Optical biopsy in head and neck malignancies. Current state of the art and prospects

The majority of head and neck cancers are diagnosed at advanced tumor stages, which can limit treatment options and often increases the radicality of treatment. Evaluation of suspicious areas is usually performed with white light endoscopy, followed by invasive tissue biopsy as the gold standard of diagnosis. However, there is a significant diagnostic deficit in the early detection of precancerous lesions and the identification of tumor margins. To address this shortcoming, several optical methods have been developed and clinically tested in the upper aerodigestive tract over the past 20 years. Common to the optical diagnostic techniques is the ability to characterize epithelial tissue microarchitecture with the goal of visualizing and/or delineating tumors noninvasively and in real time to enable an optically guided, complete, and precise excision. These systems are based on the principle that the optical spectrum derived from any tissue contains information about the histological and biochemical nature of that tissue. Narrow-band imaging, contact endoscopy, confocal laser endomicroscopy, optical coherence tomography and Raman spectroscopy are some examples of such techniques that show promising results but have not yet reached widespread clinical application. The obvious advantages of making an accurate pathological diagnosis without the need to remove a tissue sample not only reduce trauma to the patient but would also have financial implications. The precise visualization of tumor margins, as well as more targeted biopsy sampling likewise represent promising developments.

Publikationsverlauf

Artikel online veröffentlicht:
12. Mai 2023