This invention relates to an optical screening device for detecting abnormal skin tissue in a mammal and particularly in the mouth indicative of disease such as cancer or a pre-cancerous skin lesion.
Oral cancer affects over 30,000 people today in the U.S. alone. The treatment for this disease is most effective when diagnosed early. When diagnosed late the treatment is unpleasant, disfiguring and often not effective. Advanced oral cancer is treated with surgery, chemo and radiation much the same as other aggressive cancers.
The early signs of oral cancer are not always discernable upon visual examination. In an attempt to improve the visualization other modalities have been developed to assist in screening for cancer and pre-cancerous lesions. Some of these procedures involve the use of toluidine blue rinse, acetic acid rinse and biofluorescence.
As in all cancers, a biopsy is used to make a positive diagnosis; however the process of taking a biopsy tissue sample is time consuming, costly and painful. It also requires special training and as consequence, most general dentists elect to send patients to an oral surgeon or oral pathologist for a biopsy procedure.
It would be highly desirable, therefore, to have a screening device that is easy to use, low in cost and effective. Such a device is useful even if a biopsy is still necessary provided it could eliminate false positives, permit the unnecessary taking of a biopsy or be indicative of when a biopsy for lesions is likely to be cancer or pre-cancer. Such a device would also save time, money and lives.
In the past, chemoluminesence together with an acetic rinse have been used to detect acetowhite lesion or luekelakia. This technique has been used in the screening for cervical cancer as well as oral cancer. However, it does not work for all lesions and does not delineate the border between healthy and pre-cancerous or dysplastic or cancerous tissue.
It is also known to use bioflouresence for detection of pre-oral and oral cancer. This technique for pre-oral and oral cancer detection uses a light source that can typically provide energy in the 300 NM to 470 NM range. It is known to those skilled in the art that within this wavelength distribution, oral tissue will fluoresce, while diseased tissue that exhibits varying degrees of dysplasia (pre cancer) will not fluoresce. It is also known that fluorescence normally takes place at a wavelength 40-60 NM higher than the excitation source or energy. In order to enhance the contrast between healthy and diseased tissue, a filter can be employed to block the excitation source and pass the fluorescent energy.
A device designed to use the technique of bioflouresence for oral cancer screening is currently manufactured by LED Electronics, Vancouver Canada. This device is described in detail in patent application Ser. No. 11/016,567, publication number US 2005/0234526 A1, by Gilhuly and Whitehead and uses a metal halide light source with a fiber optic or liquid light guide together with associated optics and filters. The device described in the Gilhuly patent application has many drawbacks based upon its use of a metal halide lamp, specialized power supply, bandpass filter, means to block excess heat and unwanted energy, fiber optic light guide and specialized means to view the tissue. A metal halide lamp produces a broad range or energy spectrum from below 300 NM to visible light and infra-red energy well above 800 NM. Accordingly, various blocking filters are required to provide useful excitation energy in the required spectrum. Moreover, since a metal halide light source provides most of its energy outside the useful wavelength spectrum for this procedure, this device is complex, unnecessarily large, bulky and extremely expensive.
The optical screening device of this invention employs an array of light emitting diodes and a single blocking filter to cause suspected skin tissue to fluoresce enabling the discrimination between cancer, pre-cancerous and normal tissue. The array of light emitting diodes may consist of only one interconnected array of light emitting diodes to emit light in a wavelength range of between 340 nm to 370 nm or between 420 nm to 450 nm or may include a first and second array of interconnected light emitting diodes to emit light in a first wavelength range of between 340 nm to 370 nm and in a second wavelength range of between 420 nm to 450 nm. In the latter case it is preferred to also include switching means to activate either the first plurality of interconnected light emitting diodes or the second plurality of interconnected light emitting diodes. The blocking filter provides a screening area for visually observing the suspected skin tissue and should be of a defined size.
The optical screening device of the present invention is illustrated in
The array of LED's 1 are interconnected to one another to emit light in a wavelength range of between 340 NM to 470 NM when connected to a power source. The array of LED's 1 may be arranged to form any desired geometry but should preferably surround the filter 2 so that the area circumscribing the filter defines a fixed viewable window area for the screening device 8. The array of LED's 1 produce energy in a desired wavelength to provide a bioflourescent effect without the need for special power supplies, bandpass filters, heat blocking filters or light guides as in the prior art device.
The power source for the array of LED's 1 can be a conventional power source such as a battery or plural batteries 4 and 5 as shown in
In order to maintain constant light over a wide range of battery voltage, a voltage regulator circuit 17 may be included in the control circuit 3 for regulating the voltage of the power source.
As shown in
The size of the filter 2 opening is very important. If the opening 17 is too large then the irradiation of light from the circular array of LED's will land far outside the oral cavity. If the opening 17 is too small it will limit the viewable area of a suspected lesion and increase the time it will take to perform the oral examination. If the opening 17 is very small, the procedure becomes difficult and impractical, since the lesion itself might be larger than the viewable opening. For these reasons a device for oral examination should have a minimum opening diameter of ½ inch and a maximum diameter of 2½ inches. Preferably the opening 17 should be 1 to 2 inches in diameter.