Fluorescence Visualization for Oral Mucosa Using an Auto-fluorescence Imaging Analysis Software

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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“…Using this semi-quantitative evaluation, development into Medical AI is expected [ 54 ]. FV can be used in any subsite [ 56 ].…”

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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“…Since 2008, researchers from North America have attempted to develop new methods based on optical approaches for the examination and diagnosis of oral cancer. Optical instruments, such as the magnifying endoscope NBI ® (Narrow Band Imaging) system ( 12 – 14 ) and VELscope ® (DenMat) ( 2 – 5 ), have been introduced for use in non-invasive and early discovery of OSCC. The NBI ® system is an image enhancement technology that was jointly developed by Olympus Medical Systems and the Department of Gastroenterological Endoscopy, National Cancer Center Hospital East.…”

Section: Discussionmentioning

confidence: 99%

“…The portable optical instrument manufactured by Shofu Inc., which was used in the present study, irradiates the surface with a 425-nm blue light and enables the visualization of oral mucosal diseases. Using this instrument, an image analysis software that digitized the color of the mucous membrane (G value) was developed to obtain objective data that cannot be acquired with vital staining and conventional fluorescence visualization devices ( 5 ). As a result, minute changes in fluorescence that could not be recognized by visual inspection could be recorded in a digitized form, and color changes, otherwise unrecognizable by direct observation, could be detected by the software.…”

Section: Discussionmentioning

confidence: 99%

“…Tumors and inflammatory processes are indicated by reduced FAD levels and fluorescence visualization loss (FVL) due to collagen cross-link (CCL) destruction. An oral mucosa fluorescence visualization device that uses an optical instrument and an analysis software calculating its G value has also been developed in Japan and has been examined for its usefulness in distinguishing lesions (5). However, there are cases characterized by differences between the luminance values and histopathological presentation, which have led to the hypothesis that a factor other than the described principle of fluorescence visualization exists.…”

Section: Introductionmentioning

confidence: 99%

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Relationship between the immunohistological examination and fluorescence visualization of oral squamous cell carcinoma

et al. 2020

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Disorders of the oral mucosa are considered easy to diagnose since they can be visualized and examined directly. A change in the color of the oral mucosa reflects histopathological changes and is an important diagnostic parameter. However, the subjective perception of color varies. To determine the extent of resection for oral mucosa conditions, it is necessary to digitize the color and perform objective assessments. In recent years, fluorescence visualization devices and analysis software that measure tissue luminance G have been employed for the identification of oral mucosa diseases. Fluorescence visualization is presumably based on the decrease in epithelial flavin adenine dinucleotide content and luminance G values due to the destruction of collagen cross-links [fluorescence visualization loss (FVL)]. However, cases with differences between luminance values and histopathological presentation exist. Therefore, additional factors may affect fluorescence visualization. The present study used a portable, non-contact oral mucosa fluorescence visualization device for luminance measurements in seven patients with oral squamous cell carcinoma. Furthermore, Picro-Sirius Red and immunohistochemical staining were performed for CK13, CK17, Ki67, p53 and E-cadherin in the FVL(+) (lesion) and FVL(-) (resection stump) areas to elucidate the principle of fluorescence visualization. Fluorescence was significantly lower in the FVL(+) than in the FVL(-) areas, and the mean luminance G value was 56. The Picro-Sirius Red stain revealed collagen destruction in the FVL(+) areas but no collagen disruption in the FVL(-) areas. CK13 was negative in the FVL(+) and positive in the FVL(-) areas, whereas the opposite pattern was observed for CK17. In the FVL(+) area, p53 staining was positive. E-cadherin expression was enhanced in the FVL(-) areas and reduced in the FVL(+) areas. Furthermore, the luminance G value tended to be lower in cases with weaker E-cadherin staining. The aforementioned results suggest that decreased E-cadherin expression may be a factor that regulates fluorescence visualization.

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“…A region of interest (ROI, solid yellow line in Figure S6 ) was defined in the lesion area of the G-image based on intraoral photographs and intraoral findings by the attending physician. The ROIs of the NOM areas were set at the sublingual mucosa, buccal mucosa, the transition area from the molar attachment gingiva to the buccal mucosa and the mucosa on the floor of the oral cavity [ 24 , 25 ]. The NOM area was selected to be wide enough to ensure that the target lesion was at a right angle to the irradiation light.…”

Section: Methodsmentioning

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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Fluorescence Visualization for Oral Mucosa Using an Auto-fluorescence Imaging Analysis Software

Cited by 3 publications

References 0 publications

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

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

Relationship between the immunohistological examination and fluorescence visualization of oral squamous cell carcinoma

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

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