Oral Fluorescence Imaging Using 405-nm Excitation, Aiding the Discrimination of Cancers and Precancers by Identifying Changes in Collagen and Elastic Breakdown and Neovascularization in the Underlying Stroma

Abstract Background Optical spectroscopy and imaging devices are being developed and tested for the screening and diagnosis of cancer and precancer in multiple organ sites. Objective The aim of the study reported here is to optimize the capability of an optical imaging device to discriminate precancerous tissue from other lesions by identifying ideal excitation wavelengths. Methods The studies reported here used a prototype of a direct fluorescence imaging device that uses 405-nm illumination to excite tissue. Results There is ample evidence in the literature that 405 nm can distinguish oral cancers from normal tissue. Higher wavelengths may be necessary to differentiate potential confounding lesions, such as abrasions, burns, viral infections, inflammation, and gingivitis. Conclusions Imaging at 405 nm could help doctors detect precancerous and cancerous oral lesions. Such imaging could be used by dentists, family practitioners, otorhinolaryngologists, general surgeons, obstetrician gynecologists, and internists, and could greatly increase the number of patients who have lesions detected in the precancerous phase.