Comparative evaluation of autofluorescence imaging and histopathological investigation for oral potentially malignant disorders in Taiwan

Abstract

Objectives Autofluorescence imaging is gaining popularity as an adjunctive test for oral potentially malignant disorders (OPMD). This study evaluated the efficacy of autofluorescence imaging based on the current standard oral mucosal disorder checklist in Taiwan. Materials and methods In total, 126 patients suspected to have mucosal disorders at the Division of Oral and Maxillofacial Surgery, Tri-Service General Hospital, Taipei, Taiwan, were enrolled. Following a conventional oral examination by using the oral mucosal disorder checklist and an autofluorescence imaging examination, all participants underwent histopathological examination to access epithelial dysplasia. Results Among 126 patients, 68 patients were diagnosis as having an OPMD and 63 having epithelial dysplasia. Autofluorescence imaging exhibited a sensitivity, specificity, positivity predictive value (PPV), negative predictive value (NPV), and accuracy of 77.

Optical fluorescence imaging in oral cancer and potentially malignant disorders: A systematic review

“…The detection of OED or discrimination between benign, dysplastic or malignant oral mucosal lesions has been extensively researched, with literature reporting overall poorer specificity along with significant heterogeneity in published studies (Awan & Patil, ; Lingen, Tampi et al, ; Luo et al, ). The results from this review are in keeping with previous studies assessing discrimination between oral mucosal lesions, demonstrating significant heterogeneity and variation in reported efficacy (COE alone: sensitivity: 5.9%–96.6%; specificity: 42.9%–97.8%, OFI alone: sensitivity: 30%–100%; specificity: 12.5%–93%, combined examination: sensitivity: 46%–100%; specificity: 6%–74%; Amirchaghmaghi et al, ; Awan et al, ; Awan et al, ; Babiuch et al, ; Betz et al, ; Chiang et al, ; Farah et al, ; Hanken et al, ; Jayaprakash et al, ; Koch et al, ; Lalla et al, ; Lane et al, ; Marzouki et al, ; Mehrotra et al, ; Moro et al, ; Paderni et al, ; Petruzzi et al, ; Rana et al, ; Sawan & Mashlah, ; Scheer et al, ; Simonato et al, ). It is also interesting to note that all studies with a low risk of bias except Paderni et al reported an overall reduction in specificity using OFI compared to COE alone and at present OFI cannot replace histopathological assessment of a tissue biopsy as the gold standard for the diagnosis of OED or OSCC (Bhatia et al, ; Farah et al, ; Lalla et al, ; Paderni et al, ; Rana et al, ).…”

“…Fifteen studies reported efficacy on detection of OPMD and/or OSCC, with significant heterogeneity and risk of bias noted across the methodologies used (Awan, Morgan, & Warnakulasuriya, ; Betz et al, ; Bhatia et al, ; Cânjău, Todea, Sinescu, Pricop, & Duma, ; Chiang et al, ; Farah et al, ; Koch, Kaemmerer, Biesterfeld, Kunkel, & Wagner, ; Lalla, Matias, & Farah, ; Marzouki et al, ; Moro et al, ; Onizawa, Saginoya, Furuya, & Yoshida, ; Petruzzi et al, ; Sawan & Mashlah, ; Scheer et al, ; Sweeny et al, ). Only three of 15 studies demonstrated low risk of bias across all QUADAS‐2 domains (Bhatia et al, ; Farah et al, ; Lalla et al, ).…”

“…Twenty‐one studies reported efficacy on optical autofluorescence in discriminating between benign, dysplastic and neoplastic oral lesions (Amirchaghmaghi et al, ; Awan et al, ; Awan, Morgan, & Warnakulasuriya, ; Babiuch, Chomyszyn‐Gajewska, & Wyszyńska‐Pawelec, ; Betz et al, ; Chiang et al, ; Farah et al, ; Hanken et al, ; Jayaprakash et al, ; Koch et al, ; Lalla et al, ; Lane et al, ; Marzouki et al, ; Mehrotra et al, ; Moro et al, ; Paderni et al, ; Petruzzi et al, ; Rana et al, ; Sawan & Mashlah., ; Scheer et al, ; Simonato, Tomo, Miyahara, Navarro, & Villaverde, ). Significant heterogeneity and variation in reported efficacy (COE alone: sensitivity: 5.9%–96.6%; specificity: 42.9%–97.8%, OFI alone: sensitivity: 30%–100%; specificity: 12.5%–93%, combined examination: sensitivity: 46%–100%; specificity: 6%–74%) were noted.…”

“…Furthermore, future studies should include assessment of subjectivity of autofluorescence examination via an interobserver agreement assessment. This review also noted that many studies assessed the role of OFI devices as a stand‐alone diagnostic tool, rather than a true adjunctive device (Awan et al, , ; Babiuch et al, ; Cânjău et al, ; Chiang et al, ; Mehrotra et al, ; Moro et al, ; Onizawa et al, ; Paderni et al, ; Petruzzi et al, ; Sawan & Mashlah, ; Scheer et al, ,). Given the potential promising role of OFI in various clinical settings, it is recommended that this technology be considered as a “clinical” adjunct instead of a “diagnostic” adjunct.…”

Autofluorescence imaging to identify oral malignant or premalignant lesions: Systematic review and meta‐analysis

“…Standardized forms were used to collect all data. Diagnostic accuracy in terms of the diagnostic odds ratio (DOR), summary receiver operating characteristic (SROC) curve, and area under the SROC curve (AUCs), 1,3,6,12‐35 and the inter‐rater agreement of the autofluorescence analysis, 18,21,36 were analyzed. The screening performance of autofluorescence was compared with that of toluidine blue staining or clinical examination.…”