The Utility of Optical Instrument “ORALOOK®” in the Early Detection of High-risk Oral Mucosal Lesions

Abstract

Background/Aim: Oral cancer screening is important for early detection and early treatment, which help improve survival rates. Biopsy is invasive and painful, while fluorescence visualization is non-invasive, convenient, and realtime, and examinations can be repeated using optical instruments. The purpose of this study was to clarify the usefulness of an optical instrument in oral screening. Patients and Methods: A total of 201 patients, who were examined using an optical instrument in our Department between 2017 and 2018, were enrolled in this study. Fluorescence visualization images were analyzed using subjective and objective evaluations. Results: Subjective evaluations for detecting oral cancer and oral epithelial dysplasia offered 83.3% sensitivity and 75.7% specificity. Regarding the objective evaluations for detecting oral cancer and oral epithelial dysplasia, sensitivity and specificity were 47.4% and 72.4% for luminance value, 94.7% and 79.6% for luminance ratio, and 100.0% and 68.0% coefficient of variation. Conclusion: Fluorescence visualization using optical instruments is useful for oral cancer screening.

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

“…There are various types of OIs, such as VELscope ® (LED Medical Diagnostics, White Rock, BC, Canada) [ 35 ], ViziLite ® (Zila Pharmaceuticals, Phoenix, AZ, United States), ORALOOK ® (HITS PLAN, Tokyo, Japan), and IllumiScan ® (SHOFU, Kyoto, Japan) [ 13 ]. ORALOOK ® is a lightweight and simple instrument; it has a built-in filter, while FV images and oral conditions are captured using one unit [ 7 ]. This OI irradiates the target with a blue light at an excitation wavelength of about 422 nm, while it can detect only apple-green fluorescence via a filter (520–560 nm).…”

“…However, it is difficult to eliminate environmental factors completely in clinical practice. Therefore, in this study, we corrected it by using a normal mucosa as a control, represented by VRatio [ 7 , 15 , 16 , 17 , 49 ]. In this study, VRatio for oral cancers (68.9%) lower than that of OPMDs and Others (OPMDs 93.8%, Others 95.8%).…”

“…OED is at risk of malignant transformation and is HRL. It is also necessary to consider the detection of HRL [ 7 ]. Therefore, we are planning prospective studies for the detection of HRL and treatments for other oral subsites.…”

“…In ocular inspection and palpation, one major limitation is the difficulty of differentiating between benign and high-risk lesions (HRL) [ 7 ], as early-stage OSCC (T1-2N0M0) cancer in situ (CIS) [ 5 , 8 ], and OED, may not present typical features, and a wide variety of oral mucosal diseases can present in various ways in the oral cavity [ 9 ].…”

Histopathological determinants of autofluorescence patterns in oral carcinoma

“…Several devices evaluating tissue AF have been developed and commercialized in the last two decades (Jayanthi et al, 2009;Kikuta et al, 2018;Lane et al, 2006;Nazeer et al, 2014). Among these, the VELscope ® system has been proposed as a visual diagnostic aid for PMDs and malignant lesions of the oral mucosa (Morikawa, Kosugi, & Shibahara, 2019).…”