The Effectiveness of VELscope in Monitoring Cellular Alterations in Oral Premalignancies

Authors

  • Mairaj Qasim Dr.Ishrat Ul Ebad Khan Institute of Oral Health Sciences Dow University of Health Sciences Karachi.
  • Anwar Ali Dr.Ishrat Ul Ebad Khan Institute of Oral Health Sciences Dow University of Health Sciences Karachi.
  • Aliya Zaman Muhammad Medical & Dental college Mirpurkhas.
  • Shaharyar Hamid Jinnah Medical & Dental College Karachi.
  • Shahzaman Memon Muhammad Dental College Mirpurkhas.
  • Mehak Irshad Ali Abro Dr.Ishrat Ul Ebad Khan Institute of Oral Health Sciences Dow University of Health Sciences Karachi.
  • Rehmatullah Kandhro Muhammad Dental College Mirpurkhas.

DOI:

https://doi.org/10.36283/ziun-pjmd15-1/010

Keywords:

VELscope, Cellular Alteration, Oral Premalignancies, Oral Precancer, Autofluorescence Imaging

Abstract

Background: Oral cancer represents a significant global health issue, accounting for approximately 3% of all malignancies and causing considerable morbidity and mortality. The cellular alterations can result in the development of premalignant conditions, including leukoplakia, erythroplakia, and oral submucous fibrosis. To obtain autofluorescence data on different histopathologically distinct oral lesions and assessment of direct auto fluorescence examination validity in identifying premalignant and malignant lesions using VELscope.

Methods: A prospective, randomized in-vivo clinical study was conducted at Department of Oral & Maxillofacial Surgery, Dow University of Health Sciences, Karachi, in time duration of four months (i.e. 18-3-2025 to 17-6-2025) on 160 patients (ages 25–65) with clinically visible oral lesions. VELscope examination was performed to identify abnormal fluorescence (loss of green autofluorescence), followed by incisional biopsy and histopathological analysis. Sensitivity, specificity, and correlations with demographic and lesion characteristics were assessed. SPSS v.26 was used for data analysis. A p-value < 0.05 was considered statistically significant.

Results: Abnormal fluorescence was observed in 63.8% (102/160) of cases, strongly correlating with dysplasia/malignancy (p < 0.0001). Leukoplakia was the most common lesion (49.4%), followed by erythroplakia (30.0%) and oral submucous fibrosis (20.6%). No significant associations were found between fluorescence loss and gender (p = 0.610), age (p = 0.565), or lesion type, confirming VELscope’s consistent performance across subgroups.

Conclusion: VELscope effectively enhances early detection of oral premalignancies in high-risk populations, guiding targeted biopsies. While its high sensitivity aids screening, false positives necessitate histopathologic confirmation. Future research should explore longitudinal outcomes and cost-effectiveness in diverse settings to optimize clinical integration.

Author Biographies

  • Mairaj Qasim , Dr.Ishrat Ul Ebad Khan Institute of Oral Health Sciences Dow University of Health Sciences Karachi.

    FCPS-II Trainee

    oral and maxillofacial surgery department

  • Anwar Ali, Dr.Ishrat Ul Ebad Khan Institute of Oral Health Sciences Dow University of Health Sciences Karachi.

    Professor

    oral and maxillofacial surgery department

  • Aliya Zaman, Muhammad Medical & Dental college Mirpurkhas.

    Associate professor

    department of pathology

     

  • Shaharyar Hamid, Jinnah Medical & Dental College Karachi.

    senior registrar

    department of oral medicine

  • Shahzaman Memon, Muhammad Dental College Mirpurkhas.

    associate professor

    department of oral pathology

  • Mehak Irshad Ali Abro, Dr.Ishrat Ul Ebad Khan Institute of Oral Health Sciences Dow University of Health Sciences Karachi.

    Department of Oral Pathology

  • Rehmatullah Kandhro, Muhammad Dental College Mirpurkhas.

    senior lecturer

    community dentistry department

References

1. Kharma MY, Alalwani MS, Amer MF. Promising future in the detection of oral cancer by using advance screening technology. J Oral Health Craniofac Sci. 2016;1:022–33.

2. Messadi DV. Diagnostic aids for detection of oral precancerous conditions. International journal of oral science. 2013;5(2):59–65.

3. Fedele S. Diagnostic aids in the screening of oral cancer. Head Neck Oncol. 2009 Dec;1(1):5.

4. Eriksson AT, Corcuera MM, Trapero JC, Sánchez JC, Martínez AB. Analysis of new diagnostic methods in suspicious lesions of the oral mucosa. Medicina oral, patología oral y cirugía bucal Ed inglesa. 2009;14(5):1.

5. Vigneswaran N, Koh S, Gillenwater A. Incidental detection of an occult oral malignancy with autofluorescence imaging: a case report. Head Neck Oncol. 2009 Dec;1(1):37.

6. Venugopal C, Nazeer SS, Balan A, Jayasree RS. Autofluorescence Spectroscopy Augmented by Multivariate Analysis as a Potential Noninvasive Tool for Early Diagnosis of Oral Cavity Disorders. Photomedicine and Laser Surgery. 2013 Dec;31(12):605–12.

7. Luo X, Xu H, He M, Han Q, Wang H, Sun C, et al. Accuracy of autofluorescence in diagnosing oral squamous cell carcinoma and oral potentially malignant disorders: a comparative study with aero-digestive lesions. Scientific reports. 2016;6(1):29943.

