Observation of Patients with Oral Potentially Malignant Disorders Using Autofluorescence Imaging and Spectroscopy

Abstract

Objectives:

1) Describe 2 noninvasive optical techniques, widefield autofluorescence imaging (AFI) and optical spectroscopy, that may be used in conjunction with conventional oral examination (COE) for long-term surveillance of patients with oral potentially malignant disorders (OPMD). 2) Present images and spectra collected from patients with OPMD using AFI and spectroscopy over a 33-month surveillance period, and compare results to clinical observations and patient outcomes over that time period.

Methods:

Patients undergoing routine follow-up surveillance for OPMD were enrolled in a longitudinal optical imaging study. The patients were monitored over time with COE, AFI, and spectroscopy. AFI was used to observe natural tissue fluorescence over a 4-5 cm field of view. Spectroscopy was used to obtain reflectance and fluorescence spectra from selected sites within the oral cavity. The images and spectra collected from these patients were evaluated for changes over time and compared to clinical observations and (where available) histopathology results.

Results:

During the 33-month period from May 2010 to February 2013, more than 140 patients were enrolled in the study. To date, more than 1,000 optical measurements have been performed during more than 400 clinical surveillance visits. During the surveillance period 26 patients were judged clinically to have progressed from OPMD to cancer. Representative images and spectra from some of these patients will be presented.

Conclusions:

These results indicate the potential for simple optical techniques, when used in combination with COE, to assist clinicians in monitoring patients with OPMD for early detection of cancer.