A customized optical device allows dentists to visualize whether a patient might have a developing oral cancer, according to a study published online in the Journal of Biomedical Optics.
A simple, hand-held device called a Visually Enhanced Lesion Scope (VELScope) emits a cone of blue light into the mouth that excites various molecules within cells, causing them to absorb the light energy and re-emit it as visible fluorescence. When the light is removed, the fluorescence of the tissue is no longer visible.
Because changes in the natural fluorescence of healthy tissue generally reflect light-scattering biochemical or structural changes indicative of developing tumor cells, the VELScope allows dentists to shine a light onto a suspicious sore in the mouth, look through an attached eyepiece and watch directly for changes in color. Healthy oral tissue emits a pale green fluorescence, while potentially early tumor, or dysplastic, cells appear dark green to black.
Scientists from the British Columbia Cancer Research Centre, Vancouver, Canada, tested the device in 50 tissue sites in 44 people. They found that they could distinguish correctly between healthy and abnormal tissue in all but one instance. Their diagnoses were confirmed via biopsy and standard pathological testing.
"The natural fluorescence of the mouth is invisible to the naked eye," said Miriam Rosin, PhD, a senior author and cancer biologist at the research center. "The VELScope literally brings this natural fluorescence to light, helping dentists to answer in a more informed way a common question in daily practices: to biopsy or not to biopsy."
Determining whether a suspicious sore is benign or potentially cancerous is scientifically problematic. "A major reason is looks alone can be deceiving," said Dr. Rosin. "What’s been badly needed in screening for oral cancer is a way to visualize the biological information within and let it tell you whether or not a lesion is likely to become cancerous."
This study was funded by the National Institute of Dental and Craniofacial Research, National Institutes of Health.
