1
|
Zabin Alotaibi K, Hameed Kolarkodi S. Effectiveness of adjunctive screening tools for potentially malignant oral disorders and oral cancer: A systematic review. Saudi Dent J 2024; 36:28-37. [PMID: 38375389 PMCID: PMC10874794 DOI: 10.1016/j.sdentj.2023.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 10/12/2023] [Accepted: 10/16/2023] [Indexed: 02/21/2024] Open
Abstract
Background and objectives To enhance the abilities of healthcare professionals to make informed treatment decisions and establish accurate diagnoses, it is essential to assess the diagnostic reliability of different adjunctive aids. This systematic review aimed to compare the accuracy of various adjunctive methods for diagnosing suspected oral cancer (OC) or potentially malignant oral disorders (OPMD) in adults against histopathological investigative results. Materials and methods The review protocol registered in the PROSPERO database (CRD42023463525) was developed in strict accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis-Diagnostic Test Accuracy checklist. A comprehensive electronic search was conducted to identify relevant research articles published between January 2014 and April 2023 using the PubMed and EBSCO databases. The research question was meticulously structured following the participants' index test, reference standard, target condition, and study setting framework. To evaluate methodological quality and assess the risk of bias (RoB), the Quality Assessment for Diagnostic Accuracy Studies-2 tool was used. Results An initial search yielded 483 publications, which were reduced to 278 after removal of duplicates. Finally, 85 publications underwent full-text review by two investigators, which lead to 29 studies that met the inclusion criteria. Among these, 7% had a low RoB, 72% had an unclear RoB, and 21% had a high RoB. Applicability concerns were expressed in 59% of the studies with low concern, 31% with unclear quality evidence of concern, and 10% with high concern. Conclusion The review findings support the use of these diagnostic methods as valuable adjuncts to biopsy for the early detection of various OPMD and OC. They also highlight the importance of regular screening and awareness in reducing the global burden of OC, while acknowledging that they cannot replace the gold standards of surgical biopsy and histopathological evaluation.
Collapse
Affiliation(s)
- Khalid Zabin Alotaibi
- Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Qassim University, Al-Qassim, Saudi Arabia
| | - Shaul Hameed Kolarkodi
- Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Qassim University, Al-Qassim, Saudi Arabia
| |
Collapse
|
2
|
Mat Lazim N, Kandhro AH, Menegaldo A, Spinato G, Verro B, Abdullah B. Autofluorescence Image-Guided Endoscopy in the Management of Upper Aerodigestive Tract Tumors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:159. [PMID: 36612479 PMCID: PMC9819287 DOI: 10.3390/ijerph20010159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 12/16/2022] [Accepted: 12/20/2022] [Indexed: 06/17/2023]
Abstract
At this juncture, autofluorescence and narrow-band imaging have resurfaced in the medicine arena in parallel with current technology advancement. The emergence of newly developed optical instrumentation in addition to the discovery of new fluorescence biomolecules have contributed to a refined management of diseases and tumors, especially in the management of upper aerodigestive tract tumors. The advancement in multispectral imaging and micro-endoscopy has also escalated the trends further in the setting of the management of this tumor, in order to gain not only the best treatment outcomes but also facilitate early tumor diagnosis. This includes the usage of autofluorescence endoscopy for screening, diagnosis and treatment of this tumor. This is crucial, as microtumoral deposit at the periphery of the gross tumor can be only assessed via an enhanced endoscopy and even more precisely with autofluorescence endoscopic techniques. Overall, with this new technique, optimum management can be achieved for these patients. Hence, the treatment outcomes can be improved and patients are able to attain better prognosis and survival.
Collapse
Affiliation(s)
- Norhafiza Mat Lazim
- Department of Otorhinolaryngology-Head and Neck Surgery, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian 16150, Malaysia
| | - Abdul Hafeez Kandhro
- Institute of Medical Technology, Jinnah Sindh Medical University, Karachi 75510, Pakistan
| | - Anna Menegaldo
- Department of Neurosciences, Section of Otolaryngology and Regional Centre for Head and Neck Cancer, University of Padova, 31100 Treviso, Italy
| | - Giacomo Spinato
- Department of Neurosciences, Section of Otolaryngology and Regional Centre for Head and Neck Cancer, University of Padova, 31100 Treviso, Italy
- Department of Surgery, Oncology and Gastroenterology, Section of Oncology and Immunology, University of Padova, 31100 Treviso, Italy
| | - Barbara Verro
- Division of Otorhinolaryngology, Department of Biomedicine, Neuroscience and Advanced Diagnostic, University of Palermo, 90127 Palermo, Italy
| | - Baharudin Abdullah
- Department of Otorhinolaryngology-Head and Neck Surgery, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian 16150, Malaysia
| |
Collapse
|
3
|
Amirchaghmaghi M, Mohtasham N, Delavarian Z, Shakeri MT, Taghizadeh A, Khazaeni K, Hatami M. Analyzing the relationship between tissue color observed in VELscope examination and histopathological factors in OSCC patients. Photodiagnosis Photodyn Ther 2022; 41:103248. [PMID: 36565733 DOI: 10.1016/j.pdpdt.2022.103248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 11/27/2022] [Accepted: 12/16/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Early detection of OSCC is a crucial step towards improving OSCC prognosis. In recent years, novel diagnostic aids such as light-based detection systems have been introduced for early diagnosis. VELscope is one such light-based device which is used to examine tissue fluorescence. Based on different studies, VELscope has a sensitivity of 90% in the diagnosis of oral premalignant and malignant lesions. Tumor depth of invasion and invasive front have recently been proposed as influential factors in OSCC prognosis. Therefore, the aim of this study was to assess the relationship between tissue color seen through this device and tumor depth of invasion. METHODS & MATERIALS 20 histopathologically approved OSCCs were included in this study. Conventional oral examination was carried out followed by an assessment of the lesion using VELscope. The H&E slides prepared following the final OSCC surgeries were then examined by an oral pathologist to assess tumor depth of invasion (interpreted as low-risk/high-risk), invasivefront (low-risk/high-risk) and perivascular and perineural invasions. Data was transferred to SPSS 16 software. The association between color changes and histopathological factors was analyzed using the fisher's exact and chi-square tests. RESULTS The mean age of the patients was 51/5+/-16/74, 60% of which were men. Most lesions were exophytic and the most common color seen during VELscope examination was red. 55% and 50% of the OSCCs showed high-risk tumor depths and high-risk invasive fronts respectively. Perivascular and perineural invasion was seen in 55% and 35% of the samples respectively. Statistical analysis showed that 72/2% of the lesions with high tumor depths and 70% with high-risk invasive fronts were seen as red, although these associations were not significant (P>0/05). Tumor depth was significantly correlated with invasive front (P<0/05). CONCLUSION There was no significant relationship between the type of color seen through VELscope and tumor depth of invasion, however most cases with high-risk depth of invasions were red.
Collapse
Affiliation(s)
- Maryam Amirchaghmaghi
- Oral & Maxillofacial Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Nooshin Mohtasham
- Oral & Maxillofacial Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Zahra Delavarian
- Oral & Maxillofacial Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammad Taghi Shakeri
- Social Determinants of Health Research Center, Mashhad University o Medical Sciences, Mashhad, Iran
| | - Ava Taghizadeh
- Department of Oral Medicine, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran.
| | - Kamran Khazaeni
- Department of Otorhinolaryngology, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Masoud Hatami
- Assistant professor of oral and maxillofacial medicine, department of oral and maxillofacial medicine, school of dentistry, Kermanshah university of medical sciences, Kermanshah, Iran
| |
Collapse
|
4
|
Taguchi Y, Toratani S, Matsui K, Hayashi S, Eboshida N, Hamada A, Ito N, Obayashi F, Kimura N, Yanamoto S. Evaluation of Oral Mucosal Lesions Using the IllumiScan ® Fluorescence Visualisation Device: Distinguishing Squamous Cell Carcinoma. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10414. [PMID: 36012046 PMCID: PMC9408154 DOI: 10.3390/ijerph191610414] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 08/03/2022] [Accepted: 08/18/2022] [Indexed: 06/15/2023]
Abstract
We evaluated whether fluorescence intensity (FI) and its coefficient of variation (CV) can be used to diagnose squamous cell carcinoma (SCC) through IllumiScan®, an oral mucosa fluorescence visualisation (FV) device. Overall, 190 patients with oral mucosal lesions (OMLs; SCC, 59; non-SCC OMLs, 131) and 49 patients with normal oral mucosa (NOM) were enrolled between January 2019 and March 2021. The FI of the images was analysed using image analysis software. After establishing regions of interest for SCC, non-SCC, and NOM, the average FI, standard deviation (SD), and CV were compared. There was a significant difference in the average FI for all pairs of comparisons. The SD was not significantly different between the SCC and NOM groups (p = 0.07). The CV differed significantly for NOM (p < 0.001) and non-SCC groups (p < 0.001) relative to the SCC group but was not different between NOM and non-SCC groups (p = 0.15). Univariate analysis of SCC and non-SCC groups showed significant differences for all factors, except age. However, multivariate analysis showed a significant intergroup difference only in the CV (p = 0.038). Therefore, analysing the CV in FV images of OML may be useful for the diagnosis of oral cancer.
