Velscope guided oral cancer screening: A ray of hope in early oral cancer diagnosis

CONTEXT: Early oral cancer diagnosis is an important factor in reducing cancer-associated mortality and morbidity. Traditional oral cancer screening by Conventional Oral Examination (COE) is limited. A new approach in this regard is the use of “optical biopsy systems” like VELscope. AIMS: Hence, this study aimed to determine the diagnostic value of VELscope, an autofluorescence-based handheld device in detection of dysplasia and oral squamous cell carcinoma (OSCC) in general oral potentially malignant disorder. SETTINGS AND DESIGN: A prospective, cross-sectional study was conducted at a tertiary hospital in western Maharashtra, India. MATERIALS AND METHODS: Thirty patients with presence of clinically suspicious oral lesions were included, and for each lesion, both the COE and Autofluorescence Examination by VELscope were carried out at the same appointment by different experts. All lesions were biopsied and histopathological findings were documented and analyzed. STATISTICAL ANALYSIS USED: Sensitivity, specificity, positive predictive value and negative predictive value were estimated to determine the accuracy of VELscope examination analysis outcome. RESULTS: The study included a total of 30 subjects including 19 (63.33%) males and 11 (26.66%) females. Autofluorescence examination by VELscope (AFV) revealed Autofluorescence Loss in 24 (80%) patients, while 6 (20%) patients showed Autofluorescence Retained. Comparison between the “high-risk lesions” (moderate/severe dysplasia and OSCC) and “low-risk lesions” (no/mild dysplasia) showed a 90.47% sensitivity but only 44.44% specificity. CONCLUSIONS: The findings of our study indicate that although AFV cannot be a substitute for COE, it can be used as a potential complementary diagnostic aid in surveillance of the high-risk patient population.