Simple device for the direct visualization of oral-cavity tissue fluorescence

J Biomed Opt. Mar-Apr 2006;11(2):024006. doi: 10.1117/1.2193157.

Abstract

Early identification of high-risk disease could greatly reduce both mortality and morbidity due to oral cancer. We describe a simple handheld device that facilitates the direct visualization of oral-cavity fluorescence for the detection of high-risk precancerous and early cancerous lesions. Blue excitation light (400 to 460 nm) is employed to excite green-red fluorescence from fluorophores in the oral tissues. Tissue fluorescence is viewed directly along an optical axis collinear with the axis of excitation to reduce inter- and intraoperator variability. This robust, field-of-view device enables the direct visualization of fluorescence in the context of surrounding normal tissue. Results from a pilot study of 44 patients are presented. Using histology as the gold standard, the device achieves a sensitivity of 98% and specificity of 100% when discriminating normal mucosa from severe dysplasia/carcinoma in situ (CIS) or invasive carcinoma. We envisage this device as a suitable adjunct for oral cancer screening, biopsy guidance, and margin delineation.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Carcinoma, Squamous Cell / diagnosis*
  • Equipment Design
  • Equipment Failure Analysis
  • Humans
  • Luminescent Measurements / instrumentation*
  • Luminescent Measurements / methods
  • Miniaturization
  • Mouth Neoplasms / diagnosis*
  • Pilot Projects
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Spectrometry, Fluorescence / instrumentation*
  • Spectrometry, Fluorescence / methods