This is a continuation-in-part of U.S. patent application Ser. No. 11/811,580 filed Jun. 11, 2007 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 oral tissue.
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 luekoplakia. 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.
Bioflouresence is also used for detection of pre-oral cancer and oral cancer. This technique for pre-oral cancer and oral cancer detection uses a light source that can typically provide energy in the 340 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. It is based upon the use of a metal halide lamp, specialized high voltage power supply, bandpass filter, means to block excess heat and unwanted energy, a fan cooling system, 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 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 400 nm or between 400 nm to 470 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 400 nm and in a second wavelength range of between 400 nm to 470 nm. In the latter case it is preferred to also to include a switching means to activate either the first plurality of interconnected light emitting diodes or the second plurality of interconnected light emitting diodes. In another mode of operation, all LED's from 340 to 400 nm and from 400 to 470 nm may be illuminated simultaneously.
The blocking filter provides a screening area for visually observing the suspected skin tissue and should be of a defined size.
a)-9(d) show alternate light guides which may be used in the light source shown in
a) shows a metal clip for securing the light guide in the light source shown in
b) shows an o-ring for use in combination with the metal clip of
c) shows a plurality of LED's as conventionally fabricated on a die or chip; and
d) show the LED used in the light source of
The optical screening device of the present invention is illustrated in
The arrays 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, complex optics, 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 or line fluctuation in the case of AC power, a voltage regulator circuit 17 may be included in the control circuit 3 for regulating the voltage of the power source.
Device Operation
As shown in
The size of the filter 2 opening is very important. If the opening 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 2 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 2 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 2 should be 1 to 2 inches in diameter.
It should be understood that although the filter 2 is preferably a high pass filter a band pass filter may be employed. Band pass filters are usually made by vacuum depositing many layers of metal oxide materials unto the glass. High and low pass filters are made by incorporating metal oxides into the glass during manufacturing process which is much less expensive. High pass filters used in this device can be made by vacuum deposition as well. Because the LED source provides a very narrow defined spectrum of energy, a high pass filter which is a much lower cost and is less prone to degradation may be used in our invention.
Another embodiment of the invention is shown in
A manually operated switch 26 is mounted in the handle 29 and is electrically connected in a series circuit arrangement with the batteries 20, 21 and 22 and LED 28 for applying a voltage across the LED's of between 2.5 to 5 volts when the switch 26 is placed in the on position. A conventional light guide 25 is removably mounted to the nose cone 24 with one end adjacent to the LED's 28. Any conventional light guide 25 may be used preferably including a glass fused fiber light guide 25 or a tapered glass light guide 25 as shown in U.S. Pat. No. 5,371,826 the description of which is incorporated herein by reference or a clad glass rod or a transparent plastic rod 25.
A voltage regulator circuit 23 of conventional design may also be housed in the handle 29 in circuit with the batteries 20, 21 and 22 and with the manual switch 26 to maintain a constant application of voltage across the LED's so that the light output will be relatively constant even with weak batteries. The switch 26 is manually operated to turn the light source 27 ON and OFF.
One or more LED's 28 operate in the 300 to 470 NM range. Multiple LED's may be used to cover currently available wavelength distributions. For example one set of LED's could operate from 340 to 400 NM while another set of LED's could operate from 400 to 470 NM. As explained earlier one or preferably a plurality of LED's 28 on multiple dies or chips of the same or different wavelengths can be employed.
The light source 27 is intended to be used with an external optical filter which is preferably fitted into or made part of a pair of eyeglasses 31 for the operator of the light source 27 to wear for use in conjunction with the light source 27 when viewing a suspected lesion. The light source 27 operates by turning the switch 26 to the on position and directing the light guide 25 inside an oral cavity such as the mouth of a patient. At the wavelengths described above the patient's healthy tissue will fluoresce, while unhealthy tissue, 30 will remain dark. The eyes 32 of the operator can view the tissue and for better contrast, the operator will wear a pair of eyeglasses 31 with high pass filters built therein. As described earlier, such filters are designed to block the primary beam of energy and allow fluorescent energy that is 40 to 60 NM in higher in wavelength to pass through.
| Number | Date | Country | |
|---|---|---|---|
| Parent | 11811580 | Jun 2007 | US |
| Child | 12151117 | US |