A Meta-analysis on efficacy of auto fluorescence in detecting the early dysplastic changes of oral cavity

Abstract

Background:Light-based detection agents using autofluorescence may be helpful in the detection of early dysplasia, which would otherwise be misdiagnosed as nondysplastic by conventional oral examination (COE) with white light. Visually-enhanced lesion scope (VELscope) is one of such an aid used for the purpose. A meta-analysis was carried out on the sensitivity and specificity of VELscope that would enable in providing evidence of its usage in oral dysplasia.Materials and Methods:MeSH terms such as auto florescence in oral dysplasia, VELscope, Oral ID, Identifi, in a different medical database such as PubMed, Cochrane, EBSCO, and Google scholar was carried out by four research associates. The total articles available were 242, of which, 230 were excluded based on strict criteria of randomized control trials and proper design. Finally, only 12 studies were chosen for the present analysis. Of 1643 patients from 12 studies, 1264 patients had undergone the autofluorescence examination after the COE. Only 774 patients have shown the loss of fluorescence with VELScope examination and 487 had retained the fluorescence. Biopsy was performed on 1176 patients after the autofluorescence examination in the areas where there was the loss of fluorescence. The available data were subjected to software Review Manager for analysis.Results and Discussion:Of the 11 studies analyzed, majority of them showed that the autofluorescence device were sensitive enough > 0.70; however, the values of sensitivity and specificities varied significantly. With the VELscope the diagnostic performance of the inexpert examiner was not improved, obtaining a sensitivity of 0.40 (95% of confidence interval [CI]: 0.406–0.773) and a specificity of 0.80 (95% CI: 0.614–0.923).Conclusion:The new technique may help as an adjunct to histopathology in detecting the dysplasia initially and stop further progression to the carcinoma.

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

“…Although no details of the statistical analyses used in their study were reported, the methods were not likely adequate since only individual sensitivity and specificity values were described without their summation, AUC, or DOR. Thus, the study by Chaitanya et al 41 represents a narrative or systemic review based on individual study results rather than a meta‐analysis. The overall effect of autofluorescence on the diagnostic accuracy could not be evaluated using descriptive methods because the values were not weighted according to the number of enrolled patients 42,43 .…”

“…A meta‐analysis by Chaitanya et al 41 examined the ability of autofluorescence to detect cancer and precancerous lesions in 2019. The sample size of the included studies ranged from 43 to 200 patients (mean, 106 patients per study).…”

“…The sample size of the included studies ranged from 43 to 200 patients (mean, 106 patients per study). Of the 11 studies reviewed, 7 reported sensitivity values >0.70 with variable specificity values 41 . Thus, the authors concluded that autofluorescence may be used as an adjunct to identify the exact location of the biopsy site under altered mucosal conditions.…”

“…Of the 11 studies reviewed, 7 reported sensitivity values >0.70 with variable specificity values. 41 Thus, the authors concluded that autofluorescence may be used as an adjunct to identify the exact location of the biopsy site under altered mucosal conditions. Although no details of the statistical analyses used in their study were reported, the methods were not likely adequate since only individual sensitivity and specificity values were described without their summation, AUC, or DOR.…”

“…meta-analysis by Chaitanya et al41 examined the ability of autofluorescence to detect cancer and precancerous F I G U R E 3 Forest plots of the sensitivities, specificities, and negative predictive values from the included studies. Sensitivity, A, specificity, B, and diagnostic odds ratio, C…”