Clinical assessment of non carious cervical lesion using swept‐source optical coherence tomography

Non‐carious cervical lesions (NCCLs) involve various forms of tooth loss with different etiologies. This study aimed to utilize swept‐source optical coherence tomography (SS‐OCT) at 1300 nm wavelength range in vitro and in vivo to evaluate and clarify the mechanism of NCCLs. In the in vitro phase, a dentin attenuation coefficient (μ_t) derived from the SS‐OCT signal at NCCL was compared with mineral loss obtained from transverse microradiography (TMR) to determine a μ_t threshold to discriminate demineralization of cervical dentin in vivo. In the clinical study, 242 buccal surfaces were investigated in 35 subjects. Presence and dimensions of NCCLs, cervical cracking and the degree of demineralization at the exposed cervical dentin were determined using SS‐OCT. Dentin demineralization was observed in 69% of NCCLs. SS‐OCT results confirm that dentin mineral loss and occlusal attrition were associated with larger NCCLs, and can be considered as an etiological factor in formation and progress of these lesions.

( A ) We determined the attenuation coeffcient (μ_t) threshold of SS‐OCT signal for the detection of demineralization (1.21) from in vitro study. DEM: demineralized dentin, sound: sound dentin. ( B ) Using the μ_t threshold, we observed NCCLs in vivo to detect the demineralization in cervical dentin. SS‐OCT scanning was performed along the red line. ( C ) SS‐OCT image obtained along the red line in B. In SS‐OCT, brightness of dentin beneath the NCCL was increased (arrow) compared with intact zone. The cervical dentin was slightly demineralized (μ_t: 1.25). e: enamel, d: dentin, g: gingiva.     

The cornerstone of integrating circulating tumor DNA into cancer management

Recent circulating tumor DNA (ctDNA) research has demonstrated its potential as a non-invasive biomarker for cancer. However, the deployment of ctDNA assays in routine clinical practice remains challenging owing to variability in analytical approaches and the assessment of clinical significance. A well-developed, analytically valid ctDNA assay is a prerequisite for integrating ctDNA into cancer management, and an appropriate analytical technology is crucial for the development of a ctDNA assay. Other determinants including pre-analytical procedures, test validation, internal quality control (IQC), and continual proficiency testing (PT) are also important for the accuracy of ctDNA assays. In the present review, we will focus on the most widely used ctDNA detection technologies and the key quality management measures used to assure the accuracy of ctDNA assays. The aim of this review is to provide useful information for technology selection during ctDNA assay development and assure a reliable test result in clinical practice.