Collapse
Affiliation(s)
- Yuki Taguchi
- Department of Oral Oncology, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi Minami-ku, Hiroshima 734-8551, Japan
| | - Shigeaki Toratani
- Department of Oral Oncology, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi Minami-ku, Hiroshima 734-8551, Japan
| | - Kensaku Matsui
- Department of Dentistry and Oral Surgery, Hiroshima Prefectural Hospital, Hiroshima 734-8530, Japan
| | - Seiya Hayashi
- Department of Dentistry and Oral Surgery, JA Onomichi General Hospital, Onomichi 722-8508, Japan
| | - Natsuki Eboshida
- Department of Oral Oncology, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi Minami-ku, Hiroshima 734-8551, Japan
| | - Atsuko Hamada
- Department of Oral Oncology, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi Minami-ku, Hiroshima 734-8551, Japan
| | - Nanako Ito
- Department of Oral Oncology, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi Minami-ku, Hiroshima 734-8551, Japan
| | - Fumitaka Obayashi
- Department of Oral Oncology, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi Minami-ku, Hiroshima 734-8551, Japan
| | - Naohiro Kimura
- Department of Oral Oncology, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi Minami-ku, Hiroshima 734-8551, Japan
| | - Souichi Yanamoto
- Department of Oral Oncology, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi Minami-ku, Hiroshima 734-8551, Japan
| |
Collapse
|
5
|
Li C, Zhang Q, Sun K, Jia H, Shen X, Tang G, Liu W, Shi L. Autofluorescence imaging as a noninvasive tool of risk stratification for malignant transformation of oral leukoplakia: A follow-up cohort study. Oral Oncol 2022; 130:105941. [DOI: 10.1016/j.oraloncology.2022.105941] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 05/24/2022] [Indexed: 01/30/2023]
|
6
|
Mendonca P, Sunny SP, Mohan U, Birur N P, Suresh A, Kuriakose MA. Non-invasive imaging of oral potentially malignant and malignant lesions: A systematic review and meta-analysis. Oral Oncol 2022; 130:105877. [PMID: 35617750 DOI: 10.1016/j.oraloncology.2022.105877] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 04/09/2022] [Accepted: 04/18/2022] [Indexed: 12/19/2022]
Abstract
Non-invasive (NI) imaging techniques have been developed to overcome the limitations of invasive biopsy procedures, which is the gold standard in diagnosis of oral dysplasia and Oral Squamous Cell Carcinoma (OSCC). This systematic review and meta- analysis was carried out with an aim to investigate the efficacy of the NI-imaging techniques in the detection of dysplastic oral potentially malignant disorders (OPMDs) and OSCC. Records concerned in the detection of OPMDs, Oral Cancer were identified through search in PubMed, Science direct, Cochrane Library electronic database (January 2000 to October 2020) and additional manual searches. Out of 529 articles evaluated for eligibility, 56 satisfied the pre-determined inclusion criteria, including 13 varying NI-imaging techniques. Meta-analysis consisted 44 articles, wherein majority of the studies reported Autofluorescence (AFI-38.6%) followed by Chemiluminescence (CHEM), Narrow Band Imaging (NBI) (CHEM, NBI-15.9%), Fluorescence Spectroscopy (FS), Diffuse Reflectance Spectroscopy (DRS), (FS, DRS-13.6%) and 5aminolevulinic acid induced protoporphyrin IX fluorescence (5ALA induced PPIX- 6.8%). Higher sensitivities (Sen) and specificities (Spe) were obtained using FS (Sen:74%, Spe:96%, SAUC=0.98), DRS (Sen:79%, Spe:86%, SAUC = 0.91) and 5 ALA induced PPIX (Sen:91%, Spe:78%, SAUC = 0.98) in the detection of dysplastic OPMDs from non-dysplastic lesions(NDLs). AFI, FS, DRS, NBI showed higher sensitivities and SAUC (>90%) in differentiating OSCC from NDLs. Analysed NI-imaging techniques suggests the higher accuracy levels in the diagnosis of OSCC when compared to dysplastic OPMDs. 5 ALA induced PPIX, DRS and FS showed evidence of superior accuracy levels in differentiation of dysplastic OPMDs from NDLs, however results need to be validated in a larger number of studies.
Collapse
Affiliation(s)
- Pramila Mendonca
- Department of Head and Neck Surgical Oncology, Mazumdar Shaw Medical Center, NH Health City, Bangalore 99, India; Integrated Head and Neck Oncology Program, Mazumdar Shaw Medical Foundation, Narayana Health City, Bangalore 99, India.
| | - Sumsum P Sunny
- Department of Head and Neck Surgical Oncology, Mazumdar Shaw Medical Center, NH Health City, Bangalore 99, India; Integrated Head and Neck Oncology Program, Mazumdar Shaw Medical Foundation, Narayana Health City, Bangalore 99, India; Manipal Academy of Higher Education, Manipal, Karnataka, India.
| | - Uma Mohan
- Department of Head and Neck Surgical Oncology, Mazumdar Shaw Medical Center, NH Health City, Bangalore 99, India; Integrated Head and Neck Oncology Program, Mazumdar Shaw Medical Foundation, Narayana Health City, Bangalore 99, India.
| | - Praveen Birur N
- KLE Society's Institute of Dental Sciences, #20, Yeshwanthpur Suburb, II Stage, Tumkur Road, Bangalore 22, India.
| | - Amritha Suresh
- Integrated Head and Neck Oncology Program, Mazumdar Shaw Medical Foundation, Narayana Health City, Bangalore 99, India; Manipal Academy of Higher Education, Manipal, Karnataka, India.
| | - Moni A Kuriakose
- Department of Head and Neck Surgical Oncology, Mazumdar Shaw Medical Center, NH Health City, Bangalore 99, India; Integrated Head and Neck Oncology Program, Mazumdar Shaw Medical Foundation, Narayana Health City, Bangalore 99, India.
| |
Collapse
|
7
|
Mukunda DC, Rodrigues J, Joshi VK, Raghushaker CR, Mahato KK. A comprehensive review on LED-induced fluorescence in diagnostic pathology. Biosens Bioelectron 2022; 209:114230. [PMID: 35421670 DOI: 10.1016/j.bios.2022.114230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 03/19/2022] [Accepted: 03/25/2022] [Indexed: 11/02/2022]
Abstract
Sensitivity, specificity, mobility, and affordability are important criteria to consider for developing diagnostic instruments in common use. Fluorescence spectroscopy has been demonstrating substantial potential in the clinical diagnosis of diseases and evaluating the underlying causes of pathogenesis. A higher degree of device integration with appropriate sensitivity and reasonable cost would further boost the value of the fluorescence techniques in clinical diagnosis and aid in the reduction of healthcare expenses, which is a key economic concern in emerging markets. Light-emitting diodes (LEDs), which are inexpensive and smaller are attractive alternatives to conventional excitation sources in fluorescence spectroscopy, are gaining a lot of momentum in the development of affordable, compact analytical instruments of clinical relevance. The commercial availability of a broad range of LED wavelengths (255-4600 nm) has opened up new avenues for targeting a wide range of clinically significant molecules (both endogenous and exogenous), thereby diagnosing a range of clinical illnesses. As a result, we have specifically examined the uses of LED-induced fluorescence (LED-IF) in preclinical and clinical evaluations of pathological conditions, considering the present advancements in the field.
Collapse
Affiliation(s)
| | - Jackson Rodrigues
- Department of Biophysics, Manipal School of Life Sciences, Manipal Academy of Higher Education, Manipal, Karnataka-576104, India
| | - Vijay Kumar Joshi
- Department of Biophysics, Manipal School of Life Sciences, Manipal Academy of Higher Education, Manipal, Karnataka-576104, India
| | - Chandavalli Ramappa Raghushaker
- Department of Biophysics, Manipal School of Life Sciences, Manipal Academy of Higher Education, Manipal, Karnataka-576104, India
| | - Krishna Kishore Mahato
- Department of Biophysics, Manipal School of Life Sciences, Manipal Academy of Higher Education, Manipal, Karnataka-576104, India.
| |
Collapse
|
8
|
Flores dos Santos LC, Fernandes JR, Lima IFP, Bittencourt LDS, Martins MD, Lamers ML. Applicability of autofluorescence and fluorescent probes in early detection of oral potentially malignant disorders: a systematic review and meta-data analysis. Photodiagnosis Photodyn Ther 2022; 38:102764. [DOI: 10.1016/j.pdpdt.2022.102764] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 02/10/2022] [Accepted: 02/14/2022] [Indexed: 12/24/2022]
|
9
|
In Vivo Imaging-Based Techniques for Early Diagnosis of Oral Potentially Malignant Disorders-Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182211775. [PMID: 34831531 PMCID: PMC8622517 DOI: 10.3390/ijerph182211775] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 11/04/2021] [Accepted: 11/08/2021] [Indexed: 12/24/2022]
Abstract
Objectives: Oral potentially malignant disorders (OPMDs) are lesions that may undergo malignant transformation to oral cancer. The early diagnosis and surveillance of OPMDs reduce the morbidity and mortality of patients. Diagnostic techniques based on medical images analysis have been developed to diagnose clinical conditions. This systematic review and meta-analysis aimed to evaluate the efficacy of imaging-based techniques compared to the gold standard of histopathology to assess their ability to correctly identify the presence of OPMDs. Design: Literature searches of free text and MeSH terms were performed using MedLine (PubMed), Scopus, Google Scholar, and the Cochrane Library (from 2000 to 30 June 2020). The keywords used in the search strategy were: (“oral screening devices” or “autofluorescence” or “chemiluminescence” or “optical imaging” or “imaging technique”) and (“oral dysplasia” or “oral malignant lesions” or “oral precancerosis”). Results: The search strategy identified 1282 potential articles. After analyzing the results and applying the eligibility criteria, the remaining 43 papers were included in the qualitative synthesis, and 34 of these were included in the meta-analysis. Conclusions: None of the analyzed techniques based on assessing oral images can replace the biopsy. Further studies are needed to explore the role of techniques-based imaging analysis to identify an early noninvasive screening method.
Collapse
|
10
|
Vibhute NA, Jagtap SV, Patil SV. Velscope guided oral cancer screening: A ray of hope in early oral cancer diagnosis. J Oral Maxillofac Pathol 2021; 25:548-549. [PMID: 35281151 PMCID: PMC8859611 DOI: 10.4103/jomfp.jomfp_315_20] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 05/18/2021] [Accepted: 10/19/2021] [Indexed: 11/12/2022] Open
Abstract
Context: Early oral cancer diagnosis is an important factor in reducing cancer-associated mortality and morbidity. Traditional oral cancer screening by Conventional Oral Examination (COE) is limited. A new approach in this regard is the use of “optical biopsy systems” like VELscope. Aims: Hence, this study aimed to determine the diagnostic value of VELscope, an autofluorescence-based handheld device in detection of dysplasia and oral squamous cell carcinoma (OSCC) in general oral potentially malignant disorder. Settings and Design: A prospective, cross-sectional study was conducted at a tertiary hospital in western Maharashtra, India. Materials and Methods: Thirty patients with presence of clinically suspicious oral lesions were included, and for each lesion, both the COE and Autofluorescence Examination by VELscope were carried out at the same appointment by different experts. All lesions were biopsied and histopathological findings were documented and analyzed. Statistical Analysis Used: Sensitivity, specificity, positive predictive value and negative predictive value were estimated to determine the accuracy of VELscope examination analysis outcome. Results: The study included a total of 30 subjects including 19 (63.33%) males and 11 (26.66%) females. Autofluorescence examination by VELscope (AFV) revealed Autofluorescence Loss in 24 (80%) patients, while 6 (20%) patients showed Autofluorescence Retained. Comparison between the “high-risk lesions” (moderate/severe dysplasia and OSCC) and “low-risk lesions” (no/mild dysplasia) showed a 90.47% sensitivity but only 44.44% specificity. Conclusions: The findings of our study indicate that although AFV cannot be a substitute for COE, it can be used as a potential complementary diagnostic aid in surveillance of the high-risk patient population.
