Optical coherence tomography is a noninvasive imaging technique that provides three-dimensional visualization of subsurface tissue structures. OCT has been proposed and explored in the literature as a tool to assess oral cancer status, select biopsy sites, or identify surgical margins. Our endoscopic OCT device can generate widefield (centimeters long) imaging of lesions at any location in the oral cavity—but it is challenging for raters to quantitatively assess and score large volumes of data. Leveraging a previously developed epithelial segmentation network, this work develops quantifiable biomarkers that provide direct measurements of tissue properties in three dimensions. We hypothesize that features related to morphology, tissue attenuation, and contrast between tissue layers will be able to provide a quantitative assessment of disease status (dysplasia through carcinoma). This work retrospectively assesses seven biomarkers on a lesion-contralateral matched OCT dataset of the lateral and ventral tongue (40 patients, 70 sites). Epithelial depth and loss of epithelial–stromal boundary visualization provide the strongest discrimination between disease states. The stroma optical attenuation coefficient provides a distinction between benign lesions from dysplasia and carcinoma. The stratification biomarkers visualize subsurface changes, which provides potential for future utility in biopsy site selection or treatment margin delineation.
光学相干断层扫描是一种无创成像技术，能够实现皮下组织结构的三维可视化。现有文献已提出并探索将OCT作为评估口腔癌状态、选择活检部位或识别手术边界的工具。我们研发的内窥式OCT设备可对口腔任意位置病灶实现大视野（厘米级）成像，但评估者难以对海量数据进行定量评估与评分。本研究基于先前开发的上皮层分割网络，建立了可量化生物标志物体系，实现对组织三维特性的直接测量。我们假设与形态结构、组织衰减及组织层间对比度相关的特征能够为疾病状态（从异型增生到癌变）提供定量评估。本研究通过舌侧缘与舌腹面的病灶-对侧匹配OCT数据集（40例患者，70个位点）对七种生物标志物进行回顾性评估。上皮层厚度与上皮-基质边界可视化缺失在疾病状态判别中表现出最强区分度。基质光学衰减系数可有效区分良性病变与异型增生/癌变组织。这些分层生物标志物实现了皮下病变的可视化表征，为未来在活检部位选择或治疗边界划定中的应用提供了潜在可能。
肿瘤(癌症)患者之家