title: Clinical application of a digital method to improve the accuracy of color perception in toluidine blue stained oral mucosal lesions.
abstract: OBJECTIVE
  Color perception is an important variable in detecting and assessing oral conditions. The aim was to investigate clinicians' perception of toluidine blue (Tblue) staining compared to digital color analysis, which may impact mucosal lesion detection, affect the decision to biopsy, and biopsy site selection.
  
  
  METHODS
  Four oral lesions were stained with Tblue. Digital color analyses of eight areas on each image were completed and were considered as "gold standard" (GS). Twenty specialists ranked these areas according to their perceived intensity of blue stain in two sessions.
  
  
  RESULTS
  Consistency between GS and observers rankings was 0.8791. However, more than half of the observers inaccurately perceived the intermediate blue tones. Overall interobserver agreement was 0.8714; stability between two sessions decreased to 45% for intermediate tones.
  
  
  CONCLUSIONS
  Assessing the equivocal blueness of an oral mucosal lesion in clinical settings may vary due to variation in visual perception. A digital method for objective color analysis in clinical practice may be used to eliminate this deficiency by implementing a mathematical formula.
authors.affiliation: University, School of Dentistry, Department of Oral Diagnosis and Radiology, Izmir, Turkey. ilhanbetul@yahoo.com
authors.forename: Pelin
authors.initials: P
authors.lastname: Guneri
authors.forename: Joel B
authors.initials: JB
authors.lastname: Epstein
authors.forename: Betul
authors.initials: B
authors.lastname: Ilhan
authors.forename: Aslıhan
authors.initials: A
authors.lastname: Kaya
authors.forename: Hayal
authors.initials: H
authors.lastname: Boyacioglu
mesh_terms: D000328:Adult; D000465:Algorithms; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis; D018289:Carcinoma, Verrucous / Q000175:diagnosis; D003118:Color Perception / Q000502:physiology*; D003124:Colorimetry / Q000379:methods* / Q000706:statistics & numerical data; D004396:Coloring Agents; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods* / Q000706:statistics & numerical data; D017676:Lichen Planus, Oral / Q000175:diagnosis; D008875:Middle Aged; D009061:Mouth Mucosa / Q000473:pathology*; D009062:Mouth Neoplasms / Q000175:diagnosis*; D015588:Observer Variation; D010781:Photography; D011230:Precancerous Conditions / Q000175:diagnosis*; D012680:Sensitivity and Specificity; D014048:Tolonium Chloride
chemical_list: D004396:Coloring Agents; D014048:Tolonium Chloride