Collapse
Affiliation(s)
- Nupura Aniket Vibhute
- Department of Oral Pathology and Microbiology, School of Dental Sciences, Krishna Institute of Medical Sciences Deemed to be University, Karad, Maharashtra, India
| | - Sunil Vitthalrao Jagtap
- Department of Pathology, Krishna Institute of Medical Sciences Deemed to be University, Karad, Maharashtra, India
| | - Sujata Vijaysinh Patil
- Department of Community Medicine, Krishna Institute of Medical Sciences Deemed to be University, Karad, Maharashtra, India
| |
Collapse
|
11
|
Moffa A, Giorgi L, Costantino A, De Benedetto L, Cassano M, Spriano G, Mercante G, De Virgilio A, Casale M. Accuracy of autofluorescence and chemiluminescence in the diagnosis of oral Dysplasia and Carcinoma: A systematic review and Meta-analysis. Oral Oncol 2021; 121:105482. [PMID: 34399191 DOI: 10.1016/j.oraloncology.2021.105482] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 08/04/2021] [Accepted: 08/06/2021] [Indexed: 12/14/2022]
Abstract
OBJECTIVES To define the accuracy of autofluorescence-based (AF) and chemiluminescence-based (CL) systems in the diagnosis of oral dysplastic and malignant lesions in addition to the Conventional Oral Examination (COE). MATERIALS AND METHODS The study was performed according to the PRISMA-DTA guidelines. RESULTS A total of 2631 oral cavity lesions (AF, n = 2076; CL, n = 555) from 26 studies (AF = 17; CL = 9) was used for calculation of diagnostic accuracy parameters. The overall pooled sensitivity and specificity of the AF were 81.3% (95% CI: 74.3% - 87.5%) and 52.1% (95% CI: 36.9% - 67.1%), respectively. Cumulative diagnostic odds ratio (DOR) was 5.44 (95% CI: 2.29 - 10.56) with a significant heterogeneity between studies (I2 = 80.7%, 95% CI: 70.0% - 86.7%; p < .05). The overall pooled sensitivity and specificity for the CL were 84.9% (95% CI: 66.7% - 96.7%) and 51.8% (95% CI: 37.3% - 65.9%), respectively. The overall pooled DOR was 8.59 (95% CI: 2.11 - 22.38) with a significant heterogeneity between studies (I2 = 65.4%, 95% CI: 29.6% - 83.0%; p < .05). CONCLUSIONS AF and CL present a high sensitivity in the diagnosis of dysplastic and malignant oral cavity lesions, demonstrating that diagnostic biopsies may be avoided in case of a negative test result. Both tests have a low specificity, and the reduction of the false positive rate compared to the COE alone remains poor.
Collapse
Affiliation(s)
- Antonio Moffa
- Integrated Therapies in Otolaryngology, Campus Bio-Medico University, Rome, Italy; Unit of Otolaryngology, University of Foggia, Foggia, Italy
| | - Lucrezia Giorgi
- Integrated Therapies in Otolaryngology, Campus Bio-Medico University, Rome, Italy
| | - Andrea Costantino
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090 Pieve Emanuele - Milan, Italy; Otorhinolaryngology Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano - Milan, Italy.
| | - Luigi De Benedetto
- Integrated Therapies in Otolaryngology, Campus Bio-Medico University, Rome, Italy
| | | | - Giuseppe Spriano
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090 Pieve Emanuele - Milan, Italy; Otorhinolaryngology Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano - Milan, Italy
| | - Giuseppe Mercante
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090 Pieve Emanuele - Milan, Italy; Otorhinolaryngology Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano - Milan, Italy
| | - Armando De Virgilio
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090 Pieve Emanuele - Milan, Italy; Otorhinolaryngology Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano - Milan, Italy
| | - Manuele Casale
- Integrated Therapies in Otolaryngology, Campus Bio-Medico University, Rome, Italy
| |
Collapse
|
12
|
Subhash N, Anand S, Prasanna R, Managoli SP, Suvarnadas R, Shyamsundar V, Nagarajan K, Mishra SK, Johnson M, Dathurao Ramanand M, Jogigowda SC, Rao V, Gopinath KS. Bimodal multispectral imaging system with cloud-based machine learning algorithm for real-time screening and detection of oral potentially malignant lesions and biopsy guidance. JOURNAL OF BIOMEDICAL OPTICS 2021; 26:JBO-210148R. [PMID: 34402266 PMCID: PMC8367825 DOI: 10.1117/1.jbo.26.8.086003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 07/26/2021] [Indexed: 05/12/2023]
Abstract
SIGNIFICANCE Screening and early detection of oral potentially malignant lesions (OPMLs) are of great significance in reducing the mortality rates associated with head and neck malignancies. Intra-oral multispectral optical imaging of tissues in conjunction with cloud-based machine learning (CBML) can be used to detect oral precancers at the point-of-care (POC) and guide the clinician to the most malignant site for biopsy. AIM Develop a bimodal multispectral imaging system (BMIS) combining tissue autofluorescence and diffuse reflectance (DR) for mapping changes in oxygenated hemoglobin (HbO2) absorption in the oral mucosa, quantifying tissue abnormalities, and guiding biopsies. APPROACH The hand-held widefield BMIS consisting of LEDs emitting at 405, 545, 575, and 610 nm, 5MPx monochrome camera, and proprietary Windows-based software was developed for image capture, processing, and analytics. The DR image ratio (R610/R545) was compared with pathologic classification to develop a CBML algorithm for real-time assessment of tissue status at the POC. RESULTS Sensitivity of 97.5% and specificity of 92.5% were achieved for discrimination of OPML from patient normal in 40 sites, whereas 82% sensitivity and 96.6% specificity were obtained for discrimination of abnormal (OPML + SCC) in 89 sites. Site-specific algorithms derived for buccal mucosa (27 sites) showed improved sensitivity and specificity of 96.3% for discrimination of OPML from normal. CONCLUSIONS Assessment of oral cancer risk is possible by mapping of HbO2 absorption in tissues, and the BMIS system developed appears to be suitable for biopsy guidance and early detection of oral cancers.
Collapse
Affiliation(s)
- Narayanan Subhash
- Sascan Meditech Pvt Ltd, TIMed, Sree Chitra Tirunal Institute for Medical Science & Technology (SCTIMST), Thiruvananthapuram, Kerala, India
- Address all correspondence to Narayanan Subhash,
| | - Suresh Anand
- Sascan Meditech Pvt Ltd, TIMed, Sree Chitra Tirunal Institute for Medical Science & Technology (SCTIMST), Thiruvananthapuram, Kerala, India
| | - Ranimol Prasanna
- Sascan Meditech Pvt Ltd, TIMed, Sree Chitra Tirunal Institute for Medical Science & Technology (SCTIMST), Thiruvananthapuram, Kerala, India
| | - Sandeep P. Managoli
- Sascan Meditech Pvt Ltd, TIMed, Sree Chitra Tirunal Institute for Medical Science & Technology (SCTIMST), Thiruvananthapuram, Kerala, India
| | - Rinoy Suvarnadas
- Sascan Meditech Pvt Ltd, TIMed, Sree Chitra Tirunal Institute for Medical Science & Technology (SCTIMST), Thiruvananthapuram, Kerala, India
| | - Vidyarani Shyamsundar
- Sree Balaji Dental College & Hospital, Center for Oral Cancer Prevention Awareness and Research, Chennai, Tamil Nadu, India
| | - Karthika Nagarajan
- Sree Balaji Dental College & Hospital, Center for Oral Cancer Prevention Awareness and Research, Chennai, Tamil Nadu, India
| | - Sourav K. Mishra
- Institute of Medical Sciences and SUM Hospital, Department of Oncology, Bhubaneswar, Orissa, India
| | - Migi Johnson
- Government Dental College, Department of Oral Medicine and Radiology, Kottayam, Kerala, India
| | - Mahesh Dathurao Ramanand
- Dayananda Sagar College of Dental Sciences, Department of Oral Medicine, Bangalore, Karnataka, India
| | - Sanjay C. Jogigowda
- JSS Dental College & Hospital, Department of Oral Medicine, Mysore, Karnataka, India
| | - Vishal Rao
- HCG Cancer Center, HCG Towers, Bengaluru, Karnataka, India
| | | |
Collapse
|
13
|
Quantitative Multispectral Imaging Differentiates Melanoma from Seborrheic Keratosis. Diagnostics (Basel) 2021; 11:diagnostics11081315. [PMID: 34441250 PMCID: PMC8392390 DOI: 10.3390/diagnostics11081315] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 07/13/2021] [Accepted: 07/15/2021] [Indexed: 12/27/2022] Open
Abstract
Melanoma is a melanocytic tumor that is responsible for the most skin cancer-related deaths. By contrast, seborrheic keratosis (SK) is a very common benign lesion with a clinical picture that may resemble melanoma. We used a multispectral imaging device to distinguish these two entities, with the use of autofluorescence imaging with 405 nm and diffuse reflectance imaging with 525 and 660 narrow-band LED illumination. We analyzed intensity descriptors of the acquired images. These included ratios of intensity values of different channels, standard deviation and minimum/maximum values of intensity of the lesions. The pattern of the lesions was also assessed with the use of particle analysis. We found significantly higher intensity values in SKs compared with melanoma, especially with the use of the autofluorescence channel. Moreover, we found a significantly higher number of particles with high fluorescence in SKs. We created a parameter, the SK index, using these values to differentiate melanoma from SK with a sensitivity of 91.9% and specificity of 57.0%. In conclusion, this imaging technique is potentially applicable to distinguish melanoma from SK based on the analysis of various quantitative parameters. For this application, multispectral imaging could be used as a screening tool by general physicians and non-experts in the everyday practice.
