Differential diagnosis of leukoplakia versus lichen planus of the oral mucosa based on digital texture analysis in intraoral photography.

BACKGROUND

A noninvasive, accurate and quick diagnosis is very important to general practitioners and specialists who care for the health of patients' oral cavity mucosa. The main enemies are precancerous lesions: leukoplakia and lichen planus (LP).

OBJECTIVES

The aim of this study was to attempt to formulate a differential diagnosis for leukoplakia vs LP in the oral mucosa based on digital texture analysis in intraoral macrophotography.

MATERIAL AND METHODS

The study was comprised of 21 patients affected by leukoplakia, 21 affected by LP and 21 healthy volunteers. Intraoral photography of all participants was taken perpendicularly to the buccal mucosa. To achieve the maximum possible contrast, a high-pass filter was applied and level tools were then used to equalize the histograms of the images. After that, the images were converted into 8-bit grayscale. Two features of run length matrix and 2 of co-occurrence matrix were used for texture analysis. Analysis of variance (ANOVA) was used to check for differences. Factor analysis (FA) and classification with artificial neural network (ANN) were performed.

RESULTS

The results revealed a simple possible differentiation of both types of precancerous lesions from normal mucosa (p < 0.05). Factor analysis and ANN can help in differentiating the 3 study groups from one another.

CONCLUSIONS

Differential diagnosis of leukoplakia and LP in the oral mucosa based on digital texture analysis in intraoral macrophotography is possible. It can be used to develop smartphone applications and can be also a helpful tool for general dentists to define the clinical problem before a consultation with a specialist.