The use of autofluorescence technology in the detection
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Tissue autofluorescence technology can help detect oral cancer. When normal oral tissue is exposed to blue light, it emits green fluorescence but abnormal tissue will appear dark. This property is used in devices like VELscope to examine the mouth. The document discusses several studies finding that VELscope had high sensitivity and specificity for detecting cancerous and pre-cancerous lesions compared to normal tissue. It can also help surgeons delineate diseased from healthy bone during fluorescence-guided procedures. While promising for screening, further research is still needed to evaluate autofluorescence's ability to differentiate malignant from benign lesions. In summary, autofluorescence visualization aids in oral cancer detection and surgery but requires more validation.
The use of autofluorescence technology in the detection
- 1. IN THE NAME OF CREATOR OF LIGHT The Use of TISSUE Auto fluorescence Technology in the Detection of Oral Cancer Mehrdad Bayat DDS-Member, Laser Dept, Shahid Beheshti Univ., M.S. School of Dentistry 1
- 2. Cancer has many anatomic and molecular subtypes that each requiring specific management strategies. Introduction Epidemiology Definition Diagnosis Autofluorescence Conclusion 2Dr. Mehrdad Bayat
- 3. 3 • 8.8 million people worldwide died from cancer in 2015. • That is nearly 1 in 6 of all global deaths(56.4million). • US $ 1.16 trillion is the estimated total annual economic cost of cancer in 2010 Dr. Mehrdad Bayat Introduction Epidemiology Definition Diagnosis Autofluorescence Conclusion
- 4. THE MOST COMMON CANCERS 4 30-50% Of cancer could be prevented Dr. Mehrdad Bayat Introduction Epidemiology Definition Diagnosis Autofluorescence Conclusion
- 5. COMMON SYMPTOMS AND SIGNS THAT MAY BE DUE TO CANCER 5Dr. Mehrdad Bayat Introduction Epidemiology Definition Diagnosis Autofluorescence Conclusion
- 6. Up to half of oral cancer patients are diagnosed with advanced lesions Red and white surface alteration which is centrally idurated/firm was noted on routine examination in this 70 year old male. Patient has long time history of tobacco and alcohol abuse. Diagnosis: Squamous cell carcinoma 6Dr. Mehrdad Bayat Introduction Epidemiology Definition Diagnosis Autofluorescence Conclusion
- 7. ORAL CANCER 7 Oral cancer can affect any of the working parts of mouth or oral cavity, which include the: lips and cheeks teeth front two-thirds of the tongue (the back third of the tongue, or base, is considered part of the oropharynx, or throat) gums area of the mouth underneath the tongue, called the floor roof of the mouth Dr. Mehrdad Bayat Introduction Epidemiology Definition Diagnosis Autofluorescence Conclusion
- 8. 8 1 - Smoking: The risk of oral cancer is about 5–10 times greater among smokers compared to people who never smoked. 2 - Alcohol consumption: Many studies showed that more than 75–80% of the oral cancer patients drink alcohol continuously. 3 - Human papillomavirus (HPV): This virus plays an important role in the epithelial cancer of the tonsils and oropharynx. 4 - Syphilis: cancerous ability of the leukoplakia originating from syphilis is 30– 100%. 5 - Age: More than 98% of oral cancers occur at more than 40 years of age. 6 - Malnutrition: The deficiency of vitamin A and oral epithelial cancer. RISK FACTORS FOR DEVELOPING ORAL CANCER Introduction Epidemiology Definition Diagnosis Autofluorescence Conclusion
- 9. RISK FACTORS FOR DEVELOPING ORAL CANCER 9 7 - Intraoral infections. 8 - Direct sunlight: chronic facial sun exposure. 9- previous diagnosis of oral cancer 10- family history of oral or other types of cancer 11 - Precancerous lesions: The transformation of white lesions in the oral cavity into malignant ones is low; but, on the other hand, it is high when they are red lesions and traumatic ulcers which is one of the categories. 12-Being male J Int Soc Prev Community Dent. 2015 May-Jun; 5(3): 248–254. doi: Dr. Mehrdad Bayat Introduction Epidemiology Definition Diagnosis Autofluorescence Conclusion
- 10. ORAL CANCER WAS NOT JUST AN OLDER MAN’S DISEASE 10 Oral cancer is rising in women , young people and non-smokers. Oral cancers occur in people who don’t smoke and have no other risk factors Dr. Mehrdad Bayat Introduction Epidemiology Definition Diagnosis Autofluorescence Conclusion
