In vivo optical virtual biopsy of human oral cavity with harmonic generation microscopy

Oral cancer ranked number four in both cancer incident and mortality in Taiwanese male population. Early disease diagnosis and staging is essential for its clinical success. However, most patients were diagnosed in their late disease stage as ideal prescreening procedures are yet to be developed especially when dealing with a large surface of precancerous lesions. Therefore, how to detect and confirm the diagnosis of these early stage lesions are of significant clinical value. Harmonic generation process naturally occurred in biological molecules and requires no energy deposition to the target molecule. Thus harmonic generation microscopy (HGM) could potentially serve as a noninvasive tool for screening of human oral mucosal diseases. The in vivo optical biopsy of human oral cavity with HGM could be achieved with high spatial resolution to resolve dynamic physiological process in the oral mucosal tissue with equal or superior quality but devoid of complicated physical biopsy procedures. The second harmonic generation (SHG) provide significant image contrast for biomolecules with repetitive structures such as the collagen fibers in the lamina propria and the mitotic spindles in dividing cells. The cell morphology in the epithelial layer, blood vessels and blood cells flow through the capillaries can be revealed by third harmonic generation (THG) signals. Tissue transparent technology was used to increase the optical penetration of the tissue. In conclusion, this report demonstrates the first in vivo optical virtual biopsy of human oral mucosa using HGM and revealed a promising future for its clinical application for noninvasive in vivo diseases diagnosis.