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Proceedings Paper

Autofluorescence guided diagnostic evaluation of suspicious oral mucosal lesions: opportunities, limitations, and pitfalls
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Paper Abstract

Wide-filed autofluorescence examination is currently considered as a standard of care for screening and diagnostic evaluation of early neoplastic changes of the skin, cervix, lung, bladder, gastrointestinal tract and oral cavity. Naturally occurring fluorophores within the tissue absorb UV and visible light and can re-emit some of this light at longer wavelengths in the form of fluorescence. This non-invasive tissue autofluorescence imaging is used in optical diagnostics, especially in the early detection of cancer. Usually, malignant transformation is associated with thickening of the epithelium, enhanced cellular density due to increased nuclear cytoplasmic ratio which may attenuate the excitation leading to a decrease in collagen autofluorescence. Hence, dysplastic and cancerous tissues often exhibit decreased blue-green autofluorescence and appear darker compared to uninvolved mucosa. Currently, there are three commercially available devices to examine tissue autofluorescence in the oral cavity. In this study we used the oral cancer screening device IdentafiTM 3000 to examine the tissue reflectance and autofluorescence of PML and confounding lesions of the oral cavity. Wide-field autofluorescence imaging enables rapid inspection of large mucosal surfaces, to aid in recognition of suspicious lesions and may also help in discriminate the PML (class 1) from some of the confounding lesions (class II). However, the presence of inflammation or pigments is also associated with loss of stromal autofluorescence, and may give rise to false-positive results with widefield fluorescence imaging. Clinicians who use these autofluorescence based oral cancer screening devices should be aware about the benign oral mucosal lesions that may give false positivity so that unnecessary patient's anxiety and the need for scalpel biopsy can be eliminated.

Paper Details

Date Published: 17 February 2011
PDF: 6 pages
Proc. SPIE 7883, Photonic Therapeutics and Diagnostics VII, 78832I (17 February 2011); doi: 10.1117/12.887756
Show Author Affiliations
Nadarajah Vigneswaran, The Univ. of Texas Dental Branch at Houston (United States)

Published in SPIE Proceedings Vol. 7883:
Photonic Therapeutics and Diagnostics VII
Kenton W. Gregory M.D.; Nikiforos Kollias; Andreas Mandelis; Henry Hirschberg M.D.; Hyun Wook Kang; Anita Mahadevan-Jansen; Brian Jet-Fei Wong M.D.; Justus F. R. Ilgner M.D.; Bodo E. Knudsen M.D.; E. Duco Jansen; Steen J. Madsen; Guillermo J. Tearney; Bernard Choi; Haishan Zeng; Laura Marcu, Editor(s)

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