements at representative sites. The correlation between the 2D and 3D measurements, as well as intra- and inter-rater reliability, were analyzed using intraclass correlation coefficients (ICC).

Results

Mean epithelial thickness was 280 ± 64μm (range 178–500 μm) and 268 ± 49μm (range 163–425 μm) for the 2D and 3D analysis, respectively. The inter-modality correlation of the thickness values was good (ICC: 0.76 [0.626–0.846]), indicating that 3D analysis of epithelial thickness provides valid results. Intra-rater and inter-rater reliability were good (3D analysis) and excellent (2D analysis), suggesting high reproducibility.

Conclusions

Diagnostic accuracy was high for the developed 3D analysis of oral epithelia using non-invasive, radiation-free OCT imaging.

Clinical significance

This new 3D technique could potentially be used to improve time-efficiency and quality in the diagnosis of epithelial lesions compared with the 2D reference standard.

中文翻译：

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基于光学相干断层扫描的口腔上皮无创三维厚度分析——开发和诊断性能

目标

评估口腔上皮的结构变化有助于诊断癌性病变。二维 (2D) 非侵入性光学相干断层扫描 (OCT) 是用于此目的的成熟技术。本研究的目的是开发和测试三维 (3D) 评估方法的诊断准确性。

方法

使用具有增强深度成像 (EDI) 的 870 nm 光谱域 OCT 设备 (SD-OCT) 扫描了 10 名健康志愿者的口腔唇粘膜。四名评估者半自动分割上皮层两次。因此，创建了 80 个 3D 数据集并分析了上皮厚度。为了提供比较的参考标准，评估者在代表性地点进行了横截面二维测量。使用组内相关系数 (ICC) 分析 2D 和 3D 测量值之间的相关性，以及评估者内和评估者间的可靠性。

结果

2D 和 3D 分析的平均上皮厚度分别为 280 ± 64 μm（范围 178–500 μm）和 268 ± 49 μm（范围 163–425 μm）。厚度值的模态间相关性良好（ICC：0.76 [0.626-0.846]），表明上皮厚度的 3D 分析提供了有效的结果。评分者内和评分者间的可靠性良好（3D 分析）和出色（2D 分析），表明具有高可重复性。

结论

使用非侵入性、无辐射 OCT 成像对口腔上皮细胞进行 3D 分析的诊断准确性很高。

临床意义

与 2D 参考标准相比，这种新的 3D 技术可能用于提高诊断上皮病变的时间效率和质量。