Collapse
|
14
|
Walsh T, Macey R, Kerr AR, Lingen MW, Ogden GR, Warnakulasuriya S. Diagnostic tests for oral cancer and potentially malignant disorders in patients presenting with clinically evident lesions. Cochrane Database Syst Rev 2021; 7:CD010276. [PMID: 34282854 PMCID: PMC8407012 DOI: 10.1002/14651858.cd010276.pub3] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Squamous cell carcinoma is the most common form of malignancy of the oral cavity, and is often proceeded by oral potentially malignant disorders (OPMD). Early detection of oral cavity squamous cell carcinoma (oral cancer) can improve survival rates. The current diagnostic standard of surgical biopsy with histology is painful for patients and involves a delay in order to process the tissue and render a histological diagnosis; other diagnostic tests are available that are less invasive and some are able to provide immediate results. This is an update of a Cochrane Review first published in 2015. OBJECTIVES Primary objective: to estimate the diagnostic accuracy of index tests for the detection of oral cancer and OPMD, in people presenting with clinically evident suspicious and innocuous lesions. SECONDARY OBJECTIVE to estimate the relative accuracy of the different index tests. SEARCH METHODS Cochrane Oral Health's Information Specialist searched the following databases: MEDLINE Ovid (1946 to 20 October 2020), and Embase Ovid (1980 to 20 October 2020). The US National Institutes of Health Ongoing Trials Register (ClinicalTrials.gov) and the World Health Organization International Clinical Trials Registry Platform were also searched for ongoing trials to 20 October 2020. No restrictions were placed on the language or date of publication when searching the electronic databases. We conducted citation searches, and screened reference lists of included studies for additional references. SELECTION CRITERIA We selected studies that reported the diagnostic test accuracy of the following index tests when used as an adjunct to conventional oral examination in detecting OPMD or oral cavity squamous cell carcinoma: vital staining (a dye to stain oral mucosa tissues), oral cytology, light-based detection and oral spectroscopy, blood or saliva analysis (which test for the presence of biomarkers in blood or saliva). DATA COLLECTION AND ANALYSIS Two review authors independently screened titles and abstracts for relevance. Eligibility, data extraction and quality assessment were carried out by at least two authors, independently and in duplicate. Studies were assessed for methodological quality using the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2). Meta-analysis was used to combine the results of studies for each index test using the bivariate approach to estimate the expected values of sensitivity and specificity. MAIN RESULTS This update included 63 studies (79 datasets) published between 1980 and 2020 evaluating 7942 lesions for the quantitative meta-analysis. These studies evaluated the diagnostic accuracy of conventional oral examination with: vital staining (22 datasets), oral cytology (24 datasets), light-based detection or oral spectroscopy (24 datasets). Nine datasets assessed two combined index tests. There were no eligible diagnostic accuracy studies evaluating blood or salivary sample analysis. Two studies were classed as being at low risk of bias across all domains, and 33 studies were at low concern for applicability across the three domains, where patient selection, the index test, and the reference standard used were generalisable across the population attending secondary care. The summary estimates obtained from the meta-analysis were: - vital staining: sensitivity 0.86 (95% confidence interval (CI) 0.79 to 0.90) specificity 0.68 (95% CI 0.58 to 0.77), 20 studies, sensitivity low-certainty evidence, specificity very low-certainty evidence; - oral cytology: sensitivity 0.90 (95% CI 0.82 to 0.94) specificity 0.94 (95% CI 0.88 to 0.97), 20 studies, sensitivity moderate-certainty evidence, specificity moderate-certainty evidence; - light-based: sensitivity 0.87 (95% CI 0.78 to 0.93) specificity 0.50 (95% CI 0.32 to 0.68), 23 studies, sensitivity low-certainty evidence, specificity very low-certainty evidence; and - combined tests: sensitivity 0.78 (95% CI 0.45 to 0.94) specificity 0.71 (95% CI 0.53 to 0.84), 9 studies, sensitivity very low-certainty evidence, specificity very low-certainty evidence. AUTHORS' CONCLUSIONS At present none of the adjunctive tests can be recommended as a replacement for the currently used standard of a surgical biopsy and histological assessment. Given the relatively high values of the summary estimates of sensitivity and specificity for oral cytology, this would appear to offer the most potential. Combined adjunctive tests involving cytology warrant further investigation. Potentially eligible studies of blood and salivary biomarkers were excluded from the review as they were of a case-control design and therefore ineligible. In the absence of substantial improvement in the tests evaluated in this updated review, further research into biomarkers may be warranted.
Collapse
Affiliation(s)
- Tanya Walsh
- Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Richard Macey
- Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Alexander R Kerr
- Department of Oral and Maxillofacial Pathology, Radiology and Medicine, New York University College of Dentistry, New York, USA
| | - Mark W Lingen
- Pritzker School of Medicine, Division of Biological Sciences, Department of Pathology, University of Chicago, Chicago, Illinois, USA
| | - Graham R Ogden
- Division of Oral and Maxillofacial Clinical Sciences, School of Dentistry, University of Dundee, Dundee, UK
| | | |
Collapse
|
15
|
Giovannacci I, Magnoni C, Pedrazzi G, Vescovi P, Meleti M. Clinicopathological Features Associated with Fluorescence Alteration: Analysis of 108 Oral Malignant and Potentially Malignant Lesions. PHOTOBIOMODULATION PHOTOMEDICINE AND LASER SURGERY 2020; 39:53-61. [PMID: 33332238 DOI: 10.1089/photob.2020.4838] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Background: Several noninvasive diagnostic tools have been developed to aid the early detection of oral cancer and for evaluation before definitive biopsy. Among these, devices evaluating a tissues autofluorescence (AF) are emerging. In particular, the most well known of these is the VELscope® system (LED Medical Diagnostics, Inc., Barnaby, Canada), which emits a light of 400-460 nm. This study has been developed to describe the most relevant clinicopathological features associated with AF alterations in a set of patients with oral squamous cell carcinoma and potentially malignant disorders (PMDs). Materials and methods: Overall, 108 lesions from 60 patients with clinical diagnoses of potentially malignant oral disorders and carcinomas were included in the study. For each case, the following variables were recorded and compared with the AF pattern: (1) clinical appearance (white, red, and white/red); (2) histological diagnosis (no dysplasia, mild/moderate dysplasia, severe dysplasia/in situ carcinoma, invasive carcinoma, and verrucous carcinoma); and (3) clinicopathological diagnosis. Binomial logistic regression was performed to investigate whether clinical appearance and/or histological diagnosis were significant in determining the degree of AF. Results: Among the white lesions, 66% resulted in hyper-fluorescence, whereas the red lesions appeared hypo-fluorescent in 95.2% of cases. The AF was altered (both hypo-fluorescent and hyper-fluorescent) in 36% of lesions without dysplasia; in 75.9% of lesions with mild or moderate dysplasia and in the totality of the in situ, invasive, and verrucous carcinomas (p < 0.0001). With regard to the binomial logistic regression, variables were separately considered and both were extremely significant in determining the degree of AF. Conclusions: Promising evidence for the use of AF as an adjunctive tool to conventional oral examinations (COEs) has been demonstrated. However, although the sensitivity of AF examination associated with COE is very high, both the literature and this study agree to indicate a low specificity.
Collapse
Affiliation(s)
- Ilaria Giovannacci
- Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy
| | - Cristina Magnoni
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - Giuseppe Pedrazzi
- Department of Medicine and Surgery and Robust Statistics Academy (Ro.S.A.), University of Parma, Parma, Italy
| | - Paolo Vescovi
- Oral Medicine and Laser Surgery Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Marco Meleti
- Oral Medicine and Laser Surgery Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy
| |
Collapse
|
16
|
Lima IFP, Brand LM, de Figueiredo JAP, Steier L, Lamers ML. Use of autofluorescence and fluorescent probes as a potential diagnostic tool for oral cancer: A systematic review. Photodiagnosis Photodyn Ther 2020; 33:102073. [PMID: 33232819 DOI: 10.1016/j.pdpdt.2020.102073] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 10/08/2020] [Accepted: 10/19/2020] [Indexed: 02/08/2023]
Abstract
INTRODUCTION The prognosis of patients with Oral squamous cell carcinoma (OSCC) are directly related to the stage of development of the tumor at the time of diagnosis, but it is estimated an average delay in diagnosis of 2-5 months. New non-invasive techniques for the early diagnosis of OSCC are being developed, such as methodologies to detect spectral changes of tumor cells. We conducted a systematic review to analyze the potential use of autofluorescence and/or fluorescent probes for OSCC diagnosis. MATERIAL AND METHODS Four databases (PubMed, Scopus, Embase and Web of Science) were used as research sources. Protocol was registered with PROSPERO. It was included studies that evaluated tissue autofluorescence and/or used fluorescent probes as a method of diagnosing and/or treatment of oral cancer in humans. RESULTS Forty-five studies were selected for this systematic review, of which 28 dealt only with autofluorescence, 18 on fluorescent probes and 1 evaluated both methods. The VELscope® was the most used device for autofluorescence, exhibiting sensitivity (33%-100%) and specificity (12%-88.6%). 5-Aminolevulinic acid (5-ALA) was the most used fluorescent probe, exhibiting high sensitivity (90%-100%) and specificity (51.3%-96%). Hypericin, rhodamine 6 G, rhodamine 610, porphyrin and γ-glutamyl hydroxymethyl rhodamine green have also been reported. CONCLUSION Thus, the autofluorescence and fluorescent probes can provide an accurate diagnosis of oral cancer, assisting the dentist during daily clinical activity, but it is not yet possible to suggest that this method may replace histopathological examination.
