Use of fluorescent light in detecting malignant and premalignant lesions in the oral cavity: a prospective, single-blind study.

OBJECTIVE

To determine the usefulness of the VELscope in detecting malignant and premalignant oral cavity lesions.

STUDY DESIGN

Prospective clinical study.

SETTING

Head and neck oncology clinic at an academic tertiary care centre.

SUBJECTS AND METHODS

Eighty-five patients with a history of smoking, alcohol use, and/or head and neck cancer were recruited into the study. The VELscope was used to examine patients' oral cavities after a clinical examination. Biopsies were then taken from suspicious areas.

RESULTS

Of the 85 patients included in the study, 33 underwent biopsies prompted by a clinical examination, the VELscope, or both. Biopsy results that showed invasive malignancy or dysplasias were considered positive. Five positive biopsies for premalignant lesions were detected only by the VELscope and were not visible on clinical examination. On the other hand, only one positive biopsy for a premalignant lesion was detected by the clinical examination only and not seen on the VELscope. Seven positive biopsies were detected by both methods. This indicates that the diagnostic yield from a regular examination was 47% (95% CI 23-72) and that the diagnostic yield from the addition of the VELscope was an additional 31% (95% CI 11-59). Sensitivity and specificity for the VELscope were 92% and 77%, respectively.

CONCLUSION

The Velscope may add sensitivity to the clinical examination and be a useful adjunct in high-risk patients.