Vision enhancement system for detection of oral cavity neoplasia based on autofluorescence.
BACKGROUND
Early detection of squamous cell carcinoma (SCC) in the oral cavity can improve survival. It is often difficult to distinguish neoplastic and benign lesions with standard white light illumination. We evaluated whether a technique that capitalizes on an alternative source of contrast, tissue autofluorescence, improves visual examination.


METHODS
Autofluorescence of freshly resected oral tissue was observed visually and photographed at specific excitation/emission wavelength combinations optimized for response of the human visual system and tissue fluorescence properties. Perceived tumor margins were indicated for each wavelength combination. Punch biopsies were obtained from several sites from each specimen. Sensitivity and specificity were evaluated by correlating histopathologic diagnosis with visual impression.


RESULTS
Best results were achieved with illumination at 400 nm and observation at 530 nm. Here, sensitivity and specificity were 91% and 86% in discrimination of normal tissue from neoplasia. This compares favorably with white light examination, in which sensitivity and specificity were 75% and 43%.


CONCLUSIONS
Oral cavity autofluorescence can be easily viewed by the human eye in real time. Visual examination of autofluorescence enhances perceived contrast between normal and neoplastic oral mucosa in fresh tissue resections.
Department of Biomedical Engineering, The University of Texas at Austin, Austin, Texas 78712, USA.
Ekaterina
E
Svistun
Reza
R
Alizadeh-Naderi
Adel
A
El-Naggar
Rhonda
R
Jacob
Ann
A
Gillenwater
Rebecca
R
Richards-Kortum
D001707:Biopsy, Needle; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis*; D006801:Humans; D009061:Mouth Mucosa / Q000473:pathology*; D009062:Mouth Neoplasms / Q000175:diagnosis*; D011230:Precancerous Conditions / Q000175:diagnosis*; D012680:Sensitivity and Specificity; D013050:Spectrometry, Fluorescence / Q000379:methods