Evaluation of premalignant and malignant lesions by fluorescent light (VELscope)

Abstract

Aim:The purpose of this study was the early detection of premalignant and malignant oral soft lesions by fluorescent light (VELscope).Materials and Methods:A total of 748 patients were evaluated through clinical and fluorescent light analysis of the entire oral cavity. Any lesion that was detected underwent a surgical excision biopsy as the golden standard for the detection of the lesion's histology; then a comparison was made between the results to assure the efficacy of the fluorescent light analysis outcome.Results:About 9.4% of the lesions detected were abnormal lesions and 83.09% had loss of fluorescent light effect. Based on the use of surgical biopsy, the machine had a sensitivity of 74.1% and a specificity of 96.3%. According to the statistical analysis, the P value was much lower than 0.05, so we can conclude that at 95% confidence level, there was significant agreement between VELscope results and biopsy results. Kappa coefficient value was approximately 0.5, which means that the strength of the agreement was medium.Conclusion:VELscope can be used as a clinical diagnostic aid in the detection of premalignant and malignant lesions of the oral cavity. In addition, it helps in the detection of the borders in both surgical biopsy and surgical excision.

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, ).…”

“…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.…”

“…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, ).…”

“…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.…”

“…Future studies should avoid the major methodological errors that have been noted in many of the included studies in this review. These include unsatisfactory discussion of patient inclusion and exclusion criteria (Cânjău et al, ; Marzouki et al, ; Petruzzi et al, ; Sawan & Mashlah, ; Sweeny et al, ), small sample size (Babiuch et al, ; Cânjău et al, ; Marzouki et al, ; Moro et al, ; Onizawa et al, ; Scheer et al, ; Simonato et al, ; Sweeny et al, ) and insufficient reporting of patient characteristics (Babiuch et al, ; Jayaprakash et al, ; Marzouki et al, ; Moro et al, ; Petruzzi et al, ). Studies including patients with a history of treated oral cancer should provide clear details of their treatment history, as it has been shown that evaluation of oral soft tissues is challenging with OFI in patients who have undergone oral cancer treatment, especially radiotherapy (Hancock, Epstein, & Sadler, ).…”