New imaging device to aid early oral cancer diagnosis

Dr Richard Cook demonstrates the Microvascular Scope on colleague Dr Neveen Hosny

A new clinical imaging instrument to aid early mouth cancer diagnosis has been developed by a research group at King’s College London’s Dental Institute.

Oral or mouth cancer is where a lesion develops in the lining surface of the tongue, mouth, lips and gums. Diagnosis is difficult, as many other safer conditions can resemble the early stages of the disease, and several can transform into cancers at random points.

The traditional stereotype of an oral cancer patient as a hard drinking and smoking individual is also now evolving towards younger non-smokers and drinkers. Such patients are even harder to spot as their lesions are developing without the traditional risk factors being present, and can be more aggressive, too.

Biopsy is the current ‘gold standard’ for characterising abnormal tissue from the mouth. However, it is an invasive and painful procedure where suspected cancerous tissue is removed and tested, and in itself is often a deterrent for getting a lesion checked by an oral health practitioner.

Over the last 40 years, despite many technique and approach developments, the five-year survival figures of approximately 50% remain resolutely static. Many authorities feel that late presentation and diagnosis remains a key determinant in final outcome.

Wanting to aid surveillance and early tumour diagnosis, the biophotonics research group hopes the new imaging device will reduce the number of biopsies required in the future. The research group is made up of clinical doctors and laboratory scientists working together in the same labs to address the issues around oral cancer detection.

The cost-effective and non-invasive approach it has developed has already identified the location of invasive cancers as small as 1mm in diameter, allowing curative minimally invasive surgery with fewest residual scars and deformities.

The prototype, named the Microvascular Scope is a simple, portable and functional device that could change the way clinicians view oral cancer detection by allowing the host’s first response to the tumour – new blood vessel growth (angiogenesis) – to be imaged undisturbed and as it occurs, at extremely high resolution.

Dr Richard Cook from the King’s College London’s Dental Institute explains: ‘A device that can help survey suspicious lesions and guide biopsies to more accurately confirm the existence of cancer and its exact location would prove invaluable. Biopsy is an elaborate and time-consuming process and is unpleasant, deterring patients from further treatment. There is often the need for biopsies in multiple locations to ensure all areas of a potentially cancer bearing lesions are correctly assessed. This is often repeated over time to rule out misdiagnosis.’

The biophotonics research group includes Dr Frederic Festy, Dr Richard Cook, Professor Timothy Watson and Dr Neveen Hosny. The group consists of a uniquely diverse group of clinicians, engineers, physicists, and bioengineers; all collaborating to find realistic and functional solutions to health problems.

‘By having input from a mix of clinicians and scientists, we have been able to produce a functional prototype that is ready for commercialisation and clinical use. What is produced in the lab is not always practical for clinical application, but having medical professionals in our research group has ensured what has been created can be realistically translated into clinics and hospitals with minimal additional commercial input,’ explains Dr Festy, a senior lecturer in biophotonics.

Mouth cancer occurs when something goes wrong with the normal cell lifecycle, causing them to grow and reproduce uncontrollably. Smoking, drinking alcohol and infection with the human papilloma virus (HPV), the virus that causes genital warts, can all increase the risk of developing mouth cancer.

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