- 11. 11Dr. Mehrdad Bayat Introduction Epidemiology Definition Diagnosis Autofluorescence Conclusion
- 12. 12Dr. Mehrdad Bayat Introduction Epidemiology Definition Diagnosis Autofluorescence Conclusion
- 13. CANCER MANAGEMENT 13 Effective programs in: • Early diagnosis • Screening • Treatment ( surgery; medicines; chemotherapy ; radiotherapy) • Palliative care ( Improving the quality of life of patients and their families) Dr. Mehrdad Bayat Introduction Epidemiology Definition Diagnosis Autofluorescence Conclusion
- 14. HOW IS ORAL CANCER DIAGNOSED? 14 • Physical exam • If your doctor finds any tumors, growths, or suspicious lesions: • Biopsy (brush biopsy –surgical biopsy ) • The gold standard diagnostic test for oral mucosal lesions that are suggestive of premalignancy or malignancy remains tissue biopsy and histopathological examination. • In addition: • X-rays to see if cancer cells have spread to the jaw, chest, or lungs • CT scan to reveal any tumors in your mouth, throat, neck, lungs, or elsewhere in your body • PET scan to determine if the cancer has traveled to lymph nodes or other organs • MRI scan to show a more accurate image of the head and neck, and determine the extent or stage of the cancer • endoscopy to examine the nasal passages, sinuses, inner throat, windpipe, and trachea Dr. Mehrdad Bayat Introduction Epidemiology Definition Diagnosis Autofluorescence Conclusion
- 15. 15 Visual examination Tools and Time Dr. Mehrdad Bayat Introduction Epidemiology Definition Diagnosis Autofluorescence Conclusion
- 16. INTRA ORAL EXAMINATION Introduction Epidemiology Definition Diagnosis Autofluorescence Conclusion Dr. Mehrdad Bayat
- 17. INTRA ORAL EXAMINATION Introduction Epidemiology Definition Diagnosis Autofluorescence Conclusion Approximately 70% of oral SCC develop in the floor of the Mouth , tongue or retromolar region retromolar region tongue floor of the Mouth Dr. Mehrdad Bayat
- 18. EARLY DETECTION SAVES LIVES Approximately 300,000 new cases of oral cancer reported annually worldwide. Dentists and hygienists are the best overall defense against oral cancer – they are, in fact, a lifesaver. 18Dr. Mehrdad Bayat Introduction Epidemiology Definition Diagnosis Autofluorescence Conclusion
- 19. 19Dr. Mehrdad Bayat Oral cancer screening tools Toulidine blue Exfolitive cytology Brush biopsy Flowcytometry Photo Dynamic Diagnosis ( PDD ) Optical Coherence Tomography ( OCT ) Chemiluminescence Tissue autofluorescence Introduction Epidemiology Definition Diagnosis Autofluorescence Conclusion
- 20. VELSCOPE • Fluorescence technology is a noninvasive approach for assessing and aiding in the visualization of chemical and morphological patterns of the various tissues and substances within the oral cavity. 20Dr. Mehrdad Bayat Introduction Epidemiology Definition Diagnosis Autofluorescence Conclusion The VELscope® Vx, the latest model release of LED Dental’s VELscope technology, uses natural tissue fluorescence to discover abnormalities in the oral mucosa.
- 21. THE AUTOFLUORESCENCE VISUAL IMAGING 21 • This technology is widely used and safe method such as VELscope approved by the FDA. • Although this convenient autoflurescence imaging has great promise to enhance the screening and uses, sensitivity and specificity for detecting malignant lesions and differentiation from premalignant or benign lesions still remains to be evaluated. 2016 Jul 1;21(4):e447-55. Dr. Mehrdad Bayat Introduction Epidemiology Definition Diagnosis Autofluorescence Conclusion
- 22. Exposure to blue light spectra (400-460 nanometers) may maximize a differential profile in areas undergoing neoplastic change in which a loss of fluorescencevisualization is reported. 22Dr. Mehrdad Bayat Introduction Epidemiology Definition Diagnosis Autofluorescence Conclusion
- 23. • When the tissue illuminated with short wave length light (usually violet or blue ) the cells become excited and emit longer wave length (low energy) • Normal cells >> emit green light • Abnormal cells >> emit dark light 23Dr. Mehrdad Bayat Introduction Epidemiology Definition Diagnosis Autofluorescence Conclusion Unremarkable Floor of the Mouth Lichen Planus and when the light comes across abnormal tissue, it will discontinue its’ fluorescence activity that was seen on the normal tissues by changing from the green fluorescent light to a dark green color.
