Comparing the efficacy of VELscope with vital stains in the diagnosis of (common) oral potentially malignant disorders an observational study.

OBJECTIVE

Oral potentially malignant disorders (OPMDs) are a diverse group of oral mucosal lesions that carry an increased risk of malignant transformation. Although biopsy is the gold standard for the diagnosis of these lesions, early detection is crucial, emphasizing the need to introduce more reliable non-invasive screening modalities. The aim of the study was to compare the efficacy of VELscope and vital tissue staining techniques as screening tools in the detection of early dysplastic changes in OPMDS, such as oral leukoplakia (OL), oral lichen planus (OLP) & oral submucous fibrosis (OSMF) with histopathological confirmation.

STUDY

DESIGN

Thirty patients clinically diagnosed as OL, OLP and OSMF were included in the study. All patients were subjected to VELscope examination, followed by vital tissue staining procedures. Lesions that were noted as positive by these techniques were evaluated and a biopsy site was selected and performed. Histopathological findings were recorded as either the presence or absence of dysplasia.

RESULTS

Among 30 participants, histopathology revealed dysplasia in 83.3 % of cases. For OL, VELscope showed the highest diagnostic utility (AUC = 0.458), though with limited sensitivity and specificity. In OLP, toluidine blue (AUC = 0.524) was closest to histopathology because of its high positive predictive value. In OSMF, VELscope demonstrated 100 % sensitivity in comparison to other tests, but its low specificity & negative predictive value limited its reliability. Overall, none of the diagnostic adjuvants were independently reliable compared with histopathology.

CONCLUSION

VELscope showed comparatively better utility for oral leukoplakia and OSMF, while toluidine blue performed slightly better in oral lichen planus due to its positive predictive values. None of these diagnostic tools can be used as a standalone diagnostic method due to their specificity & negative predictive values. They may be used as supportive aids in guiding biopsy site selection, but histopathology remains the gold standard for definitive diagnosis.