Oral cancer screening is pivotal as early diagnosis can dramatically increase the survival rate. Visually Enhanced Lesion Scope (VELscope) is a handheld device that uses natural tissue fluorescence to visualize the abnormalities of the oral mucosa that are not apparent with naked eyes. The objective was to assess the sensitivity and specificity of VELscope in screening for dysplasia, potentially malignant disorders and oral cancer. Three electronic databases were used to obtain the literature with desired criteria. A Meta – Analysis to evaluate the effectiveness of VELscope was undertaken. The data collected was statistically analyzed and Meta-Analysis was then performed for the sensitivity and specificity of VELscope with a forest plot. Meta- Analysis on the efficacy of VELscope showed high sensitivity values (80.47%) in detecting oral lesions such as dysplasia, premalignant and malignant lesions. However, the study reported relatively low specificity rates (56.43%).  The Forest plot graph also substantiated the results. The cumulative result of the meta-analysis on VELscope demonstrated that it is sensitive enough to detect mucosal abnormalities in the oral cavity but not consistent in discriminating dysplasia cases form non-dysplasia cases.  Hence, it can be used only as an adjunct to other aids for screening of oral dysplasia.

Reference

1.       Pereira LHM, Reis IM, Reategui EP, Gordon C, Saint-Victor SS, Duncan R, Gomez C, Bayers S, Fisher P, Perez A, Goodwin WJ, Hu JJ, Franzmann EJ. Risk stratification system for oral cancer screening. Cancer Prev Res. 2016;9(6):445-55. doi: 10.1158/1940-6207.CAPR-15-0200, PMID 27020654.

2.       Marocchio LS, Lima J, Sperandio FF, Corrêa L, de Sousa SO. Oral squamous cell carcinoma: an analysis of 1,564 cases showing advances in early detection. J Oral Sci. 2010;52(2):267-73. doi: 10.2334/josnusd.52.267, PMID 20587952.

3.       Nevielle BW et al. Epithelia Pathology, oral and maxillofacial pathology. 3rd ed. St. Louis: Saunders/Elsevier; 2009p. p. 388-98, 409-21.

4.       Messadi DV. Diagnostic aids for detection of oral precancerous conditions. Int J Oral Sci. 2013;5(2):59-65. doi: 10.1038/ijos.2013.24, PMID 23743617.

5.       Brocklehurst P, Kujan O, Glenny AM, Oliver R, Sloan P, Ogden G, Shepherd S. Screening programmes for the early detection and prevention of oral cancer. Cochrane Database Syst Rev. 2010;10(11):CD004150. doi: 10.1002/14651858.CD004150.pub3, PMID 21069680.

6.       Garg P, Karjodkar F. ’Catch Them before it Becomes Too Late’-oral cancer detection. Int J Prev Med. 2012;3(10):737-41. PMID 23112903.

7.       Lingen MW, Kalmar JR, Karrison T, Speight PM. Critical evaluation of diagnostic aids for the detection of oral cancer. Oral Oncol. 2008;44(1):10-22. doi: 10.1016/j.oraloncology.2007.06.011, PMID 17825602.

8.       Rana M, Zapf A, Kuehle M, Gellrich NC, Eckardt AM. Clinical evaluation of an autofluorescence diagnostic device for oral cancer detection: a prospective randomized diagnostic study. Eur J Cancer Prev. 2012;21(5):460-66. doi: 10.1097/CEJ.0b013e32834fdb6d, PMID 22217551.

9.       Richards-Kortum R, Sevick-Muraca E. Quantitative optical spectroscopy for tissue diagnosis. Annu Rev Phys Chem. 1996;47(1):555-606. doi: 10.1146/annurev.physchem.47.1.555, PMID 8930102.

10.     Lane PM, Gilhuly T, Whitehead PD, Zeng H, Poh CF, Ng S, Williams PM, Zhang L, Rosin MP, MacAulay CE. Simple device for the direct visualization of oral-cavity tissue fluorescence. J Biomed Opt. 2006;11(2):024006. doi: 10.1117/1.2193157.