Collapse
Affiliation(s)
- Igor Felipe Pereira Lima
- Department of Oral Pathology, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Luiza Meurer Brand
- Academic in Dentistry, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - José Antônio Poli de Figueiredo
- Department of Morphological Sciences, Institute of Basic Health Sciences, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Liviu Steier
- Division of Restorative Dentistry, Penn Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Marcelo Lazzaron Lamers
- Department of Morphological Sciences, Institute of Basic Health Sciences, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil.
| |
Collapse
|
17
|
Awais M, Ghayvat H, Krishnan Pandarathodiyil A, Nabillah Ghani WM, Ramanathan A, Pandya S, Walter N, Saad MN, Zain RB, Faye I. Healthcare Professional in the Loop (HPIL): Classification of Standard and Oral Cancer-Causing Anomalous Regions of Oral Cavity Using Textural Analysis Technique in Autofluorescence Imaging. SENSORS (BASEL, SWITZERLAND) 2020; 20:E5780. [PMID: 33053886 PMCID: PMC7601168 DOI: 10.3390/s20205780] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 10/05/2020] [Accepted: 10/08/2020] [Indexed: 02/07/2023]
Abstract
Oral mucosal lesions (OML) and oral potentially malignant disorders (OPMDs) have been identified as having the potential to transform into oral squamous cell carcinoma (OSCC). This research focuses on the human-in-the-loop-system named Healthcare Professionals in the Loop (HPIL) to support diagnosis through an advanced machine learning procedure. HPIL is a novel system approach based on the textural pattern of OML and OPMDs (anomalous regions) to differentiate them from standard regions of the oral cavity by using autofluorescence imaging. An innovative method based on pre-processing, e.g., the Deriche-Canny edge detector and circular Hough transform (CHT); a post-processing textural analysis approach using the gray-level co-occurrence matrix (GLCM); and a feature selection algorithm (linear discriminant analysis (LDA)), followed by k-nearest neighbor (KNN) to classify OPMDs and the standard region, is proposed in this paper. The accuracy, sensitivity, and specificity in differentiating between standard and anomalous regions of the oral cavity are 83%, 85%, and 84%, respectively. The performance evaluation was plotted through the receiver operating characteristics of periodontist diagnosis with the HPIL system and without the system. This method of classifying OML and OPMD areas may help the dental specialist to identify anomalous regions for performing their biopsies more efficiently to predict the histological diagnosis of epithelial dysplasia.
Collapse
Affiliation(s)
- Muhammad Awais
- Center for Intelligent Medical Electronics, Department of Electronic Engineering, School of Information Science and Technology, Fudan University, Shanghai 200433, China;
| | - Hemant Ghayvat
- Innovation Division Technical University of Denmark, 2800 Lyngby, Denmark;
| | - Anitha Krishnan Pandarathodiyil
- Oral Diagnostic Sciences, Faculty of Dentistry, SEGi University, Jalan Teknologi, Kota Damansara, Petaling Jaya 47810, Selangor, Malaysia;
| | - Wan Maria Nabillah Ghani
- Oral Cancer Research and Coordinating Centre, Faculty of Dentistry, University of Malaya, Kuala Lumpur 50603, Malaysia; (W.M.N.G.); (A.R.); (R.B.Z.)
| | - Anand Ramanathan
- Oral Cancer Research and Coordinating Centre, Faculty of Dentistry, University of Malaya, Kuala Lumpur 50603, Malaysia; (W.M.N.G.); (A.R.); (R.B.Z.)
- Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, University of Malaya, Kuala Lumpur 50603, Malaysia
| | - Sharnil Pandya
- Symbiosis Centre for Applied Artificial Intelligence and CSE Dept, Symbiosis International (Deemed) University, Pune 412115, Maharashtra, India;
| | - Nicolas Walter
- Department of Electrical and Electronic Engineering, Universiti Teknologi PETRONAS, Bandar Seri Iskandar 32610, Perak, Malaysia; (N.W.); (M.N.S.)
| | - Mohamad Naufal Saad
- Department of Electrical and Electronic Engineering, Universiti Teknologi PETRONAS, Bandar Seri Iskandar 32610, Perak, Malaysia; (N.W.); (M.N.S.)
| | - Rosnah Binti Zain
- Oral Cancer Research and Coordinating Centre, Faculty of Dentistry, University of Malaya, Kuala Lumpur 50603, Malaysia; (W.M.N.G.); (A.R.); (R.B.Z.)
- MAHSA University, Dean Office, Level 9, Dental Block, Bandar Saujana Putra, Jenjarom 42610, Selangor, Malaysia
| | - Ibrahima Faye
- Department of Fundamental and Applied Sciences, Universiti Teknologi PETRONAS, Bandar Seri Iskandar 32610, Perak, Malaysia
| |
Collapse
|
18
|
Kim DH, Kim SW, Hwang SH. Autofluorescence imaging to identify oral malignant or premalignant lesions: Systematic review and meta‐analysis. Head Neck 2020; 42:3735-3743. [DOI: 10.1002/hed.26430] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 06/29/2020] [Accepted: 08/03/2020] [Indexed: 12/15/2022] Open
Affiliation(s)
- Do Hyun Kim
- Department of Otolaryngology—Head and Neck Surgery, Seoul St. Mary's Hospital, College of Medicine The Catholic University of Korea Seoul South Korea
| | - Sung Won Kim
- Department of Otolaryngology—Head and Neck Surgery, Seoul St. Mary's Hospital, College of Medicine The Catholic University of Korea Seoul South Korea
| | - Se Hwan Hwang
- Department of Otolaryngology—Head and Neck Surgery, Bucheon St. Mary's Hospital, College of Medicine, College of Medicine The Catholic University of Korea Seoul South Korea
| |
Collapse
|
19
|
May VelScope Be Deemed an Opportunistic Oral Cancer Screening by General Dentists? A Pilot Study. J Clin Med 2020; 9:jcm9061754. [PMID: 32516953 PMCID: PMC7356111 DOI: 10.3390/jcm9061754] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Revised: 05/26/2020] [Accepted: 06/03/2020] [Indexed: 12/25/2022] Open
Abstract
Early diagnosis of oral cancer through visual inspection followed by histopathological confirmation is a pivotal step for reducing rates of morbidity and mortality. There are several auxiliary devices used to improve oral examination. The purpose of this cross-sectional pilot study is to evaluate the sensitivity and specificity of the Visually Enhance Lesion Scope (VelScope) system when it is used by the general dentist after a yearly oral medicine training. Thirty-five patients with oral lesions were evaluated with clinical and VelScope examination by two general dentists, one of which trained with a specific course. A comparison of the histopathological results, clinical examination, and VelScope made by both dentists was performed through statistical analysis. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for detecting oral potentially malignant disorders (OPMDs) are 53.3%, 65%, 53.3%, 76.5% for unskilled dentist, 73.3%, 65%, 61.1%, 76.5% for skilled clinician. When both examiners use VelScope the values are 53.3%, 70%, 57.1%, 66.7% for unskilled general dentist (u-GD), 86.7%, 90%, 86.7%, 90% for skilled general dentist (s-GD). Improvement of a skilled general dentist for detecting malignancies is higher than inexperienced examiner when using VelScope. VelScope alone is unable to improve the general dentist’s ability to detect malignancies, but it could be a useful adjunctive device for clinicians when a focused training program is performed.
Collapse
|
20
|
Jeng MJ, Sharma M, Chao TY, Li YC, Huang SF, Chang LB, Chow L. Multiclass classification of autofluorescence images of oral cavity lesions based on quantitative analysis. PLoS One 2020; 15:e0228132. [PMID: 32017775 PMCID: PMC6999883 DOI: 10.1371/journal.pone.0228132] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2019] [Accepted: 01/08/2020] [Indexed: 12/24/2022] Open
Abstract
Background Oral cancer is one of the most common diseases globally. Conventional oral examination and histopathological examination are the two main clinical methods for diagnosing oral cancer early. VELscope is an oral cancer-screening device that exploited autofluorescence. It yields inconsistent results when used to differentiate between normal, premalignant and malignant lesions. We develop a new method to increase the accuracy of differentiation. Materials and methods Five samples (images) of each of 21 normal mucosae, as well as 31 premalignant and 16 malignant lesions of the tongue and buccal mucosa were collected under both white light and autofluorescence (VELscope, 400-460 nm wavelength). The images were developed using an iPod (Apple, Atlanta Georgia, USA). Results The normalized intensity and standard deviation of intensity were calculated to classify image pixels from the region of interest (ROI). Linear discriminant analysis (LDA) and quadratic discriminant analysis (QDA) classifiers were used. The performance of both of the classifiers was evaluated with respect to accuracy, precision, and recall. These parameters were used for multiclass classification. The accuracy rate of LDA with un-normalized data was increased by 2% and 14% and that of QDA was increased by 16% and 25% for the tongue and buccal mucosa, respectively. Conclusion The QDA algorithm outperforms the LDA classifier in the analysis of autofluorescence images with respect to all of the standard evaluation parameters.
Collapse
Affiliation(s)
- Ming-Jer Jeng
- Department of Electronic Engineering, Chang Gung University, Taoyuan, Taiwan
- Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Mukta Sharma
- Department of Electronic Engineering, Chang Gung University, Taoyuan, Taiwan
| | - Ting-Yu Chao
- Department of Electronic Engineering, Chang Gung University, Taoyuan, Taiwan
| | - Ying-Chang Li
- Green Technology Research Center, Chang Gung University, Taoyuan, Taiwan
| | - Shiang-Fu Huang
- Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan
- Department of Public Health, Chang Gung University, Taoyuan, Taiwan
- * E-mail: (SFH); (LBC)
| | - Liann-Be Chang
- Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan
- Green Technology Research Center, Chang Gung University, Taoyuan, Taiwan
- * E-mail: (SFH); (LBC)
| | - Lee Chow
- Department of Physics, University of Central Florida, Orlando, FL, United States of America
| |
Collapse
|
21
|
Shi L, Li C, Liu W. Reply to "Is no biopsy appropriate for oral potentially malignant lesion(s) without loss of autofluorescence using VELscope?". Oral Oncol 2020; 103:104566. [PMID: 31980288 DOI: 10.1016/j.oraloncology.2020.104566] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Accepted: 01/07/2020] [Indexed: 12/25/2022]
Affiliation(s)
- Linjun Shi
- Department of Oral Mucosal Diseases, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - Chenxi Li
- Department of Oral Mucosal Diseases, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - Wei Liu
- Department of Oral and Maxillofacial-Head and Neck Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| |
Collapse
|
22
|
Fricain JC, Fenelon M, Baschet L, Catros S, Glock N, Lerici S, Gaston R, Perez P, Doussau A. Reproducibility of tissue autofluorescence for screening potentially malignant disorders. JOURNAL OF ORAL MEDICINE AND ORAL SURGERY 2020. [DOI: 10.1051/mbcb/2020037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Introduction: Direct tissue autofluorescence (AF) visualization devices such as VELscope® are gaining interest to improve early detection of oral potentially malignant disorders (OPMD) and cancers. The main objective of this study was to assess inter-observer reproducibility of incandescent light (IL) and AF observations for OPMD and cancer. Materials and methods: High risk patients (exposed to alcohol or tobacco) were screened by two independent operators with a conventional oral examination (IL) followed by AF examination. The primary endpoint was the inter-observer agreement on the decision to biopsy assessed by kappa coefficients.Accuracy of IL and AF were estimated by the relative true positive rate (RTPR, increase of sensitivity), relative false positive rate (RFPR, loss of specificity) and their ratio. Results: 179 patients were included. 833 lesions were identified after IL and AF. Indication for biopsy was retrieved for 41 patients (61 lesions). Inter-observer agreement on the indications for biopsy was 93.3% after IL (Kappa coefficient 0.88 [0.80, 0.97]) and 96.1% after IL and AF (Kappa coefficient 0.78 [0.66, 0.90]). RTPR was 1.2, RFPR was 1 and their ratio was 1.2. Conclusion: IL and AF examination has shown good inter-observer reproducibility. Adjunction of AF allowed diagnosing more leukoplakia without dysplasia.
