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Development of a widefield reflectance and fluorescence imaging device for the detection of skin and oral cancer

Oral and skin cancers constitute a major global health problem that cause great impact in patients. The most common screening method for oral cancer is visual inspection and palpation of the mouth. Visual examination relies heavily on the experience and skills of the physician to identify and delineate early premalignant and cancer changes, which is not simple due to the similar characteristics of early stage cancers and benign lesions. Optical imaging has the potential to address these clinical challenges. Contrast between normal and neoplastic areas may be increased, distinct to the conventional white light, when using illumination and detection conditions. Reflectance imaging can detect local changes in tissue scattering and absorption and fluorescence imaging can probe changes in the biochemical composition. These changes have shown to be indicatives of malignant progression. Widefield optical imaging systems are interesting because they may enhance the screening ability in large regions allowing the discrimination and the delineation of neoplastic and potentially of occult lesions. Digital image processing allows the combination of autofluorescence and reflectance images in order to objectively identify and delineate the peripheral extent of neoplastic lesions in the skin and oral cavity. Combining information from different imaging modalities has the potential of increasing diagnostic performance, due to distinct provided information. A simple widefiled imaging device based on fluorescence and reflectance modes together with a digital image processing was assembled and its performance tested in an animal study.