8. Bhatia N, Matias MAT, Farah CS. Assessment of a decision making protocol to improve the efficacy of VELscopeTM in general dental practice: a prospective evaluation. Oral oncology. 2014;50(10):1012–9.

9. Rashid A, Warnakulasuriya S. The use of light‐based (optical) detection systems as adjuncts in the detection of oral cancer and oral potentially malignant disorders: a systematic review. J Oral Pathology Medicine. 2015 May;44(5):307–28.

10. Mello FW, Miguel AFP, Dutra KL, Porporatti AL, Warnakulasuriya S, Guerra ENS, Rivero ERC. Prevalence of oral potentially malignant disorders: A systematic review and meta-analysis. J Oral Pathol Med. 2018 Aug;47(7):633-640. doi: 10.1111/jop.12726.

11. Epstein JB, Güneri P, Boyacioglu H, Abt E. The limitations of the clinical oral examination in detecting dysplastic oral lesions and oral squamous cell carcinoma. Texas dental journal. 2013;130(5):410–24.

12. Cicciù M, Herford AS, Cervino G, Troiano G, Lauritano F, Laino L. Tissue fluorescence imaging (VELscope) for quick non-invasive diagnosis in oral pathology. Journal of Craniofacial Surgery. 2017;28(2):e112–5.

13. Sawan D, Mashlah A. Evaluation of premalignant and malignant lesions by fluorescent light (VELscope). Journal of International Society of Preventive and Community Dentistry. 2015;5(3):248–54.

14. Ganga RS, Gundre D, Bansal S, Shirsat PM, Prasad P, Desai RS. Evaluation of the diagnostic efficacy and spectrum of autofluorescence of benign, dysplastic and malignant lesions of the oral cavity using VELscope. Oral oncology. 2017;75:67–74.

15. Wang C, Qi X, Zhou X, Liu H, Li M. Diagnostic value of objective VELscope fluorescence methods in distinguishing oral cancer from oral potentially malignant disorders (OPMDs). Translational Cancer Research. 2022;11(6):1603.

16. Chaitanya NC, Chavva S, Surekha E, Priyanka V, Akhila M, Ponnuru HK, et al. A meta-analysis on efficacy of auto fluorescence in detecting the early dysplastic changes of oral cavity. South Asian journal of cancer. 2019;8(04):233–6.

17. Amirchaghmaghi M, Mohtasham N, Delavarian Z, Shakeri MT, Hatami M, Mozafari PM. The diagnostic value of the native fluorescence visualization device for early detection of premalignant/malignant lesions of the oral cavity. Photodiagnosis and photodynamic therapy. 2018;21:19–27.

18. Farah CS, Dost F, Do L. Usefulness of optical fluorescence imaging in identification and triaging of oral potentially malignant disorders: a study of VELscope in the LESIONS programme. Journal of Oral Pathology & Medicine. 2019;48(7):581–7.

19. Raghushaker CR, D’Souza M, Urala AS, Ray S, Mahato KK. An overview of conventional and fluorescence spectroscopy tools in oral cancer diagnosis. Lasers in Dental Science. 2020;4(4):167–79.

20. Adil HA, Yuwanati M, Singh A, Sawant S, Umarji HR. Comparative study on the efficacy of tissue autofluorescence (visually enhanced lesion scope) and toluidine blue as a screening method in oral potentially malignant and malignant lesions. Journal of Medical Sciences. 2017;37(3):91–6.

21. Dos Santos LCF, Fernandes JR, Lima IFP, da Silva Bittencourt L, Martins MD, Lamers ML. Applicability of autofluorescence and fluorescent probes in early detection of oral potentially malignant disorders: A systematic review and meta-data analysis. Photodiagnosis and Photodynamic Therapy. 2022;38:102764.

22. Cânjău S, Todea DCM, Sinescu C, Pricop MO, Duma VF. Fluorescence influence on screening decisions for oral malignant lesions. Rom J Morphol Embryol. 2018;59(1):203–9.

23. Yeladandi M, Maheswari TNU, Muthukumaran D, Padala SB, Sujatha MM, Kala T, et al. Efficacy of VELscope in the Early Diagnosis of Dysplasia in Oral Potentially Malignant Disorders: A Prospective Cohort Study. World Journal of Dentistry. 2025;15(11):938–43.

24. Araújo DC, Veloso AA, de Oliveira Filho RS, Giraud MN, Raniero LJ, Ferreira LM, et al. Finding reduced Raman spectroscopy fingerprint of skin samples for melanoma diagnosis through machine learning. Artificial Intelligence in Medicine. 2021;120:102161.

25. Simon SR, Florie M, Pilz W, Winkens B, Winter N, Kremer B, et al. Association between pharyngeal pooling and aspiration using fiberoptic endoscopic evaluation of swallowing in head and neck cancer patients with dysphagia. Dysphagia. 2020;35(1):42–51.

Downloads

Published

2026-01-14

Metrics

How to Cite

1.
Qasim M, Ali A, Zaman A, Hamid S, Memon S, Ali Abro MI, et al. The Effectiveness of VELscope in Monitoring Cellular Alterations in Oral Premalignancies. PJMD [Internet]. 2026 Jan. 14 [cited 2026 Jun. 14];15(1). Available from: https://ojs.zu.edu.pk/pjmd/article/view/4418

Similar Articles

11-20 of 236

You may also start an advanced similarity search for this article.