Collapse
|
23
|
K Chaitanya NCS, Chavva S, Surekha E, Priyanka V, Akhila M, Ponnuru HK, Reddy CK. A Meta-analysis on efficacy of auto fluorescence in detecting the early dysplastic changes of oral cavity. South Asian J Cancer 2019; 8:233-236. [PMID: 31807485 PMCID: PMC6852629 DOI: 10.4103/sajc.sajc_336_18] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background Light-based detection agents using autofluorescence may be helpful in the detection of early dysplasia, which would otherwise be misdiagnosed as nondysplastic by conventional oral examination (COE) with white light. Visually-enhanced lesion scope (VELscope) is one of such an aid used for the purpose. A meta-analysis was carried out on the sensitivity and specificity of VELscope that would enable in providing evidence of its usage in oral dysplasia. Materials and Methods MeSH terms such as auto florescence in oral dysplasia, VELscope, Oral ID, Identifi, in a different medical database such as PubMed, Cochrane, EBSCO, and Google scholar was carried out by four research associates. The total articles available were 242, of which, 230 were excluded based on strict criteria of randomized control trials and proper design. Finally, only 12 studies were chosen for the present analysis. Of 1643 patients from 12 studies, 1264 patients had undergone the autofluorescence examination after the COE. Only 774 patients have shown the loss of fluorescence with VELScope examination and 487 had retained the fluorescence. Biopsy was performed on 1176 patients after the autofluorescence examination in the areas where there was the loss of fluorescence. The available data were subjected to software Review Manager for analysis. Results and Discussion Of the 11 studies analyzed, majority of them showed that the autofluorescence device were sensitive enough > 0.70; however, the values of sensitivity and specificities varied significantly. With the VELscope the diagnostic performance of the inexpert examiner was not improved, obtaining a sensitivity of 0.40 (95% of confidence interval [CI]: 0.406-0.773) and a specificity of 0.80 (95% CI: 0.614-0.923). Conclusion The new technique may help as an adjunct to histopathology in detecting the dysplasia initially and stop further progression to the carcinoma.
Collapse
Affiliation(s)
- Nallan C S K Chaitanya
- Department of Oral Medicine and Radiology, Panineeya Mahavidyalaya Institute of Dental Sciences and Research Centre, Hyderabad, Telangana, India
| | - Sunanda Chavva
- Department of Oral Medicine and Radiology, Panineeya Mahavidyalaya Institute of Dental Sciences and Research Centre, Hyderabad, Telangana, India
| | - Elizabeth Surekha
- Department of Oral Medicine and Radiology, Panineeya Mahavidyalaya Institute of Dental Sciences and Research Centre, Hyderabad, Telangana, India
| | - Vedula Priyanka
- Department of Oral Pathology and Microbiology, Panineeya Institute of Dental Sciences, Hyderabad, Telangana, India
| | - Mule Akhila
- Department of Oral Medicine and Radiology, Panineeya Mahavidyalaya Institute of Dental Sciences and Research Centre, Hyderabad, Telangana, India
| | - Hari Kiran Ponnuru
- Department of Conservative Dentistry and Endodontics, Mamata Dental College, Khammam, Telangana, India
| | - Charan Kumar Reddy
- Department of Oral Medicine and Radiology, Panineeya Institute of Dental Sciences, Hyderabad, Telangana, India
| |
Collapse
|
24
|
History and future perspectives for the use of fluorescence visualization to detect oral squamous cell carcinoma and oral potentially malignant disorders. Photodiagnosis Photodyn Ther 2019; 28:308-317. [DOI: 10.1016/j.pdpdt.2019.10.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Revised: 10/03/2019] [Accepted: 10/04/2019] [Indexed: 12/20/2022]
|
25
|
Emran S, Hurskainen M, Tomppo L, Lappalainen R, Kullaa AM, Myllymaa S. Bioimpedance spectroscopy and spectral camera techniques in detection of oral mucosal diseases: a narrative review of the state-of-the-art. J Med Eng Technol 2019; 43:474-491. [DOI: 10.1080/03091902.2019.1692940] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Affiliation(s)
- Shekh Emran
- SIB Labs, University of Eastern Finland, Kuopio, Finland
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| | - Miia Hurskainen
- SIB Labs, University of Eastern Finland, Kuopio, Finland
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| | - Laura Tomppo
- SIB Labs, University of Eastern Finland, Kuopio, Finland
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| | - Reijo Lappalainen
- SIB Labs, University of Eastern Finland, Kuopio, Finland
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| | - Arja M. Kullaa
- Institute of Dentistry, University of Eastern Finland, Kuopio, Finland
- Research Unit of Oral Health Sciences, University of Oulu, Oulu, Finland
- Educational Dental Clinic, Kuopio University Hospital, Kuopio, Finland
| | - Sami Myllymaa
- SIB Labs, University of Eastern Finland, Kuopio, Finland
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| |
Collapse
|
26
|
Petruzzi M, Della Vella F, Cassandro A, Mosca A, Di Comite M, Contaldo M, Grassi FR, Lauritano D. Dorsal tongue porphyrin autofluorescence and Candida saprophytism: A prospective observational study. PLoS One 2019; 14:e0223072. [PMID: 31557235 PMCID: PMC6762088 DOI: 10.1371/journal.pone.0223072] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Accepted: 09/12/2019] [Indexed: 12/12/2022] Open
Abstract
Aim To investigate the correlation between the dorsal tongue porphyrin autofluorescence, revealed using VELscope, and Candida saprophytism. Material and methods Consecutive patients underwent an autofluorescence examination by the VELscope device to establish the presence or absence of porphyrin fluorescence. A tongue swab was collected for the Candida cultural test. Sensitivity, specificity, accuracy, negative predictive value and positive predictive value were calculated considering the oral swab as the gold standard. The degree of agreement between the two tests was calculated using Cohen's K coefficient. Results One hundred twenty-six patients were enrolled. Porphyrin fluorescence method showed a sensitivity of 78%, specificity of 76% and an accuracy of 78%. Negative predictive value and positive predictive value were respectively 90% and 59%. The strength of agreement between the two methods resulted to be moderate (k = 0.551). Conclusions Off-label use of tongue autofluorescence examination to detect the presence of Candida species is characterized by a loss of porphyrin fluorescence. The high negative predictive value of porphyrin fluorescence loss suggests its use in preliminary selection of Candida carriers, in order to plan preventive and therapeutic strategies.
Collapse
Affiliation(s)
- Massimo Petruzzi
- Interdisciplinary Department of Medicine, University "Aldo Moro" of Bari, Bari, Italy
| | - Fedora Della Vella
- Interdisciplinary Department of Medicine, University "Aldo Moro" of Bari, Bari, Italy
| | - Andrea Cassandro
- Interdisciplinary Department of Medicine, University "Aldo Moro" of Bari, Bari, Italy
| | - Adriana Mosca
- Interdisciplinary Department of Medicine, University "Aldo Moro" of Bari, Bari, Italy
| | - Mariasevera Di Comite
- Department of Basic Medical Sciences, Neurosciences and Sensory Organs, University of Bari "Aldo Moro", Bari, Italy
| | - Maria Contaldo
- Multidisciplinary Department of Medical-Surgical and Odontostomatological Specialties, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Felice Roberto Grassi
- Department of Basic Medical Sciences, Neurosciences and Sensory Organs, University of Bari "Aldo Moro", Bari, Italy
| | - Dorina Lauritano
- Department of Medicine and Surgery, University Milano-Bicocca, Monza, Italy
| |
Collapse
|
27
|
Early Diagnosis on Oral and Potentially Oral Malignant Lesions: A Systematic Review on the VELscope ® Fluorescence Method. Dent J (Basel) 2019; 7:dj7030093. [PMID: 31487927 PMCID: PMC6784481 DOI: 10.3390/dj7030093] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 08/15/2019] [Accepted: 08/20/2019] [Indexed: 12/14/2022] Open
Abstract
The fluorescence method is an innovative technique used by pathologists for examining body mucosa, and for the abnormalities tissue screening, potentially leading to the earlier discovery of pre-cancer, cancer or other disease processes. The early detection is one of the best mechanisms for enabling treatment success, increasing survival rates and maintaining a high quality of life. The purpose of this review is to evaluate the clinical efficiency of this diagnostic tool applied to the oral cavity (VELscope®). A literature systematic review has been performed. The initial research provided 53 results after applying the inclusion and exclusion criteria, and after a manual screening of the abstracts by the authors, only 25 results were eligible for review. The results and data contained in all the researches, no older than 10 years, were manually evaluated, and provided useful information on this diagnostic method. The VELscope® mean value about sensitivity and specificity resulted of 70.19% and 65.95%, respectively, by results analysis, but despite this some studies disagree about its clinical effectiveness, and this diagnostic method is still much debated in scientific and clinical medical literature. Surely being able to have efficient and effective tools from this point of view could help the clinician in the diagnosis, and also make timelier the pharmacological or surgical therapy, improving the quality of life of the patient, and in some cases guaranteeing a longer survival term.
