Fluorescence patterns and longitudinal changes of oral potentially malignant disorders (OPMDs) lesions using biofluorescence imaging: case reports.

OBJECTIVE

This study aimed to observe the biofluorescence patterns of oral potentially malignant disorders (OPMDs) lesions using Qraycam Pro, a device equipped with quantitative light-induced fluorescence (QLF) technology based on biofluorescence detection, and to serially observe longitudinal changes in lesion margins and areas of fluorescence patterns compared with white-light images (WLI).

METHOD: White-light images (WLI) and fluorescent-light images (FLI) were acquired under identical conditions at each of the three visits in two patients with OPMD. Each case was histopathologically diagnosed as epithelial dysplasia, moderate to severe, hyperkeratosis and acanthosis. WLI and FLI were compared, focusing on lesion areas showing clinically abnormal findings, and longitudinal changes in fluorescence loss and red fluorescence areas were qualitatively observed.

RESULT: In both cases, clinical changes in lesions were observed over time on WLI, and FLI obtained at the same time points showed areas of fluorescence in the lesion areas that were distinguishable from the surrounding normal mucosa. Different fluorescence findings were observed depending on the lesion. In Case 1, areas of fluorescence loss with reduced fluorescence relative to the surrounding normal mucosa were identified, whereas in Case 2, areas of red fluorescence were observed within the lesion. In particular, in some areas, the lesion margins were visualized more clearly by fluorescence loss or red fluorescence than the clinical margins observed in the WLI. Changes in the fluorescence patterns were also observed over time.

CONCLUSION

These cases suggest that biofluorescence imaging based on QLF technology may be helpful in adjunctively repeated assessment of changes in OPMD lesions during non-invasive longitudinal monitoring and may have the potential to be used in future clinical decision-making processes, such as determining lesion margins.