[Early recognition of cancerous lesions in the mouth and oropharynx: Automated evaluation of hyperspectral image stacks]. / Früherkennung kanzeröser Läsionen in Oropharynx und Mundhöhle: Automatisierte Evaluation hyperspektraler Bildstapel.

BACKGROUND: Early detection of cancerous lesions is still crucial for a patient's prognosis. Although diagnostic access to the oral cavity and oropharynx is comparably easy, the incidence of resulting disease remains high. This is due to the fact that in many cases, malignity is recognized too late on a purely visual basis. Previously, we discussed the application of hyperspectral imaging for early detection of precancerous and cancerous lesions of the larynx. This time, we evaluate the method in the oral cavity and oropharynx. MATERIALS AND METHODS: In 85 patients scheduled for endoscopy, hyperspectral imaging was performed. We used a rigid 0-degree endoscope, a light-adjustable monochromator, and a hyperspectral camera. For evaluation of the method, 3 patients were chosen exemplarily. Training sites from physiological and cancerous tissues were marked. Hyperspectral data from 1 patient were used to train a classifier, which was then used for automatic detection of precancerous and cancerous lesions in another 2 patients. RESULTS: Intraoperative hyperspectral imaging was performed without any problems. Classification showed sensitivities of 61 and 43%, and a specificity of 100%. CONCLUSION: This proof-of-concept study underscores the high potential of hyperspectral imaging for early recognition of cancer in the mouth and oropharynx. Besides a better prognosis for cancer patients, this approach could lead to higher cost efficiency in the health system.

[Hyperspectral imaging in head & neck oncology]. / Hyperspectral Imaging in der Kopf-Hals-Onkologie.

Hyperspectral Imaging has long been established in other scientific disciplines than medicine (e. g. earth science) as a means for objective classification of image data information. Some 10 years ago it was first introduced into medicine. Due to its immanent advantages - non-destructive specimen, compatibility with established optical tools (microscope, endoscope), objectivity, and user-independence - several attempts have been made in order to use its potential for the treatment of cancer patients. This publication reviews which methods have been developed for analogue issues in disciplines other than medicine, how these can be transferred into medicine, and what the perspectives are for the traditional innovative field of head-and-neck-oncology.

[Endoscopy of the larynx by hyperspectral imaging]. / Endoskopie des Larynx mit Hyperspectral Imaging.

BACKGROUND: Hyperspectral imaging has been proven to be useful in remote earth sensing, e.g., satellite-based classification of vegetation. After modifying it for in vivo evaluation of the larynx using microscopy, we show its adoption for endoscopes. MATERIALS AND METHODS: In addition to routine microlaryngoscopies under white light inspection, the laryngoscopy was also performed with not only a conventional operation microscope mounted with a tuneable monochromatic light source and a synchronously triggered monochromatic CCD camera (n = 47 patients), but also a similarly modified rigid 0° endoscope (n = 16 patients). Hyperspectral image cubes were obtained between 390 and 680 nm, analyzed using established software tools, and the data using microscope versus endoscope were compared. RESULTS: Under endoscopy, illumination was more even and sterical resolution appeared unchanged at significantly shorter image acquisition times. Hyperspectral classification delineated areas of altered mucosa without further external information irrespective of whether image cubes were generated with microscopy or endoscopy. CONCLUSION: Hyperspectral imaging can be transferred not only to micro(laryngo)scopy but also to endoscopy with rigid optics. This opens the way to a variety of clinically relevant anatomical regions (e.g., upper aerodigestive tract). Its adoption to flexible optics will further broaden this spectrum.

Activation of protein kinase C accelerates contraction kinetics of airway smooth muscle.

Contraction kinetics of isolated rat tracheal smooth muscle were studied by analysing the increase of force subsequent to force-inhibiting passive length changes lasting 1 s (100 Hz, sinus, 5% of muscle length). Compared with carbachol activation, phorboldibutyrate (PDBu)-induced stimulation of protein kinase C (PKC) demonstrated no significant difference in the extent of force development in the polarized preparation [mean peak force 9.16 +/- 0.37 mN (carbachol) vs. 9.12 +/- 0.37 mN (PDBu)]. However, the time constant calculated for the slow component of post-vibration force recovery was 6.40 +/- 0.29 s after addition of PDBu vs. 22.39 +/- 1.40 s during carbachol activation, indicating a significant phorbol ester-induced acceleration of the cross-bridge cycling rate. In the K-depolarized preparation, treatment with 26.4 microM indolactam (IL) to activate PKC produced muscle relaxation (9.94 +/- 0.16 mN measured 0-30 min after the onset of depolarization vs. 4.13 +/- 0.05 mN measured during 30-60 min of IL treatment). Again, even in the presence of high sarcoplasmic Ca2+ resulting from tonic depolarization, PKC activation was associated with a distinct diminution of the time constant (25.99 +/- 0.79 s during the first 30 min of depolarization vs. 10.32 +/- 0.21 s during 30-60 min of IL treatment). In contrast, addition of 0.035 microM verapamil, 1.5 microM isoproterenol, and 32 microM dibutyryl-cAMP to the bathing medium induced relaxation without affecting the rate of post-vibration force recovery. The results suggest that the calcium-dependent signal cascade (agonist receptor/inositol trisphosphate/ Ca(2+)-calmodulin/myosin light chain kinase) hardly affects the regulation of contraction kinetics in the tonically activated intact smooth muscle preparation. PKC stimulation, however, accelerates actin/myosin interaction kinetics, possibly by inhibition of phosphatase(s).