• Admin
  • 2 October, 2021

Minimally Invasive Oral Cancer Detection Methods

Minimally invasive methods of oral cancer detection can aid in early diagnosis and prompt treatment planning. Here are two methods which are minimal or non-invasive methods of oral cancer detection.

Chemiluminescent Illumination - A minimally invasive method

  • The term "chemiluminescence" refers to the emission of light from a chemical reaction.  
  • A nontoxic blue-white chemiluminescent light is shone into mouth and tissue reflectance is observed. 
  • Improve the identification of mucosal abnormalities with respect to the use of normal incandescent light. 
  • Devices working based on this principle: Vizilite, Microlux DL unit

Vizilite 

  • Is an oral lesion identification and marking system 
  • Used as an adjunct to the conventional head and neck examination
  • Comprised of a chemiluminescent light source (ViziLite) to improve the identification of lesions and a blue phenothiazine dye to mark those lesions identified by ViziLite 
  • Has outer flexible plastic capsule containing aspirin or acetyl salicylic acid- inner fragile glass vial containing hydrogen peroxide 
  • These chemicals react to produce light of blue-white color (430-580 nm) which lasts for 10 min 
  • Normal epithelium will absorb light and appear dark 
  • Hyperkeratinized or dysplastic lesions appear white 

Contraindications : 

  • For those who might have difficulties understanding instructions and for who have physical impairments. 

Microlux DL 

  • Painless, non-invasive test, takes less than three minutes 
  • Acetic acid dehydrates the cytoplasm of acetowhite lesions and the lesion's refractive properties are changed 
  • The irregular cells take on a whitish hue which contrasts with surrounding tissue, helping to identify abnormalities which require further testing 

Oral Brush Biopsy 

  • Introduced in 1999 
  • It utilizes a stiff brush to collect the sample cells from the basal layer cells non invasively and assess the dysplasia by computer assisted neural network. 
  • Is a rapidly conducted chair side procedure 
  • Results in minimal bleeding, requires no topical or local anesthetic, and results in a collection of a complete transepithelial tissue sample 
  • The cutting edge of the brush  is placed against the lesion and while maintaining firm pressure, rotated in a clockwise fashion 
  • The brush is repeatedly rotated about 5-15 times 
  • Red lesions and  ulcerations generally require little pressure and few rotations. 
  • White lesions, lesions on the palate and gingiva which are typically covered with keratin, require more pressure and more rotations to reach the basement membrane 
  • After obtaining the sample - the cellular material on the brush - transferred  and rotated on the glass slide from one end to another  
  • The high accuracy of OralCDx is due to the fact that analyses of oral brush biopsies are accomplished with the assistance of sophisticated computers and advances in image recognition 

Indication:

  • Small or tiny, nonsuspicious, common, unexplained red or white spots. 

Contraindication:

  • Lesions that are highly suspicious and require immediate scalpel biopsy. 
  • Lesions with an intact epithelium - submucosal masses, pigmented lesions, fibromas and mucoceles should be biopsied with a scalpel when indicated.

 Article by Dr. Siri P.B.


 
 
 


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