A Prospective Study to Assess In Vivo Optical Coherence Tomography Imaging for Early Detection of Chemotherapy-induced Oral Mucositis

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Departmental Papers (Dental)
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Author keywords: cancer therapy
imaging
monitoring
oral diagnosis
oral mucosa
prediction MeSH: Antineoplastic Agents
Breast Neoplasms
Early Diagnosis
Female
Humans
Neoadjuvant Therapy
Predictive Value of Tests
Prospective Studies
Reproducibility of Results
Stomatitis
Tomography
Optical Coherence EMTREE drug terms: antineoplastic agent EMTREE medical terms:article
breast cancer
cancer adjuvant therapy
chemotherapy induced oral mucositis
clinical article
controlled study
diagnostic imaging
female
human
in vivo study
non invasive procedure
optical coherence tomography
oral mucositis
priority journal
prospective study
scoring system
Dentistry
Oral Biology and Oral Pathology
Periodontics and Periodontology
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Calantog, Alden
Hallajian, Lucy
Nabelsi, Tasneem
Mansour, Stephanie
Le, Ahn
Epstein, Joel
Wilder-Smith, Petra
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Abstract

Background and Objective Oral mucositis (OM) is a common and severe complication of many cancer therapies. Currently, prediction and early detection are not possible and objective monitoring remains problematic. Goal of this prospective study is to assess non-invasive imaging using optical coherence tomography (OCT) for early detection and evaluation of chemotherapy-induced OM in 48 patients, 12 of whom developed clinical mucositis. Study Design/Materials and Methods In 48 patients receiving neoadjuvant chemotherapy for primary breast cancer, oral mucosal health was assessed clinically, and imaged using non-invasive OCT. Images were evaluated for mucositis using an imaging-based scoring system ranging from 0 to 6. Conventional clinical assessment using the OM assessment scale (OMAS) was used as the gold standard. Patients were evaluated on Days 0-11 after commencement of chemotherapy. OCT images were visually scored by three blinded investigators. Results The following events were identified from OCT images (1) change in epithelial thickness and subepithelial tissue integrity (beginning on Day 2), (2) loss of surface keratinized layer continuity (beginning on Day 4), (3) loss of epithelial integrity (beginning on Day 4). Imaging data gave higher scores compared to clinical scores early in treatment, suggesting that the imaging-based diagnostic scoring was more sensitive to early mucositic change than the clinical scoring system. Once mucositis was established, imaging and clinical scores converged. Conclusion Using OCT imaging and a novel scoring system, earlier, more sensitive detection of mucositis was possible than using OMAS. Specific imaging-based changes were a consistent predictor of clinical mucositis. Lasers Surg. Med. 45: 22-27, 2013. © 2013 Wiley Periodicals, Inc. Copyright © 2013 Wiley Periodicals, Inc.

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2013-01-01
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Lasers in Surgery and Medicine
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