Narrow-Band Imaging in oncologic otorhinolaryngology: State of the art

Chabrillac, Emilien; Dupret‐Bories, Agnès; Vairel, B.; Woisard, Virginie; Bonnecaze, Guillaume de; Vergez, S.

doi:10.1016/j.anorl.2021.03.004

Cited by 12 publications

(4 citation statements)

References 49 publications

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“…Even though a vast number of publications have confirmed noninvasive biological endoscopy, such as narrow-band imaging (NBI) and Storz SPIES [ 30 , 35 , 36 , 37 ], to have great accuracy when predicting the final histopathology results for glottic lesions, a gold-standard policy for the management and follow-up of precancerous laryngeal lesions has not yet been defined [ 38 ]. The NBI technique, for instance, has always, with few exceptions, been assessed alongside VLE [ 39 ].…”

Section: Discussionmentioning

confidence: 99%

Videolaryngoendoscopic and Stroboscopic Evaluation in Predicting the Malignancy Risk of Vocal Fold Leukoplakia

Leduchowska

Morawska

Pietruszewska

2022

JCM

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Background: Vocal fold leukoplakia (VFL), despite our knowledge of its etiopathogenetic factors, and the development of laryngeal visualization, remains a diagnostic and therapeutic challenge. Objective: This research aimed to explore the efficacy of clinical and morphological feature identification in videolaryngoendoscopy (VLE) using a three-tier classification, and videolaryngostroboscopy (VLS) in predicting the risk of VFL malignant transformation. Material and Methods: We examined 98 patients with VFL by flexible endoscopy under VLE and VLS. Morphological characteristics of 123 lesions including the surface, margin, and texture were assessed; then, VFL was subdivided into three types: I—flat and smooth, II—elevated and smooth, and III—rough. Based on the histopathological findings, 76 (61.79%) lesions were classified as low- and 47 (38.21%) lesions as high-grade dysplasia. Results: The inter-rater agreement between two raters evaluating the VFL in VLE was almost perfect (Cohen’s kappa = 0.826; p < 0.00; 95% CI 0.748–0.904). In ROC curve analysis, the AUC difference between Rater I and Rater II was 0.024 (0.726 vs. 0.702). In multivariate analysis, high-risk VFL was positively related to unilateral plaque localization (p = 0.003), the type III VLE classification (p = 0.013), absence of a mucosal wave (p = 0.034), and a positive history of alcohol consumption (p = 0.047). In ROC analysis, VLE had an AUC of 0.726, with a high sensitivity of 95.7% and low specificity of 40.8%. The NPV was high, at 93.9%; however, the PPV was low, at 50%. The proposed logistic regression model including features significant in multivariate analysis showed lower sensitivity (80.9% vs. 95.7%) and lower NPV (86.2% vs. 93.9%); however, the specificity and PPV were improved (73.7% vs. 40.8% and 65.5% vs. 50.0%, respectively). Conclusions: The combination of clinical history with endoscopic (plaque morphology) and stroboscopic examination (mucosal wave assessment) can fairly estimate the degree of dysplasia in VFL and thus is recommended for use in clinical settings. The findings of this study can be used to guide the decision regarding immediate biopsy or watchful waiting.

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Section: Discussionmentioning

confidence: 99%

Videolaryngoendoscopic and Stroboscopic Evaluation in Predicting the Malignancy Risk of Vocal Fold Leukoplakia

Leduchowska

Morawska

Pietruszewska

2022

JCM

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“…Another systematic review (search date September 2020) reported that also in oral and oropharyngeal cancer surgery the use of NBI was associated with significantly less positive superficial margins than in a historical control group. However, the resection extent was sometimes mistakenly increased due to nonoptimal specificity and further studies are needed to determine the subsequent functional impact [16 ▪ ].…”

Section: Image-guided Surgerymentioning

confidence: 99%

Image-guided surgery in oral cancer: toward improved margin control

Noorlag

Bree

Witjes

2022

Current Opinion in Oncology

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Purpose of reviewThe aim of this review is to discuss recent studies on the assessment of tumor extension and resection margins by different intraoperative techniques allowing for image-guided surgery of oral cancer. Recent findingsThere are different in-vivo and ex-vivo intraoperative techniques to improve margin control of which intraoperative ultrasound and targeted fluorescence-guided resections have high potential clinical value and are closest to clinical implementation.

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“…Non-invasive methods to characterise mucosal changes of the head and neck region, such as narrow-band imaging, confocal laser imaging, optical coherence tomography and fluorescence endoscopy, have been emerging recently 1-4 . One method that has shown a potential advance regarding its broad application outside of experimental studies is confocal laser endomicroscopy (CLE), which has demonstrated its value in the fairly similar oesophageal, gastric and intestinal epithelium in a wide range of clinical applications 5-8 .…”

Section: Introductionmentioning

confidence: 99%

Systematic interpretation of confocal laser endomicroscopy: larynx and pharynx confocal imaging score

Sievert

Mantsopoulos

Mueller

et al. 2022

Acta Otorhinolaryngol Ital

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Objective. Development and validation of a confocal laser endomicroscopy (CLE) classification score for the larynx and pharynx. Methods. Thirteen patients (154 video sequences, 9240 images) with laryngeal or pharyngeal SCC were included in this prospective study between October 2020 and February 2021. Each CLE sequence was correlated with the gold standard of histopathological examination. Based on a dataset of 94 video sequences (5640 images), a scoring system was developed. In the remaining 60 sequences (3600 images), the score was validated by four CLE experts and four head and neck surgeons who were not familiar with CLE. Results. Tissue homogeneity, cell size, borders and clusters, capillary loops and the nucleus/cytoplasm ratio were defined as the scoring criteria. Using this score, the CLE experts obtained an accuracy, sensitivity, and specificity of 90.8%, 95.1%, and 86.4%, respectively, and the CLE non-experts of 86.2%, 86.4%, and 86.1%. Interobserver agreement Fleiss' kappa was 0.8 and 0.6, respectively. Conclusions. CLE can be reliably evaluated based on defined and reproducible imaging features, which demonstrate a high diagnostic value. CLE can be easily integrated into the intraoperative setting and generate real-time, in-vivo microscopic images to demarcate malignant changes.

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Narrow-Band Imaging in oncologic otorhinolaryngology: State of the art

Cited by 12 publications

References 49 publications

Videolaryngoendoscopic and Stroboscopic Evaluation in Predicting the Malignancy Risk of Vocal Fold Leukoplakia

Videolaryngoendoscopic and Stroboscopic Evaluation in Predicting the Malignancy Risk of Vocal Fold Leukoplakia

Image-guided surgery in oral cancer: toward improved margin control

Systematic interpretation of confocal laser endomicroscopy: larynx and pharynx confocal imaging score

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