High-Resolution Optical Imaging of Benign and Malignant Mucosa in the Upper Aerodigestive Tract: An Atlas for Image-Guided Surgery

Abstract

Background . High-resolution optical imaging provides real-time visualization of mucosa in the upper aerodigestive tract (UADT) which allows non-invasive discrimination of benign and neoplastic epithelium. The high-resolution microendoscope (HRME) utilizes a fiberoptic probe in conjunction with a tissue contrast agent to display nuclei and cellular architecture. This technology has broad potential applications to intraoperative margin detection and early cancer detection. Methods . Our group has created an extensive image collection of both neoplastic and normal epithelium of the UADT. Here, we present and describe imaging characteristics of benign, dysplastic, and malignant mucosa in the oral cavity, oropharynx, larynx, and esophagus. Results . There are differences in the nuclear organization and overall tissue architecture of benign and malignant mucosa which correlate with histopathologic diagnosis. Different anatomic subsites also display unique imaging characteristics. Conclusion . HRME allows discrimination between benign and neoplastic mucosa, and familiarity with the characteristics of each subsite facilitates correct diagnosis.