Collapse
|
28
|
Shi L, Li C, Shen X, Zhou Z, Liu W, Tang G. Potential role of autofluorescence imaging in determining biopsy of oral potentially malignant disorders: A large prospective diagnostic study. Oral Oncol 2019; 98:176-179. [PMID: 31416690 DOI: 10.1016/j.oraloncology.2019.08.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 07/27/2019] [Accepted: 08/07/2019] [Indexed: 12/30/2022]
Abstract
Autofluorescence examination of oral tissues using the VELscope has been suggested as an adjunctive tool for cancer detection and diagnosis. This study aimed to determine the diagnostic value of VELscope in a large prospective study of 517 patients with oral potentially malignant disorders (OPMD). For the outcome assessments of discrimination of carcinoma form general OPMD and distinguishing high-risk lesions (moderate/severe dysplasia and carcinoma) from low-risk lesions (no/mild dysplasia), high sensitivity (100% and 95.9% respectively) and negative predictive value (100% and 98.2% respectively) were observed. All the carcinoma and showed loss of autofluorescence (LAF) and only 3 (0.6%) moderate/severe dysplasia were observed without LAF. These data indicate that the cases without LAF using VELscope substantially rule out the presence of high-risk lesions including cancer. This may prove to be useful specially to alleviate patient anxiety regarding a clinically suspicious oral lesion without the LAF, and to avoid a unnecessary biopsy for these cases. Collectively, a perspective to highlight was that a no biopsy strategy may be appropriate for OPMD without LAF using VELscope after conventional oral examination.
Collapse
Affiliation(s)
- Linjun Shi
- Department of Oral Mucosal Diseases, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - Chenxi Li
- Department of Oral Mucosal Diseases, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - Xuemin Shen
- Department of Oral Mucosal Diseases, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - Zengtong Zhou
- Department of Oral Mucosal Diseases, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - Wei Liu
- Department of Oral and Maxillofacial-Head and Neck Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Guoyao Tang
- Department of Oral Mucosal Diseases, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China.
| |
Collapse
|
29
|
Peterson G, Zanoni DK, Ardigo M, Migliacci JC, Patel SG, Rajadhyaksha M. Feasibility of a Video-Mosaicking Approach to Extend the Field-of-View For Reflectance Confocal Microscopy in the Oral Cavity In Vivo. Lasers Surg Med 2019; 51:439-451. [PMID: 31067360 PMCID: PMC6842028 DOI: 10.1002/lsm.23090] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/22/2019] [Indexed: 12/24/2022]
Abstract
BACKGROUND Reflectance confocal microscopy (RCM) is a developing approach for noninvasive detection of oral lesions with label-free contrast and cellular-level resolution. For access into the oral cavity, confocal microscopes are being configured with small-diameter telescopic probes and small objective lenses. However, a small probe and objective lens allows for a rather small field-of-view relative to the large areas of tissue that must be examined for diagnosis. To extend the field-of-view for intraoral RCM imaging, we are investigating a video-mosaicking approach. METHODS A relay telescope and objective lens were adapted to an existing confocal microscope for access into the oral cavity. Imaging was performed using metal three-dimensional-printed objective lens front-end caps with coverslip windows to contact and stabilize the tissue and set depth. Four healthy volunteers (normal oral mucosa), one patient (with an amalgam tattoo) in a clinical setting, and 20 anesthetized patients (with oral squamous cell carcinoma [OSCC]) in a surgical setting were imaged. Instead of the usual still RCM images, videos were recorded and then processed into video-mosaics. Thirty video-mosaics were read and qualitatively assessed by an expert reader of RCM images of the oral mucosa. RESULTS Whereas the objective lens' native field-of-view is 0.75 mm × 0.75 mm, the video-mosaics display larger areas, ranging from 2 mm × 2 mm to 4 mm × 2 mm, with resolution, morphologic detail, and image quality that is preserved relative to that observed in the original videos (individual images). Video-mosaics in healthy volunteers' and the patients' images showed cellular morphologic patterns in the lower epithelium and at the epithelial junction, and connective tissue along with capillary loops and blood flow in the deeper lamina propria. In OSCC, tumor nests could be observed along with normal looking mucosa in margin areas. CONCLUSIONS Video-mosaicking is a reasonably quick and efficient approach for extending the field-of-view of RCM imaging, which can, to some extent, overcome the inherent limitation of an intraoral probe's small field-of-view. Reading video-mosaics can mimic the procedure for examining pathology: initial visualization of the spatial cellular and morphologic patterns of the tumor and the spread of tumor margins over larger areas of the lesion, followed by digitally zooming (magnifying) for closer inspection of suspicious areas. However, faster processing of videos into video-mosaics will be necessary, to allow examination of video-mosaics in real-time at the bedside. Lasers Surg. Med. 51:439-451, 2019. © 2019 Wiley Periodicals, Inc.
Collapse
Affiliation(s)
- Gary Peterson
- Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, New York, 10022, USA
| | - Daniella Karassawa Zanoni
- Head and Neck Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, 10065, USA
| | - Marco Ardigo
- Department of Clinical Dermatology, San Gallicano Dermatological Institute, 00144, Rome, Italy
| | - Jocelyn C Migliacci
- Head and Neck Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, 10065, USA
| | - Snehal G Patel
- Head and Neck Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, 10065, USA
| | - Milind Rajadhyaksha
- Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, New York, 10022, USA
| |
Collapse
|
30
|
Kosugi A, Kasahara M, Yang L, Nakamura-Takahashi A, Shibahara T, Mori T. Method for diagnosing neoplastic lesions by quantitative fluorescence value. Sci Rep 2019; 9:7833. [PMID: 31127170 PMCID: PMC6534587 DOI: 10.1038/s41598-019-44287-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Accepted: 05/09/2019] [Indexed: 12/13/2022] Open
Abstract
Fluorescence visualization devices (FVs) are useful for detecting malignant lesions because of their simple and noninvasive application. However, their quantitative application has been challenging. This study aimed to quantitatively and statistically evaluate the change in fluorescence intensity (FI) during the progression from normal epithelium to squamous cell carcinoma using a reproducible animal tongue carcinogenesis model. To establish this model, rats were treated with 50 ppm 4-Nitroquinoline 1-oxide (4NQO) in their drinking water for 10, 15, and 20 weeks. After 4NQO administration, each rat tongue was evaluated by gross observation, histology, and FI measurements. Fluorescence images were captured by FV, and ImageJ was used to measure FI, which was analyzed quantitatively and statistically. The establishment of a reproducible tumor progression model was confirmed, showing precancerous lesions (low-grade dysplasia [LGD]), early cancers (high-grade dysplasia/carcinoma in situ [HGD/CIS]), and advanced cancers (Cancer). This carcinogenesis model was quantitatively evaluated by FI. The FI of LGD stage was 54.6, which was highest intensity of all groups. Subsequently, the HGD/CIS and Cancer stages showed decreased FI (HGD/CIS: 46.1, Cancer: 49.1) and manifested as dark spots. This result indicates that FI had more variation and a wider range with increasing tumor progression. We demonstrated that FI migration and an uneven distribution are consistent with tumor progression. Since each step of tumor progression occurs reproducibly in this animal model, statistical evaluation was possible. In addition, tumor progression can be monitored by this new FI analysis method in humans.
Collapse
Affiliation(s)
- Ayaka Kosugi
- Department of Pathology and Clinical Laboratories, National Cancer Center Hospital, Tokyo, Japan.,Department of Oral Maxillofacial Surgery, Tokyo Dental College, Tokyo, Japan.,Department of Pharmacology, Tokyo Dental College, Tokyo, Japan
| | | | - Longqiang Yang
- Department of Pharmacology, Tokyo Dental College, Tokyo, Japan
| | | | - Takahiko Shibahara
- Department of Oral Maxillofacial Surgery, Tokyo Dental College, Tokyo, Japan
| | - Taisuke Mori
- Department of Pathology and Clinical Laboratories, National Cancer Center Hospital, Tokyo, Japan.
| |
Collapse
|
31
|
Panta P. Co-existing 'Oral Potentially Malignant Disorders' - A high risk clinical entity? Oral Oncol 2019; 89:157-158. [PMID: 30598382 DOI: 10.1016/j.oraloncology.2018.12.025] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 12/17/2018] [Accepted: 12/22/2018] [Indexed: 12/14/2022]
Affiliation(s)
- Prashanth Panta
- Department of Oral Medicine and Radiology, MNR Dental College and Hospital, Narsapur Road, Sangareddy 502294, Telangana, India.
| |
Collapse
|
32
|
Shah AM, Bansal S, Shirsat PM, Prasad P, Desai RS. Exophytic verrucous hyperplasia in oral submucous fibrosis: A single-center study. J Oral Maxillofac Pathol 2019; 23:393-399. [PMID: 31942120 PMCID: PMC6948049 DOI: 10.4103/jomfp.jomfp_276_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Introduction: The present study analyzed the occurrence of exophytic verrucous hyperplasia (EVH) in the background of oral submucous fibrosis (OSF), which presents clinically as a solitary verrucopapillary lesion (VPL) mimicking malignancy. We also aimed to obtain additional information on VELscope appearance and histopathological features of EVH. Materials and Methods: The prevalence of EVH in OSF background was assessed from January 2014 to December 2018 using VELscope and histopathological examination. Results: Six hundred and sixty-two OSF patients were examined. Thirteen patients presented with solitary VPL in OSF background. A VELscope examination found ten cases with increased autofluorescence (fluorescence visualization increase, FVI), two cases with autofluorescence loss (fluorescence visualization loss, FVL), whereas one case exhibited dual autofluorescence (focal areas of FVL within FVI regions). Histopathologic examination revealed two FVL cases as oral verrucous carcinoma (OVC) and oral squamous cell carcinoma (OSCC) and one dual autofluorescence case as OVC, while six FVI cases showed nondysplastic epithelium having verrucopapillary pattern without connective tissue invasion, consistent with the clinicopathological diagnosis of EVH. Conclusion: The present study demonstrated the evidence of EVH in OSF background, which on histopathological examination revealed nondysplastic epithelium exhibiting the verrucopapillary pattern. A VELscope examination of these lesions showed increased autofluorescence, suggesting its nonneoplastic nature of clinically malignant-looking exophytic VPLs in OSF background. Present study suggests newer perspective for using the term oral verrucous hyperplasia (OVH) and EVH with justification and also proposes to introduce new terminology such as oral verrucous dysplasia and exophytic verrucous dysplasia.
