A researcher at the University of Oklahoma (OU) is developing computer technology and a medical device that he hopes can detect oral cancer at an early stage when survival rates are much higher.
Javier Jo, PhD, a professor with the School of Electrical and Computer Engineering and a member of the Stephenson Cancer Center at OU Medicine, has received a $2.5 million grant from the National Cancer Institute for his work.
Jo’s research involves creating a handheld endoscope to look for precancerous and cancerous lesions of the mouth and “training” it to recognize patterns and signatures of those lesions with more accuracy and at an earlier stage.
“When oral cancer is diagnosed early, treating the patient is much more effective and a lot less invasive,” Jo said. “The survival rate and quality of life of the patient is fairly high if the cancer is detected early.”
Jo’s technology aims to address two problems in oral cancer detection. General dentists are usually the first health providers to examine the tissue inside the mouth and search for lesions based on look and feel.
However, it’s difficult to distinguish between a benign lesion from a cancerous or precancerous lesion, Jo said. In addition, dentists have varying degrees of experience in oral cancer screenings.
When dentists discover a suspicious lesion, they usually refer the patient to an oral pathologist, who may decide to do a tissue biopsy. But because some lesions are quite large, the pathologist has to decide from which area to take the biopsy sample.
Unfortunately, the pathologist may take a sample from a non-cancerous portion of the lesion, while another area may be cancerous, Jo said.
“Those are two main barriers to detecting oral cancer early,” said Jo. “What’s missing is an objective and quantitative tool to provide more precise information about the presence of malignant versus benign lesions.”
Jo is developing fluorescence imaging endoscopes and combining them with artificial intelligence technologies. When he shines light of a specific color into the tissues of a person’s mouth, the molecules in those tissues respond by emitting light of their own, known as fluorescence.
Because cancer cells divide very quickly, Jo is looking for changes in the fluorescence characteristics of specific molecules associated with increased cell activity, which is a hallmark of cancer cells.
Jo’s team is now engineering the endoscopes, which will be sent to several clinical centers where patients with suspicious lesions will be imaged before having a biopsy to confirm whether oral cancer is present.
This multicenter study will provide data to develop artificial intelligence algorithms that aim to distinguish between benign, precancerous, and cancerous oral lesions.
“Once we have a computer algorithm that can discern different types of lesions, we can put that algorithm into the endoscope and test it on a larger group of patients to see if it works with enough accuracy to be clinically useful,” said Jo.
Jo’s aim is that the technology first will be used in the dentist’s office for a more accurate determination of whether a patient needs to be referred to an oral pathologist. He also envisions an oral pathologist using the tool to determine which area of the lesion needs to be biopsied.
Robert Mannel, MD, Stephenson Cancer Center director and Rainbolt Family Chair in Cancer, said Jo’s research has the potential to dramatically increase the number of oral cancer patients who are diagnosed at an earlier stage.
“We are excited by the prospects of Dr. Jo’s innovative research,” Mannel said. “Not only does it point to a promising avenue of improving patient outcomes through earlier cancer detection, it also underscores the close collaboration between Stephenson Cancer Center researchers at the OU Health Sciences Center and OU Norman campuses.”