11.     Mehrotra R, Singh M, Thomas S, Nair P, Pandya S, Nigam NS, Shukla P. A cross-sectional study evaluating chemiluminescence and autofluorescence in the detection of clinically innocuous precancerous and cancerous oral lesions. J Am Dent Assoc. 2010;141(2):151-6. doi: 10.14219/jada.archive.2010.0132, PMID 20123872.

12.     Koch FP, Kaemmerer PW, Biesterfeld S, Kunkel M, Wagner W. Effectiveness of autofluorescence to identify suspicious oral lesions—a prospective, blinded clinical trial. Clin Oral Investig. 2011;15(6):975-82. doi: 10.1007/s00784-010-0455-1, PMID 20714910.

13.     Farah CS, Mcintosh L, Georgiou A, McCullough MJ. Efficacy of tissue autofluorescence imaging (VELScope) in the visualization of oral mucosal lesions. Head Neck. 2012;34(6):856-62. doi: 10.1002/hed.21834, PMID 21818819.

14.     Scheer M, Neugebauer J, Derman A, Fuss J, Drebber U, Zoeller JE. Autofluorescence imaging of potentially malignant mucosa lesions. Oral Surg Oral Med Oral Pathol Oral Radiol. 2011;111(5):568-77. doi: 10.1016/j.tripleo.2010.12.010, PMID 21429774.

15.     Awan KH, Morgan PR, Warnakulasuriya S. Evaluation of an autofluorescence based imaging system (VELscope™) in the detection of oral potentially malignant disorders and benign keratoses. Oral Oncol. 2011;47(4):274-7. doi: 10.1016/j.oraloncology.2011.02.001, PMID 21396880.

16.     Paderni C, Compilato D, Carinci F, Nardi G, Rodolico V, Lo Muzio L, Spinelli G, Mazzotta M, Campisi G. Direct visualization of oral-cavity tissue fluorescence as novel aid for early oral cancer diagnosis and potentially malignant disorders monitoring. Int J Immunopathol Pharmacol. 2011;24(2);Suppl:121-8. doi: 10.1177/03946320110240S221, PMID 21781457.

17.     Babiuch K, Chomyszyn-Gajewska M, Wyszy?ska-Pawelec G. The use of VELscope® for detection of oral potentially malignant disorders and cancers – a pilot study. J Biol Sci;26(4). doi: 10.2478/v10251-012-0069-8.

18.     Marzouki HZ, Tuong Vi Vu T, Ywakim R, Chauvin P, Hanley J, Kost KM. Use of fluorescent light in detecting malignant and premalignant lesions in the oral cavity: a prospective, single-blind study. J Otolaryngol Head Neck Surg. 2012;41(3):164-8. PMID 22762697.

19.     Hanken H, Kraatz J, Smeets R, Heiland M, Assaf AT, Blessmann M, Eichhorn W, Clauditz TS, Gröbe A, Kolk A, Rana M. The detection of oral pre- malignant lesions with an autofluorescence based imaging system (VELscope™) - a single blinded clinical evaluation. Head Face Med. 2013;9:23. doi: 10.1186/1746-160X-9-23, PMID 23967796.

20.     Bhatia N, Matias MA, Farah CS. Assessment of a decision making protocol to improve the efficacy of VELscope™ in general dental practice: a prospective evaluation. Oral Oncol. 2014;50(10):1012-9. doi: 10.1016/j.oraloncology.2014.07.002, PMID 25096826.

21.     Sawan D, Mashlah A. Evaluation of premalignant and malignant lesions by fluorescent light (VELscope). J Int Soc Prev Commun Dent. 2015;5(3):248-54. doi: 10.4103/2231-0762.159967, PMID 26236687.

22.     Huang TT, Huang JS, Wang YY, Chen KC, Wong TY, Chen YC, Wu CW, Chan LP, Lin YC, Kao YH, Nioka S, Yuan SF, Chung PC. Novel quantitative analysis of autofluorescence images for oral cancer screening. Oral Oncol. 2017;68:20-6. doi: 10.1016/j.oraloncology.2017.03.003, PMID 28438288.

23.     Shah S, Waknis P, Saha A, Setiya S, Ratra T, Vaswani V. The use of Velscope to assess cellular changes occuring in oral premalignancy. J Oral Biol Craniofac Res. 2020 Mar 14;10(2):99-103. doi: 10.1016/j.jobcr.2020.03.004, PMID 32211285.