Collapse
Affiliation(s)
- Aakruti M Shah
- Department of Oral Pathology, Nair Hospital Dental College, Mumbai, Maharashtra, India
| | - Shivani Bansal
- Department of Oral Pathology, Nair Hospital Dental College, Mumbai, Maharashtra, India
| | - Pankaj M Shirsat
- Department of Oral Pathology, Nair Hospital Dental College, Mumbai, Maharashtra, India
| | - Pooja Prasad
- Department of Oral Pathology, Nair Hospital Dental College, Mumbai, Maharashtra, India
| | - Rajiv S Desai
- Department of Oral Pathology, Nair Hospital Dental College, Mumbai, Maharashtra, India
| |
Collapse
|
33
|
Strome A, Kossatz S, Zanoni DK, Rajadhyaksha M, Patel S, Reiner T. Current Practice and Emerging Molecular Imaging Technologies in Oral Cancer Screening. Mol Imaging 2018; 17:1536012118808644. [PMID: 32852263 PMCID: PMC6287312 DOI: 10.1177/1536012118808644] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Oral cancer is one of the most common cancers globally. Survival rates for patients are directly correlated with stage of diagnosis; despite this knowledge, 60% of individuals are presenting with late-stage disease. Currently, the initial evaluation of a questionable lesion is performed by a conventional visual examination with white light. If a lesion is deemed suspicious, a biopsy is taken for diagnosis. However, not all lesions present suspicious under visual white light examination, and there is limited specificity in differentiating between benign and malignant transformations. Several vital dyes, light-based detection systems, and cytology evaluation methods have been formulated to aid in the visualization process, but their lack of specific biomarkers resulted in high false-positive rates and thus limits their reliability as screening and guidance tools. In this review, we will analyze the current methodologies and demonstrate the need for specific intraoral imaging agents to aid in screening and diagnosis to identify patients earlier. Several novel molecular imaging agents will be presented as, by result of their molecular targeting, they aim to have high specificity for tumor pathways and can support in identifying dysplastic/cancerous lesions and guiding visualization of biopsy sites. Imaging agents that are easy to use, inexpensive, noninvasive, and specific can be utilized to increase the number of patients who are screened and monitored in a variety of different environments, with the ultimate goal of increasing early detection.
Collapse
Affiliation(s)
- Arianna Strome
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Susanne Kossatz
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | | | - Milind Rajadhyaksha
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Snehal Patel
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Thomas Reiner
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.,Department of Radiology, Weill-Cornell Medical College, New York, NY, USA
| |
Collapse
|
34
|
Mascitti M, Orsini G, Tosco V, Monterubbianesi R, Balercia A, Putignano A, Procaccini M, Santarelli A. An Overview on Current Non-invasive Diagnostic Devices in Oral Oncology. Front Physiol 2018; 9:1510. [PMID: 30410451 PMCID: PMC6209963 DOI: 10.3389/fphys.2018.01510] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Accepted: 10/08/2018] [Indexed: 11/30/2022] Open
Abstract
Oral squamous cell carcinoma (OSCC) is the most common head and neck malignancy, and despite advances in cancer therapies, the overall 5-year survival rate has remained below 50% over the past decades. OSCC is typically preceded by potentially malignant disorders (PMD), but distinguishing high-risk from low-risk PMD is challenging. In the last years, several diagnostic methods as light-based detection systems (LBDS) have been proposed to facilitate the detection of OSCC and PMD. Furthermore, the recent evolution of nanotechnology may provide new opportunities to detect PMD and OSCC at an early stage. Indeed, several preclinical studies showed the potential of nanotechnology to enhance diagnostic accuracy. For these reasons, it is fundamental to conduct studies to evaluate the efficacy of nanotechnology implementation in LBDS. The aim of this article is to review the current literature on LBDS and to provide a summary of the sensitivity and specificity of each technique, and possible future applications of nanotechnologies. The LBDS showed great potential for screening and monitoring oral lesions, but there are several factors that hinder an extensive use of these devices. These devices seem to be useful in assessing lesion margins that must be biopsied. However, to date, conventional oral examination, and tissue biopsy remain the gold standard for OSCC diagnosis. The use of nanotechnologies could be the next step in the evolution of LBDS, thus providing devices that can help clinicians to detect and better monitor oral lesions.
Collapse
Affiliation(s)
- Marco Mascitti
- Department of Clinical Sciences and Stomatology, Marche Polytechnic University, Ancona, Italy
| | - Giovanna Orsini
- Department of Clinical Sciences and Stomatology, Marche Polytechnic University, Ancona, Italy
| | - Vincenzo Tosco
- Department of Clinical Sciences and Stomatology, Marche Polytechnic University, Ancona, Italy
| | | | - Andrea Balercia
- Department of Oral and Head-Neck Surgery, Umberto I General Hospital, Marche Polytechnic University, Ancona, Italy
| | - Angelo Putignano
- Department of Clinical Sciences and Stomatology, Marche Polytechnic University, Ancona, Italy
| | - Maurizio Procaccini
- Department of Clinical Sciences and Stomatology, Marche Polytechnic University, Ancona, Italy.,National Institute of Health and Science of Aging, INRCA, Ancona, Italy
| | - Andrea Santarelli
- Department of Clinical Sciences and Stomatology, Marche Polytechnic University, Ancona, Italy.,National Institute of Health and Science of Aging, INRCA, Ancona, Italy
| |
Collapse
|
35
|
Sumi S, Umemura N, Adachi M, Ohta T, Naganawa K, Kawaki H, Takayama E, Kondoh N, Sumitomo S. The luminance ratio of autofluorescence in a xenograft mouse model is stable through tumor growth stages. Clin Exp Dent Res 2018; 4:174-181. [PMID: 30386639 PMCID: PMC6203828 DOI: 10.1002/cre2.126] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Revised: 07/11/2018] [Accepted: 07/13/2018] [Indexed: 12/25/2022] Open
Abstract
The aim of this research was to investigate the value of autofluorescence imaging of oral cancer across different stages of tumor growth, to assist in detecting tumors. A xenograft mouse model was created with human oral squamous cell carcinoma cell line HSC-3 being subcutaneously inoculated into nude mice. Tumor imaging was performed with an autofluorescence imaging method (Illumiscan®) using the luminance ratio, which was defined as the luminance of the tumor site over the luminance of normal skin tissue normalized to a value of 1.0. This luminance ratio was continuously observed postinoculation. Tumor and normal skin tissues were harvested, and differences in the concentrations of flavin adenine dinucleotide and nicotinamide adenine dinucleotide were examined. The luminance ratio of the tumor sites was 0.85 ± 0.05, and there was no significant change in the ratio over time, even if the tumor proliferated and expanded. Furthermore, flavin adenine dinucleotide and nicotinamide adenine dinucleotide were significantly lower in tumor tissue than in normal skin tissue. A luminance ratio under 0.90 indicates a high possibility of tumor, irrespective of the tumor growth stage. However, this cutoff value was determined using a xenograft mouse model and therefore requires further validation before being used in clinical diagnosis.
Collapse
Affiliation(s)
- Shigeki Sumi
- Department of Oral and Maxillofacial SurgeryAsahi University School of DentistryJapan
| | - Naoki Umemura
- Department of Oral BiochemistryAsahi University School of DentistryJapan
| | - Makoto Adachi
- Department of Oral and Maxillofacial SurgeryAsahi University School of DentistryJapan
| | - Takahisa Ohta
- Department of Oral and Maxillofacial SurgeryAsahi University School of DentistryJapan
| | - Kosuke Naganawa
- Department of Oral and Maxillofacial SurgeryAsahi University School of DentistryJapan
| | - Harumi Kawaki
- Department of Oral BiochemistryAsahi University School of DentistryJapan
| | - Eiji Takayama
- Department of Oral BiochemistryAsahi University School of DentistryJapan
| | - Nobuo Kondoh
- Department of Oral BiochemistryAsahi University School of DentistryJapan
| | - Shinichiro Sumitomo
- Department of Oral and Maxillofacial SurgeryAsahi University School of DentistryJapan
| |
Collapse
|
36
|
Lihachev A, Lihacova I, Plorina EV, Lange M, Derjabo A, Spigulis J. Differentiation of seborrheic keratosis from basal cell carcinoma, nevi and melanoma by RGB autofluorescence imaging. BIOMEDICAL OPTICS EXPRESS 2018; 9:1852-1858. [PMID: 29675324 PMCID: PMC5905929 DOI: 10.1364/boe.9.001852] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Revised: 03/01/2018] [Accepted: 03/04/2018] [Indexed: 05/06/2023]
Abstract
A clinical trial on the autofluorescence imaging of skin lesions comprising 16 dermatologically confirmed pigmented nevi, 15 seborrheic keratosis, 2 dysplastic nevi, histologically confirmed 17 basal cell carcinomas and 1 melanoma was performed. The autofluorescence spatial properties of the skin lesions were acquired by smartphone RGB camera under 405 nm LED excitation. The diagnostic criterion is based on the calculation of the mean autofluorescence intensity of the examined lesion in the spectral range of 515 nm-700 nm. The proposed methodology is able to differentiate seborrheic keratosis from basal cell carcinoma, pigmented nevi and melanoma. The sensitivity and specificity of the proposed method was estimated as being close to 100%. The proposed methodology and potential clinical applications are discussed in this article.
Collapse
Affiliation(s)
- Alexey Lihachev
- Institute of Atomic Physics and Spectroscopy, University of Latvia, Raina Blvd. 19, Riga LV-1586, Latvia
| | - Ilze Lihacova
- Institute of Atomic Physics and Spectroscopy, University of Latvia, Raina Blvd. 19, Riga LV-1586, Latvia
| | - Emilija V. Plorina
- Institute of Atomic Physics and Spectroscopy, University of Latvia, Raina Blvd. 19, Riga LV-1586, Latvia
| | - Marta Lange
- Institute of Atomic Physics and Spectroscopy, University of Latvia, Raina Blvd. 19, Riga LV-1586, Latvia
| | - Alexander Derjabo
- Riga Eastern University Hospital, Oncology Centre of Latvia, Hipokrata Street 4, Riga LV-1079, Latvia
| | - Janis Spigulis
- Institute of Atomic Physics and Spectroscopy, University of Latvia, Raina Blvd. 19, Riga LV-1586, Latvia
| |
Collapse
|