title: Autofluorescence imaging of potentially malignant mucosa lesions.
abstract: OBJECTIVE
  Several noninvasive adjunctive methods have been proposed for identification of potentially malignant mucosa lesions. The VELscope is an optical device for detecting spatial changes in mucosa autofluorescence caused by premalignant lesions in conjunction with an intraoral exam. The aim of our prospective study was to correlate loss of autofluorescence from undiagnosed mucosa lesions with histology.
  
  
  RESULTS
  In total 64 patients considered at risk for squamous cell carcinoma (20 had previous OSCC) were included in the study. Regions with fluorescence visualization loss were considered as malignant or dysplastic. All patients underwent biopsy after VELscope examination. In 22 patients (34.4%) a loss of autofluorescence indicating a squamous intraepithelial neoplasia (SIN) or malignant mucosal lesion was detected. The sensitivity of identification of malignant and dysplastic areas with the VELscope was 100% and the specificity was 80.8%, respectively, compared with histology as gold standard. The positive predictive value was 54.5% and the negative predictive value was 100% respectively.
  
  
  CONCLUSIONS
  Evaluation of autofluorescence imaging with VELscope can assist in the identification of malignant and potentially malignant oral lesions from normal mucosa in high-risk patients but does not help discriminating benign lesions from malignant or premalignant mucosal conditions.
authors.affiliation: Department of Oral and Craniomaxillo-facial Plastic Surgery, University of Cologne, Cologne, Germany. m.scheer@uni-koeln.de
authors.forename: Martin
authors.initials: M
authors.lastname: Scheer
authors.forename: Joerg
authors.initials: J
authors.lastname: Neugebauer
authors.forename: Ali
authors.initials: A
authors.lastname: Derman
authors.forename: Julianne
authors.initials: J
authors.lastname: Fuss
authors.forename: Uta
authors.initials: U
authors.lastname: Drebber
authors.forename: Joachim E
authors.initials: JE
authors.lastname: Zoeller
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis*; D016009:Chi-Square Distribution; D003945:Diagnosis, Oral / Q000295:instrumentation*; D005188:False Negative Reactions; D005189:False Positive Reactions; D005260:Female; D005453:Fluorescence; D005470:Fluorometry / Q000295:instrumentation*; D006801:Humans; D007972:Leukoplakia, Oral / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D009061:Mouth Mucosa / Q000473:pathology*; D009062:Mouth Neoplasms / Q000175:diagnosis*; D011230:Precancerous Conditions / Q000175:diagnosis; D011446:Prospective Studies; D012680:Sensitivity and Specificity