Early detection of oral precancerous and early cancerous lesions by fluorescence visualization

Abstract

Early detection of precancerous and early cancerous lesions could greatly reduce both mortality and morbidity of oral cancer. We describe a simple handheld device that facilitates the direct visualization of oral-cavity fluorescence for the detection of precancerous and early cancerous lesions. Blue excitation light (400 to 460nm) is employed to excite green-red fluorescence from fluorophores in the oral mucosa. Tissue fluorescence is viewed directly along an optical axis collinear with the axis of excitation to reduce interand 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 17 patients are presented. In conjunction with histological examinations, this device is extremely useful in detecting oral precancerous and early cancerous lesions. We envisage this device as a suitable adjunct for oral cancer screening and margin determination.