OBJECTIVE: Although approved by the US Food and Drug Administration for clinical use, the utility of handheld tissue reflectance and autofluorescence devices for screening head and neck cancer patients is poorly defined. There is limited published evidence regarding the efficacy of these devices. The authors investigated the sensitivity and specificity of these modalities compared with standard examination. STUDY DESIGN: Prospective, cross-sectional analysis. SETTING: Tertiary care medical center. SUBJECTS AND METHODS: Patients who were treated previously for head and neck cancer (n = 88) between 2009 and 2010 were included. Patients were screened using white light visualization (standard of care) and compared with tissue reflectance and autofluorescence visualization. Screening results were compared with biopsy or long-term follow-up. RESULTS: Autofluorescence visualization had a specificity of 81% and a sensitivity of 50% for detecting oral cavity cancer, whereas white light visualization had a specificity of 98% and a sensitivity of 50%. Tissue reflectance visualization had low sensitivity (0%) and good specificity (86%). The power of this study was insufficient to compare the positive and negative predictive values of standard white light examination (50% and 98%, respectively) to tissue autofluorescence (11% and 97%) or reflectance (0% and 95%). In addition, stratification by previous radiation therapy found no statistically significant difference in screening results. CONCLUSION: Standard clinical lighting has a higher specificity than tissue reflectance and autofluorescence visualization for detection of disease in patients with a history of head and neck cancer. This study does not support the added costs associated with these devices.
OBJECTIVE: Although approved by the US Food and Drug Administration for clinical use, the utility of handheld tissue reflectance and autofluorescence devices for screening head and neck cancerpatients is poorly defined. There is limited published evidence regarding the efficacy of these devices. The authors investigated the sensitivity and specificity of these modalities compared with standard examination. STUDY DESIGN: Prospective, cross-sectional analysis. SETTING: Tertiary care medical center. SUBJECTS AND METHODS: Patients who were treated previously for head and neck cancer (n = 88) between 2009 and 2010 were included. Patients were screened using white light visualization (standard of care) and compared with tissue reflectance and autofluorescence visualization. Screening results were compared with biopsy or long-term follow-up. RESULTS: Autofluorescence visualization had a specificity of 81% and a sensitivity of 50% for detecting oral cavity cancer, whereas white light visualization had a specificity of 98% and a sensitivity of 50%. Tissue reflectance visualization had low sensitivity (0%) and good specificity (86%). The power of this study was insufficient to compare the positive and negative predictive values of standard white light examination (50% and 98%, respectively) to tissue autofluorescence (11% and 97%) or reflectance (0% and 95%). In addition, stratification by previous radiation therapy found no statistically significant difference in screening results. CONCLUSION: Standard clinical lighting has a higher specificity than tissue reflectance and autofluorescence visualization for detection of disease in patients with a history of head and neck cancer. This study does not support the added costs associated with these devices.
Authors: Michael P Rethman; William Carpenter; Ezra E W Cohen; Joel Epstein; Caswell A Evans; Catherine M Flaitz; Frank J Graham; Philippe P Hujoel; John R Kalmar; Wayne M Koch; Paul M Lambert; Mark W Lingen; Bert W Oettmeier; Lauren L Patton; David Perkins; Britt C Reid; James J Sciubba; Scott L Tomar; Alfred D Wyatt; Krishna Aravamudhan; Julie Frantsve-Hawley; Jennifer L Cleveland; Daniel M Meyer Journal: J Am Dent Assoc Date: 2010-05 Impact factor: 3.634
Authors: Catherine F Poh; Samson P Ng; P Michele Williams; Lewei Zhang; Denise M Laronde; Pierre Lane; Calum Macaulay; Miriam P Rosin Journal: Head Neck Date: 2007-01 Impact factor: 3.147
Authors: Ina Pavlova; Michelle Williams; Adel El-Naggar; Rebecca Richards-Kortum; Ann Gillenwater Journal: Clin Cancer Res Date: 2008-04-15 Impact factor: 12.531
Authors: K E Tipirneni; E L Rosenthal; L S Moore; A D Haskins; N Udayakumar; A H Jani; W R Carroll; A B Morlandt; M Bogyo; J Rao; Jason M Warram Journal: Mol Imaging Biol Date: 2017-10 Impact factor: 3.488
Authors: Tanya Walsh; Saman Warnakulasuriya; Mark W Lingen; Alexander R Kerr; Graham R Ogden; Anne-Marie Glenny; Richard Macey Journal: Cochrane Database Syst Rev Date: 2021-12-10
Authors: Denise M Laronde; P M Williams; T G Hislop; Catherine Poh; Samson Ng; Chris Bajdik; Lewei Zhang; Calum MacAulay; Miriam P Rosin Journal: J Oral Pathol Med Date: 2013-06-10 Impact factor: 4.253
Authors: Tanya Walsh; Joseph L Y Liu; Paul Brocklehurst; Anne-Marie Glenny; Mark Lingen; Alexander R Kerr; Graham Ogden; Saman Warnakulasuriya; Crispian Scully Journal: Cochrane Database Syst Rev Date: 2013-11-21