Clinical Application of the IllumiScan Fluorescence Visualization Device in Detecting Oral Mucosal Lesions

Kikuta, Shogo; Iwanaga, Joe; Todoroki, Keita; Shinozaki, Katsumi; Tanoue, Ryuichiro; Nakamura, Moriyoshi; Kusukawa, Jingo

doi:10.7759/cureus.3111

Cited by 8 publications

(10 citation statements)

References 21 publications

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“…These changes led to additional scattering and decreased FI compared to the LGD stage, which manifested as an area of low intensity in the HGD/CIS stage. This decrease in FI with tumor progression has been reported in human patients as the same change in FI through the early stages to late stage cancer 26 . The epithelium was showed extensive scattering in the Cancer stage, appearing as dark spots like HGD/CIS.…”

Section: Discussionsupporting

confidence: 80%

Method for diagnosing neoplastic lesions by quantitative fluorescence value

Kosugi

Kasahara

Yang

et al. 2019

Sci Rep

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Fluorescence visualization devices (FVs) are useful for detecting malignant lesions because of their simple and noninvasive application. However, their quantitative application has been challenging. This study aimed to quantitatively and statistically evaluate the change in fluorescence intensity (FI) during the progression from normal epithelium to squamous cell carcinoma using a reproducible animal tongue carcinogenesis model. To establish this model, rats were treated with 50 ppm 4-Nitroquinoline 1-oxide (4NQO) in their drinking water for 10, 15, and 20 weeks. After 4NQO administration, each rat tongue was evaluated by gross observation, histology, and FI measurements. Fluorescence images were captured by FV, and ImageJ was used to measure FI, which was analyzed quantitatively and statistically. The establishment of a reproducible tumor progression model was confirmed, showing precancerous lesions (low-grade dysplasia [LGD]), early cancers (high-grade dysplasia/carcinoma in situ [HGD/CIS]), and advanced cancers (Cancer). This carcinogenesis model was quantitatively evaluated by FI. The FI of LGD stage was 54.6, which was highest intensity of all groups. Subsequently, the HGD/CIS and Cancer stages showed decreased FI (HGD/CIS: 46.1, Cancer: 49.1) and manifested as dark spots. This result indicates that FI had more variation and a wider range with increasing tumor progression. We demonstrated that FI migration and an uneven distribution are consistent with tumor progression. Since each step of tumor progression occurs reproducibly in this animal model, statistical evaluation was possible. In addition, tumor progression can be monitored by this new FI analysis method in humans.

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Section: Discussionsupporting

confidence: 80%

Method for diagnosing neoplastic lesions by quantitative fluorescence value

Kosugi

Kasahara

Yang

et al. 2019

Sci Rep

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“…One of the reasons for this is as follows. The CV of FI in images may indicate intra-tumour heterogeneity [ 19 , 36 ]. Kosugi et al [ 37 ] quantitatively evaluated the changes in FI during progression in the transformation from normal epithelium to SCC in rats and reported that the FI variability increased with progression.…”

Section: Discussionmentioning

confidence: 99%

“…Although many devices have been developed and commercialised to evaluate tissue autofluorescence, the VELscope ® (LED Dental Inc., Vancouver, BC, Canada) was the first commercial auto-focus imaging device approved for oral use in 2008 [ 4 , 17 ]. The IllumiScan ® (Shoufu, Kyoto, Japan) ( Figure S1 ) is an FV device that emits a 425 nm blue light and receives images of the fluorescence generated by the mucosa [ 18 , 19 ]. The light received includes autofluorescence from the mucosa, reflected light, and red fluorescence from bacteria.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Oral Mucosal Lesions Using the IllumiScan® Fluorescence Visualisation Device: Distinguishing Squamous Cell Carcinoma

Taguchi

Toratani

Matsui

et al. 2022

IJERPH

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We evaluated whether fluorescence intensity (FI) and its coefficient of variation (CV) can be used to diagnose squamous cell carcinoma (SCC) through IllumiScan®, an oral mucosa fluorescence visualisation (FV) device. Overall, 190 patients with oral mucosal lesions (OMLs; SCC, 59; non-SCC OMLs, 131) and 49 patients with normal oral mucosa (NOM) were enrolled between January 2019 and March 2021. The FI of the images was analysed using image analysis software. After establishing regions of interest for SCC, non-SCC, and NOM, the average FI, standard deviation (SD), and CV were compared. There was a significant difference in the average FI for all pairs of comparisons. The SD was not significantly different between the SCC and NOM groups (p = 0.07). The CV differed significantly for NOM (p < 0.001) and non-SCC groups (p < 0.001) relative to the SCC group but was not different between NOM and non-SCC groups (p = 0.15). Univariate analysis of SCC and non-SCC groups showed significant differences for all factors, except age. However, multivariate analysis showed a significant intergroup difference only in the CV (p = 0.038). Therefore, analysing the CV in FV images of OML may be useful for the diagnosis of oral cancer.

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“…As a result of objective evaluation in this study, we set various factors, such as MeanV and MediV. MeanV was reported to contribute to the detection of oral cancer [ 15 , 16 , 48 ]. On the other hand, Kozakai also reported that it is difficult to distinguish oral cancer from OLP [ 49 ].…”

Section: Discussionmentioning

confidence: 99%

Non-Invasive Early Detection of Oral Cancers Using Fluorescence Visualization with Optical Instruments

Morikawa

Shibahara

Nomura

et al. 2020

Cancers

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Background: Oral cancer screening is important for early detection and early treatment, which help improve survival rates. Biopsy is the gold standard for a definitive diagnosis but is invasive and painful, while fluorescence visualization is non-invasive, convenient, and real-time, and examinations can be repeated using optical instruments. The purpose of this study was to clarify the usefulness of fluorescence visualization in oral cancer screening. Methods: A total of 502 patients, who were examined using fluorescence visualization with optical instruments in our hospitals between 2014 and 2019, were enrolled in this study. The final diagnosis was performed by pathological examination. Fluorescence visualization was analyzed using subjective and objective evaluations. Results: Subjective evaluations for detecting oral cancer offered 96.8% sensitivity and 48.4% specificity. Regarding the objective evaluations, sensitivity and specificity were 43.7% and 84.6% for mean green value, 55.2% and 67.0% for median green value, 82.0% and 44.2% for coefficient of variation of value, 59.6% and 45.3% for skewness, and 85.1% and 75.8% for value ratio. For the sub-analysis of oral cancer, all factors on objective and subjective evaluation showed no significant difference. Conclusions: Fluorescence visualization with subjective and objective evaluation is useful for oral cancer screening.

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Clinical Application of the IllumiScan Fluorescence Visualization Device in Detecting Oral Mucosal Lesions

Cited by 8 publications

References 21 publications

Method for diagnosing neoplastic lesions by quantitative fluorescence value

Method for diagnosing neoplastic lesions by quantitative fluorescence value

Evaluation of Oral Mucosal Lesions Using the IllumiScan® Fluorescence Visualisation Device: Distinguishing Squamous Cell Carcinoma

Non-Invasive Early Detection of Oral Cancers Using Fluorescence Visualization with Optical Instruments

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