Non-invasive detection of oral potentially malignant and malignant lesions using an optical multispectral screening device

Oral carcinogenesis is a multistep process that usually arises in the superficial epithelial layer covering the lining of the body cavities. The early changes in the oral mucosa reflect as oral precancers or oral potentially malignant disorders (OPMD). The most common OPMD are erythroplakia and leukoplakia, with their chances of malignant transformation being approximately 90% and 10%, respectively. The development of epithelial precancers is initiated through changes in nuclear shape, size, and density of cells and overall thickening of the epithelial layer. Conventional oral examination (COE) with white light is the most common technique for detection of malignant changes in the oral cavity. This often poses a diagnostic challenge for the clinicians in differentiation of normal and early malignant changes. Thus, biopsy of the site is the accepted clinical procedure for diagnosis of the lesion. A major hurdle here is to identify visually, the most malignant location for a biopsy. As the selection of a site is subjective, the chosen site may not always be representative of the disease and this often leads to repeated biopsies and discomfort to the patients. A novel device known as OralScan was recently introduced by Sascan Meditech, Thiruvananthapuram, for screening and early detection of oral cancers. The clinical application of the device in different clinical scenarios are discussed in this case series report.