Development and Diagnostic Potential of a Handheld Probe Polarization‐Sensitive Optical Coherence Tomography in Oral Mucosa Imaging

Early detection of oral cancer through routine screening is important. Therefore, developing noninvasive, good‐resolution, and cost‐effective screening tools that provide real‐time in vivo oral health imaging is paramount. This study aimed to demonstrate a handheld probe (Polarization‐Sensitive Optical Coherence Tomography PS‐OCT) in the human oral cavity. A handheld PS‐OCT probe was designed, measuring 180 mm in length, 12.7 mm in diameter, and weighing 440 g. The device captures three‐dimensional images of the oral cavity within 10 s and creates enface projection images to visualize the distribution of scattering and birefringence. In vivo measurements were performed on high‐risk areas in the oral cavities of four volunteers, and ex vivo testing was conducted on two patients with oral cancer. The handheld probe successfully identified various microarchitectures within the oral cavity, including the lower lip mucosa, lower gingiva, buccal mucosa, sublingual area, and tongue. Different oral mucosa layers, including the epithelium, lamina propria, and basement membrane, were well identified. Furthermore, eight clinicians evaluated their ability to differentiate between normal oral and cancerous mucosa using handheld PS‐OCT images. The integration of enface scattering and birefringence maps demonstrated superior performance compared to the enface scattering map alone, achieving higher specificity (83.3% vs. 55.0%, p = 0.03) and accuracy (81.3% vs. 58.8%, p = 0.011). The handheld probe PS‐OCT shows significant potential as a tool for oral screening, providing a practical and noninvasive solution for early oral cancer detection in clinical settings.