Diffuse reflectance spectroscopy in the identification of oral potentially malignant disorders

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dc.check.chapterOfThesisNoneen
dc.contributor.advisorNi Riordain, Richeal
dc.contributor.advisorBurke, Ray
dc.contributor.authorFahy, Edwarden
dc.date.accessioned2024-09-19T14:24:27Z
dc.date.available2024-09-19T14:24:27Z
dc.date.issued2024
dc.date.submitted2024
dc.description.abstractAims: Diffuse reflectance spectroscopy (DRS) examines the composition of tissue by analysing light reflected from inside the tissue. DRS has been applied to cancer diagnostics in liver, brain, breast and others. The aims of this study were to (i) to formulate a clinical protocol for use of DRS in diagnosis of oral potentially malignant disorder (OPMD), (ii) to explore the clinical utility for this probe in the mouth and (iii) to review the protocol and assess its potential use in clinical practice. Materials and Methods: A clinical protocol for use of the DRS probe was formulated based on literature review and clinical experience. A translational clinical research study with two groups, one with histologically confirmed OPMD (n=53) and a control group (n=27) were enrolled. All participants received DRS of mucosal surfaces, including areas of OPMD, in the mouth. The readings were then investigated to find reliable biomarkers and their accuracy to differentiate the two groups. Repeatability and reproducibility with two users were examined. Interviews were carried out with oral surgery clinicians after reading the protocol. Results: The protocol produced good results, which were grouped based on the site of acquisition. Our analysis found accuracy figures of 89% and 87% respectively for distinguishing OPMD and normal mucosa in the buccal mucosa and ventral tongue. This OPMD group was made up of mostly oral lichen planus (OLP), with small numbers of other diagnoses. (OLP n=41, oral leukoplakia n=5, others n=5) Accuracy figures for the dorsum of the tongue were poor. DRS was easy to use, quick and acceptable to patients. Repeatability was shown to be good, however reproducibility was fair. This may be due to inter-user pressure differences in the mouth. Clinicians were sceptical of this new technology, in part due to lack of evidence of clinical utility compared with biopsy. Conclusion: DRS has shown a new role in identifying oral lichen planus in the buccal mucosa and ventral tongue. This device may have poor accuracy in identifying oral lichen planus on the dorsal surface of the tongue. It has potential as a replacement for biopsy as a screening tool, however observed difficulties in clinical use preclude widespread implementation. Observed inter-user variability in the mouth has not been thus far explored in the DRS literature. Further studies are needed to confirm this observation.en
dc.description.statusNot peer revieweden
dc.description.versionAccepted Versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.citationFahy, E. 2024. Diffuse reflectance spectroscopy in the identification of oral potentially malignant disorders. DClinDent Thesis, University College Cork.
dc.identifier.endpage212
dc.identifier.urihttps://hdl.handle.net/10468/16410
dc.language.isoenen
dc.publisherUniversity College Corken
dc.rights© 2024, Edward Fahy.
dc.rights.urihttps://creativecommons.org/publicdomain/zero/1.0/
dc.subjectDiffuse reflectance spectroscopy
dc.subjectOral potentially malignant disease
dc.subjectOral potentially malignant disorders
dc.subjectOral squamous cell carcinoma
dc.subjectOral cancer
dc.subjectOptical spectroscopy
dc.subjectSpectroscopy
dc.subjectBiophotonics
dc.subjectDetection
dc.subjectOral medicine
dc.subjectOral surgery
dc.titleDiffuse reflectance spectroscopy in the identification of oral potentially malignant disordersen
dc.typeDoctoral thesisen
dc.type.qualificationlevelPractitioner Doctorateen
dc.type.qualificationnameDClinDent - Doctor of Clinical Dentistryen
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