Clinical Application of the IllumiScan Fluorescence Visualization Device in Detecting Oral Mucosal Lesions.

Shogo Kikuta,Joe Iwanaga,Katsumi Shinozaki,Jingo Kusukawa,Moriyoshi Nakamura,Ryuichiro Tanoue,Keita Todoroki

doi:10.7759/cureus.3111

Shogo Kikuta, Joe Iwanaga + Show 5 more

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https://doi.org/10.7759/cureus.3111

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Journal: Cureus	Publication Date: Aug 6, 2018
Citations: 11	License type: cc-by

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Objective: Fluorescence visualization devices are screening devices that can be used to examine lesions of the oral mucosa non-invasively. We observed oral squamous cell carcinoma (OSCC) and leukoplakia using the IllumiScan (Shofu, Kyoto, Japan) fluorescence visualization device and examined its usefulness and characteristics.Methods: We investigated 31 OSCC and nine leukoplakia in patients who were examined using the IllumiScan and treated in our department from January 2017 to February 2018. Images taken with the IllumiScan were analyzed using image analysis software. We also examined the lesions using narrowband imaging (NBI). Additionally, the IllumiScan and NBI images and the non-stained areas of iodine staining method (IOM) were visually evaluated.Results: The average luminance of OSCC in the keratinized mucosa was significantly lower than that of OSCC in non-keratinized mucosa. The average luminance of OSCC was significantly lower than that of leukoplakia. Even in keratinized mucosa where IOM is impossible to use, the OSCC lesion exhibited fluorescence visualization loss.Conclusion: The application of the fluorescence visualization device to the oral mucosa may be useful for distinguishing between cancer and normal areas and can be used to detect OSCC in the keratinized mucosa. The use of the IllumiScan in combination with other conventional screening methods may lead to a better diagnosis.

Highlights

Oral cancers account for 2.1% of all cancers globally [1]
We investigated the clinical application of the IllumiScan for detecting oral squamous cell carcinoma (OSCC) and leukoplakia and compared it with other adjunctive screening methods, such as narrow band imaging (NBI) and iodine staining method (IOM)
31 patients were pathologically diagnosed with oral squamous cell carcinoma (OSCC) of the tongue (18 cases), gingiva (11 cases), or palate, and nine patients were clinically diagnosed with leukoplakia

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Introduction

Oral squamous cell carcinoma (OSCC) makes up approximately 94% of these oral cancers [2]. Oral cancer is one of the few malignant tumors that is directly visible, but in many cases, it is difficult to make a definite diagnosis because of the existence of many oral potentially malignant disorders (OPMD), precancerous lesions, and precancerous conditions in the oral mucosa. Oral cancers present with a wide range of tumor morphologies, and invasive and sometimes painful biopsies may be necessary for a definitive diagnosis. Lugol’s iodine staining method (IOM) is a useful modality that is commonly used to detect OSCC and epithelial dysplasia [3,4]. Previous studies have shown that IOM was useful for detecting oral or esophageal carcinoma and the surrounding epithelial dysplasia [56]. Iodine is irritative to the mucosa, so it cannot be used on keratinized mucosa such as the gingiva and hard palate or in patients with an allergy to iodine [3,7]

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