A novel diagnostic device for oral cancer
Oral cancer in the mouth, lips or throat, is often curable if diagnosed and treated early. However, conventional imaging techniques do not provide the necessary sensitivity for detecting oral cancer during early stages. Thus, almost half of the patients have a maximum life expectancy of only five years after diagnosis. This is complicated further by the fact that although most oral lesions are benign, many have the appearance of a malignant lesion and vice versa. Currently there is no commercially available solution for routine screening of the oral cavity. The EU-funded EDOCALD (Early detection of cancer using lasers demonstrator) project set out to develop an optical imaging device that offered an improved detection accuracy for oral cancer lesions. Work during the predecessor EDOCAL project had demonstrated that it was possible to discriminate pre-cancerous tumours at an early stage before mucosal changes appeared. This was performed through the excitation of the molecule protoporphyrin, which is generally present in blood vessels. The identification of mucosal dysplasia, however, required an absence of auto-fluorescence for a confident assessment of risk and lesion localisation. To address this, EDOCALD partners combined the EDOCAL detection method with narrow and broad field detection modes and a statistical model for correlating data with known outcomes. This device constituted the first generation demonstrator of a real-time photonic cancer detector and contained a narrow field tuneable laser detector. It created images of the oral cavity and helped map highly suspicious lesions with 100 % sensitivity and specificity. The device also offered the capacity to overlay recorded images and monitor the progression of lesions over time following treatment. Overall, the EDOCALD device constitutes a practical tool for everyday routine medical practice. It should improve the diagnosis of oral cancer, and reduce the number of unnecessary biopsies. In the future, EDOCALD partners hope to apply the same technology to identify which pre-malignant tissues will result in malignancy.
Keywords
Oral cancer, laser, imaging, lesion, protoporphyrin, photonic cancer detector
