UTHealth Houston
School of Dentistry
WHEN AND WHAT TO BIOPSY?
New system promises answers at point of care
by Rhonda Whitmeyer
Oral cancer presents with a paradox: It should be among the
easiest cancers to detect, yet patients are often diagnosed late
in the game. Why is that?
Three problems tend to stand in the way, said UTHealth
Houston School of Dentistry Professor and Oral Pathologist
Nadarajah Vigneswaran, BDS, DrMedDent, DMD.
Some clinicians see oral cancer infrequently.
Even when a pathology report is clearly needed, the 4-5 mm
punch biopsy may not land on the malignancy.
When the biopsy is inconclusive, the patient is told to come
back for follow-up examinations every six months to one
year. Will the clinician be able to detect any changes?
At least 60 percent of biopsy-confirmed precancers never
become malignant, Vigneswaran said. “The surgeon is not going
14 HOUSTON DENTISTRY | www.houstondentistrymagazine.com
to cut the tongue unless there really is a cancer, because the
impact on the patient is so terrible. It’s because of that reluc-
tance and not knowing that cancers are diagnosed late.”
He is currently testing new technology developed at Rice Uni-
versity and UT MD Anderson Cancer Center that promises to
help clinicians visually distinguish oral cancer from benign
lesions while providing an objective way to measure clinical and
pathologic changes over time. Although a confirmed biopsy
would still be required, the technology would highlight areas of
likely malignancy and help the clinician decide which tissue to
sample.
The new Multimodal Optical Imaging System is a non-invasive,
point-of-care diagnostic tool that could be used in settings with
limited resources.