Konfokale Laser-Endomikroskopie des Kopf-Hals-Plattenepithelkarzinoms: eine systematische Übersicht

Sievert, Matti; Auberville, Marc; Oetter, Nicolai; Stelzle, Florian; Maier, Andreas; Mantsopoulos, Konstantinos; Iro, Heinrich; Goncalves, Miguel

doi:10.1055/a-1339-1635

Cited by 7 publications

(1 citation statement)

References 40 publications

(79 reference statements)

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“…Concerning the 13 patients of this pilot trial, this resulted in a sensitivity, specificity, and accuracy for tumor detection or exclusion of 87.5, 80.0, and 84.6%, respectively. This is in the range reported for other CLE systems: According to data of other studies, the sensitivity and specificity of diagnosing head and neck squamous cell cancer is reported to 85.0-95.3% and 72.0-100%, respectively (19,20). Next step, a prospective trial with intraoperative in-vivo CLE classification compared to frozen section and final histopathology is needed.…”

Section: Discussionmentioning

confidence: 74%

Fluorescein-Guided Panendoscopy for Head and Neck Cancer Using Handheld Probe-Based Confocal Laser Endomicroscopy: A Pilot Study

et al. 2021

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BackgroundWhite-light endoscopy and microscopy combined with histological analysis is currently the mainstay for intraprocedural tissue diagnosis during panendoscopy for head and neck cancer. However, taking biopsies leads to selection bias, ex vivo histopathology is time-consuming, and the advantages of in-vivo intraoperative decision making cannot be used. Confocal laser endomicroscopy (CLE) has the potential for a rapid and histological assessment in the head and neck operating room.MethodsBetween July 2019 and January 2020, 13 patients (69% male, median age: 61 years) with newly diagnosed head and neck cancer (T3/T4: 46%) underwent fluorescein-guided panendoscopy. CLE was performed from both the tumor and margins followed by biopsies from the CLE spots. The biopsies were processed for histopathology. The CLE images were ex vivo classified blinded with a CLE cancer score (DOC score). The classification was compared to the histopathological results.ResultsMedian additional time for CLE during surgery was 9 min. A total of 2,565 CLE images were taken (median CLE images: 178 per patient; 68 per biopsy; evaluable 87.5%). The concordance between histopathology and CLE images varied between the patients from 82.5 to 98.6%. The sensitivity, specificity, and accuracy to detect cancer using the classified CLE images was 87.5, 80.0, and 84.6%, respectively. The positive and negative predictive values were 87.0 and 80.0%, respectively.ConclusionCLE with a rigid handheld probe is easy and intuitive to handle during panendoscopy. As next step, the high accuracy of ex vivo CLE image classification for tumor tissue suggests the validation of CLE in vivo. This will evolve CLE as a complementary tool for in vivo intraoperative diagnosis during panendoscopy.

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Section: Discussionmentioning

confidence: 74%

Fluorescein-Guided Panendoscopy for Head and Neck Cancer Using Handheld Probe-Based Confocal Laser Endomicroscopy: A Pilot Study

et al. 2021

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Feasibility of Optical Biopsy During Endoscopic Sinus Surgery With Confocal Laser Endomicroscopy: A Pilot Study

Frenken,

Sievert,

Panuganti

et al. 2024

The Laryngoscope

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ObjectiveConfocal laser endomicroscopy (CLE) is an optical imaging technique that allows in vivo, real‐time, microscope‐like assessment of superficial lesions. Although there is substantial data on CLE use in the upper GI tract, there is limited information regarding its application in the nasal cavity and paranasal sinuses. This study aims to assess the feasibility and diagnostic metrics of CLE in the nasal cavity and paranasal sinuses regarding differentiation between healthy/benign and malignant tissue. These structures show, however, a wider variety of frequent and concomitant benign and malignant pathologies, which could pose an increased challenge for optical biopsy by CLE.MethodsWe performed CLE on a case series of six patients with various findings in the nose (three chronic rhinosinusitis, adenocarcinoma, meningoenzephalozele, esthesionneuroblastoma). Forty‐two sequences (3792 images) from various structures in the nasal cavity and/or paranasal sinuses were acquired. Biopsies were taken at corresponding locations and analyzed in hematoxylin and eosin staining as a standard of reference. Three independent examiners blinded to the histopathology assessed the sequences.ResultsHealthy and inflamed mucosa could be distinguished from malignant lesions with an accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of 84.1%, 85.4%, 83.1%, 72.5%, and 92.1%, respectively, with a substantial agreement between raters (Fleiss κ = 0.62).ConclusionThis technique shows, despite its limitations, potential as an adjunctive imaging technique during sinus surgery; however, the creation of a scoring system based on reproducible and defined characteristics in a larger more diverse population should be the focus of further research to improve its diagnostic value and clinical utility.Level of EvidenceNA Laryngoscope, 2024

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Few Shot Learning for the Classification of Confocal Laser Endomicroscopy Images of Head and Neck Tumors

Aubreville,

Pan,

Sievert

et al. 2024

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Konfokale Laser-Endomikroskopie des Kopf-Hals-Plattenepithelkarzinoms: eine systematische Übersicht

Cited by 7 publications

References 40 publications

Fluorescein-Guided Panendoscopy for Head and Neck Cancer Using Handheld Probe-Based Confocal Laser Endomicroscopy: A Pilot Study

Fluorescein-Guided Panendoscopy for Head and Neck Cancer Using Handheld Probe-Based Confocal Laser Endomicroscopy: A Pilot Study

Feasibility of Optical Biopsy During Endoscopic Sinus Surgery With Confocal Laser Endomicroscopy: A Pilot Study

Few Shot Learning for the Classification of Confocal Laser Endomicroscopy Images of Head and Neck Tumors

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