- 24. THE FLUORESCENCE VISUALIZATION SYSTEM FOR THE DETECTION OF ORAL PRECANCEROUS AND EARLY CANCEROUS LESIONS. 24 • Early detection of precancerous and early cancerous lesions could greatly reduce both the mortality and morbidity of oral cancer • The normal oral mucosa emitted various shades of pale green autofluorescence. In the precancerous and early cancerous cases, the lesion appeared as an irregular dark area. • Histological examination of the lesions showed that the VELscope system had a sensitivity of 95% and specificity of 100% in discriminating normal mucosa from dysplasia/carcinoma in situ (CIS) or invasive carcinoma. 2016 Jul;36(1):514-20. doi: 10.3892/or.2016.4776. Epub 2016 Apr 28. Dr. Mehrdad Bayat Introduction Epidemiology Definition Diagnosis Autofluorescence Conclusion
- 25. ORAL CANCER EARLY DETECTION 25Dr. Mehrdad Bayat Introduction Epidemiology Definition Diagnosis Autofluorescence Conclusion
- 26. OVERVIEW OF VELSCOPE 26 Completely non-invasive No rinsing or staining Easy-takes only 1-2 minutes Non-expensive The early detection of : • Cancer and pre cancer • Inflammation from numerous causes • Various other condition • Fluorescence-guided surgery Dr. Mehrdad Bayat Introduction Epidemiology Definition Diagnosis Autofluorescence Conclusion
- 27. 27Dr. Mehrdad Bayat Introduction Epidemiology Definition Diagnosis Autofluorescence Conclusion Former Smoker Examined After a Surgical Excision of Severe Epithelial Dysplasia on the Left Lateral Tongue 6 Months White-light image of a well-healed scar on the left lateral tongue (arrow) 6 Months The anterior aspect of this scar (arrow) under fluorescen t visualization showing a dark brown region of autofluorescence loss The same area (arrow) showed a persistent autofluorescence loss of increased size; at 20 months after initial treatment (data not shown), a biopsy from the region of loss (arrow) showed carcinoma in situ. POST SURGICAL EVALUATION
- 28. CLINICAL CASE 28Dr. Mehrdad Bayat Introduction Epidemiology Definition Diagnosis Autofluorescence Conclusion Lichenoid Mucositis Salivary Gland Tumour
- 29. VELSCOPE ORAL CANCER SCREENING 29 • Oral cavity with precancerous 2013; 9: 23. Published online 2013 Aug 23. doi: Oral cavity with VELscope examination, the arrow shows the region of loss of fluorescence. Dr. Mehrdad Bayat Introduction Epidemiology Definition Diagnosis Autofluorescence Conclusion
- 30. CLINICAL CASE 30Dr. Mehrdad Bayat Introduction Epidemiology Definition Diagnosis Autofluorescence Conclusion
- 31. CLINICAL CASE 31 • the response of the tissues reveals the tissues with malignant or premalignant lesion the color changes into dark colors as shown in Figure : Fluorescent discontinuity and dark color showing abnormal tissues. 2015 May-Jun; 5(3): 248–254. doi: Dr. Mehrdad Bayat Introduction Epidemiology Definition Diagnosis Autofluorescence Conclusion
- 32. 32 • Diffuse chronic sclerosingosteomyelitis (DCSO) is a refractory disease, because the etiology and pathogenesis remain poorly understood and to determine the border between unhealthy bone and healthy bone is difficult. • Using a VELscope®was handy and useful to determine the border between DCSO lesion and healthy bone .The free fibula flap under the minocycline- derived bone fluorescence by using a VELscope® offered a good quality of mandibular bone and the successful management of an advanced and refractory DCSO. • 2015 Oct 1;7(4):e548-51. doi: 10.4317/jced.52268. eCollection 2015.Dr. Mehrdad Bayat Introduction Epidemiology Definition Diagnosis Autofluorescence Conclusion FLUORESCENCE-GUIDED SURGERY
- 33. FLUORESCENCE-GUIDED SURGERY 33 • Fluorescence-guided surgery for the treatment of medication- related osteonecrosis of the jaw (MRONJ). • The delineation of the necrotic bone is a crucial step in the surgical treatment of medication-related osteonecrosis of the jaw Patients received doxycycline 100 mg twice a day for at least seven days preoperatively. • The fluorescence-guided surgery is a safe and successful treatment option which can be considered for all stages of MRONJ. . 2016 Aug;44(8):1073-80. doi 10.1016/j.jcms.2016.05.018. Epub 2016 May 24. Introduction Epidemiology Definition Diagnosis Autofluorescence Conclusion Dr. Mehrdad Bayat
- 34. CONCLUSION 34 • The use of VELscope is effective in the detection of malignant and premalignant lesions • VELscope aids in the detection of the site of biopsy • VELscope is used an aiding tool inside the surgical treatment for the detection of the borders on enucleation . 2015 May-Jun; 5(3): 248–254. doi: Dr. Mehrdad Bayat Introduction Epidemiology Definition Diagnosis Autofluorescence Conclusion
Editor's Notes
- #20: PDD: :فتوسنستایزر + نور سبز ابیanalyzed by spectroscope .