Dual-Excitation Multispectral Fluorescence Lifetime Endoscopic Imaging Differentiates Early-Stage Malignant Oral Lesions

Early detection of oral cancer significantly improves survival rates, yet only about 30% of cases are diagnosed early due to the challenge of distinguishing benign from malignant lesions. Malignant transformation in epithelial cells is linked to increased metabolic activity, which induces subtle but specific changes in tissue autofluorescence spectra and lifetimes. A research team at the University of Oklahoma hypothesized that these metabolic biomarkers can be quantified using endogenous fluorescence lifetime imaging (FLIM). To test this, they developed a novel FLIM endoscopy system featuring a dual-excitation, multispectral, frequency-domain design optimized for NADH and FAD autofluorescence sensing.

Four systems were deployed across partner clinical sites, imaging over 300 patients with oral lesions. Preliminary results from classical machine learning (ML) models trained and cross-validated on this dataset show promising diagnostic performance, with sensitivity and specificity exceeding 0.8 and a negative predictive value approaching 1.0. These findings support the potential of label-free, ML-driven FLIM for accurate, noninvasive early differentiation of benign and malignant oral lesions.

About the presenter
Javier A. Jo, Ph.D., is a biomedical scientist and professor of electrical and computer engineering at the University of Oklahoma.

He is a leading innovator in the integration of optical imaging and machine learning, developing intelligent imaging systems that enable quantitative, information-rich visualization and automated, objective data interpretation. His work advances precision medicine by transforming imaging big data into actionable insights for more effective, personalized clinical decision-making.

Jo earned his bachelor’s in electrical engineering from Universidad Católica del Perú, and his master’s in electrical engineering and doctorate in biomedical engineering from the University of Southern California. He is a Fellow of the Society of Photo-Optical Instrumentation Engineers (SPIE), the American Institute for Medical and Biological Engineering (AIMBE), and Optica.