Endoscopic Fluorescence Lifetime Imaging for <i>In Vivo</i> Intraoperative Diagnosis of Oral Carcinoma

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<jats:title>Abstract</jats:title><jats:p>A clinically compatible fluorescence lifetime imaging microscopy (FLIM) system was developed. The system was applied to intraoperative <jats:italic>in vivo</jats:italic> imaging of head and neck squamous cell carcinoma (HNSCC). The endoscopic FLIM prototype integrates a gated (down to 0.2 ns) intensifier imaging system and a fiber-bundle endoscope (0.5-mm-diameter, 10,000 fibers with a gradient index lens objective 0.5 NA, 4-mm field of view), which provides intraoperative access to the surgical field. Tissue autofluorescence was induced by a pulsed laser (337 nm, 700 ps pulse width) and collected in the 460 ± 25 nm spectral band. FLIM experiments were conducted at 26 anatomic sites in ten patients during head and neck cancer surgery. HNSCC exhibited a weaker florescence intensity (~50% less) when compared with healthy tissue and a shorter average lifetime (τ<jats:sub>HNSCC</jats:sub> = 1.21 ± 0.04 ns) than the surrounding normal tissue (τ<jats:sub>N</jats:sub> = 1.49 ± 0.06 ns). This work demonstrates the potential of FLIM for label-free head and neck tumor demarcation during intraoperative surgical procedures.</jats:p>

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