{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T16:44:27Z","timestamp":1783356267323,"version":"3.54.6"},"reference-count":79,"publisher":"MDPI AG","issue":"20","license":[{"start":{"date-parts":[[2020,10,12]],"date-time":"2020-10-12T00:00:00Z","timestamp":1602460800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"UM.C\/625\/1\/HIR\/MOHE\/DENT\/06","award":["Ministry of Education (MOE) Malaysia High Impact Research (HIR) Grant"],"award-info":[{"award-number":["Ministry of Education (MOE) Malaysia High Impact Research (HIR) Grant"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Sensors"],"abstract":"<jats:p>Oral mucosal lesions (OML) and oral potentially malignant disorders (OPMDs) have been identified as having the potential to transform into oral squamous cell carcinoma (OSCC). This research focuses on the human-in-the-loop-system named Healthcare Professionals in the Loop (HPIL) to support diagnosis through an advanced machine learning procedure. HPIL is a novel system approach based on the textural pattern of OML and OPMDs (anomalous regions) to differentiate them from standard regions of the oral cavity by using autofluorescence imaging. An innovative method based on pre-processing, e.g., the Deriche\u2013Canny edge detector and circular Hough transform (CHT); a post-processing textural analysis approach using the gray-level co-occurrence matrix (GLCM); and a feature selection algorithm (linear discriminant analysis (LDA)), followed by k-nearest neighbor (KNN) to classify OPMDs and the standard region, is proposed in this paper. The accuracy, sensitivity, and specificity in differentiating between standard and anomalous regions of the oral cavity are 83%, 85%, and 84%, respectively. The performance evaluation was plotted through the receiver operating characteristics of periodontist diagnosis with the HPIL system and without the system. This method of classifying OML and OPMD areas may help the dental specialist to identify anomalous regions for performing their biopsies more efficiently to predict the histological diagnosis of epithelial dysplasia.<\/jats:p>","DOI":"10.3390\/s20205780","type":"journal-article","created":{"date-parts":[[2020,10,14]],"date-time":"2020-10-14T21:24:39Z","timestamp":1602710679000},"page":"5780","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":41,"title":["Healthcare Professional in the Loop (HPIL): Classification of Standard and Oral Cancer-Causing Anomalous Regions of Oral Cavity Using Textural Analysis Technique in Autofluorescence Imaging"],"prefix":"10.3390","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0379-0744","authenticated-orcid":false,"given":"Muhammad","family":"Awais","sequence":"first","affiliation":[{"name":"Center for Intelligent Medical Electronics, Department of Electronic Engineering, School of Information Science and Technology, Fudan University, Shanghai 200433, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hemant","family":"Ghayvat","sequence":"additional","affiliation":[{"name":"Innovation Division Technical University of Denmark, 2800 Lyngby, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5436-0138","authenticated-orcid":false,"given":"Anitha","family":"Krishnan Pandarathodiyil","sequence":"additional","affiliation":[{"name":"Oral Diagnostic Sciences, Faculty of Dentistry, SEGi University, Jalan Teknologi, Kota Damansara, Petaling Jaya 47810, Selangor, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wan Maria","family":"Nabillah Ghani","sequence":"additional","affiliation":[{"name":"Oral Cancer Research and Coordinating Centre, Faculty of Dentistry, University of Malaya, Kuala Lumpur 50603, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6496-7139","authenticated-orcid":false,"given":"Anand","family":"Ramanathan","sequence":"additional","affiliation":[{"name":"Oral Cancer Research and Coordinating Centre, Faculty of Dentistry, University of Malaya, Kuala Lumpur 50603, Malaysia"},{"name":"Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, University of Malaya, Kuala Lumpur 50603, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4507-1844","authenticated-orcid":false,"given":"Sharnil","family":"Pandya","sequence":"additional","affiliation":[{"name":"Symbiosis Centre for Applied Artificial Intelligence and CSE Dept, Symbiosis International (Deemed) University, Pune 412115, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas","family":"Walter","sequence":"additional","affiliation":[{"name":"Department of Electrical and Electronic Engineering, Universiti Teknologi PETRONAS, Bandar Seri Iskandar 32610, Perak, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamad Naufal","family":"Saad","sequence":"additional","affiliation":[{"name":"Department of Electrical and Electronic Engineering, Universiti Teknologi PETRONAS, Bandar Seri Iskandar 32610, Perak, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosnah Binti","family":"Zain","sequence":"additional","affiliation":[{"name":"Oral Cancer Research and Coordinating Centre, Faculty of Dentistry, University of Malaya, Kuala Lumpur 50603, Malaysia"},{"name":"MAHSA University, Dean Office, Level 9, Dental Block, Bandar Saujana Putra, Jenjarom 42610, Selangor, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ibrahima","family":"Faye","sequence":"additional","affiliation":[{"name":"Department of Fundamental and Applied Sciences, Universiti Teknologi PETRONAS, Bandar Seri Iskandar 32610, Perak, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,10,12]]},"reference":[{"key":"ref_1","unstructured":"(2020, October 11). 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