Abstract
Objective: Although FDA approved for clinical use, the utility of hand-held tissue reflectance and autofluorescence devices for screening head and neck cancer (HNC) patients is poorly defined. There is no published evidence regarding the efficacy of these devices. We investigated the sensitivity and specificity of these modalities compared with standard examination.
Method: Study design: prospective, cross sectional analysis. Included patients previously treated for HNC (n = 89) and patients being evaluated for a new primary (n = 10) between 2009 to 2010. Patients were screened using white light illumination (standard of care) followed by tissue reflectance and autofluorescence illumination. Results were compared with biopsy results or follow-up screening.
Results: Violet light had a specificity (Sp) of 67% and a sensitivity (Sn) of 79%, which was comparable with standard of care (white light) examinations (67% Sp and 86% Sn). Amber light had poor specificity (0%) and good sensitivity (83%). The positive and negative predictive values for standard white light examination (15% and 96% respectively) were superior to both violet and amber light. For patients presenting with new lesions (n = 10), tissue reflectance (60% Sp, 83% Sn) and autoflourescence (50% Sp, 75% Sn) were inferior to standard white light examination (100% Sp and Sn).
Conclusion: Standard clinical lighting has a higher sensitivity than tissue reflectance and autoflourescence visualization for detection of disease in new patients or those with a history of HNC. This study does not support the added costs associated with these devices.
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