title: Direct fluorescence visualization of clinically occult high-risk oral premalignant disease using a simple hand-held device.
abstract: BACKGROUND
  A considerable proportion of oral cancer and precancer is not clinically apparent and could contribute significantly to the late diagnosis and high mortality of oral cancer. A simple method to identify such occult change is needed.
  
  
  METHODS
  Patients in the Oral Dysplasia Clinics at British Columbia are currently being examined with a simple hand-held device that permits the direct visualization of alterations to autofluorescence in the oral cavity. Tissue showing loss of autofluorescence is biopsied.
  
  
  RESULTS
  We present 3 representative cases in which occult lesions were identified with fluorescence visualization during longitudinal follow-up, resulting in the diagnosis of a primary dysplasia in case 1, a second primary cancer in case 2, and cancer recurrence in case 3.
  
  
  CONCLUSIONS
  This is the first report of the diagnosis of occult oral disease using a simple noninvasive device. These early examples indicate the potential value of this technology to guide the management of patients with oral lesions, facilitating the detection of high-risk changes not apparent with white-light visualization.
authors.affiliation: BC Cancer Agency, Cancer Control Research Program, Vancouver, British Columbia V5Z 1L3, Canada.
authors.forename: Catherine F
authors.initials: CF
authors.lastname: Poh
authors.forename: Samson P
authors.initials: SP
authors.lastname: Ng
authors.forename: P Michele
authors.initials: PM
authors.lastname: Williams
authors.forename: Lewei
authors.initials: L
authors.lastname: Zhang
authors.forename: Denise M
authors.initials: DM
authors.lastname: Laronde
authors.forename: Pierre
authors.initials: P
authors.lastname: Lane
authors.forename: Calum
authors.initials: C
authors.lastname: Macaulay
authors.forename: Miriam P
authors.initials: MP
authors.lastname: Rosin
mesh_terms: D000328:Adult; D042241:Early Diagnosis; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008163:Luminescent Measurements / Q000295:instrumentation*; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000175:diagnosis*; D011230:Precancerous Conditions / Q000175:diagnosis*; D013050:Spectrometry, Fluorescence / Q000295:instrumentation*