High specificity of combined narrow band imaging and autofluorescence mucosal assessment of patients with head and neck cancer (original) (raw)
Autofluorescence improves pretreatment mucosal assessment in head and neck cancer patients
Otolaryngology - Head and Neck Surgery, 2010
Objective: Panendoscopy is used in selected patients with head and neck cancer to detect second primary disease. We hypothesized that adding autofluorescence to the bronchoscopy and laryngoscopy part of this procedure could add to the detection of clinically meaningful dysplasias and carcinomas in both the head and neck and bronchus, with resultant change in management. Study Design: Prospective observational study on consecutive patients with head and neck cancer who had panendoscopy prior to surgery. Setting: Teaching hospital, tertiary referral center. Subjects and Methods: All patients had white-light inspection observed by ENT surgeons, followed by autofluorescence inspection of the head and neck tumor and surrounding area as well as the bronchus. Extra biopsies were taken from regions of abnormal fluorescence where there was no white-light abnormality. Results: Sixty-six patients were studied; mean age 64.9 ± 11 years. As a result of autofluorescence, 33 mucosal biopsies were ...
Autofluorescence imaging of potentially malignant mucosa lesions
Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology, 2011
Oral potentially malignant disorders Sensitivity and specificity VELscope Early detection s u m m a r y Early detection of oral cancer is crucial in improving survival rate. Identification and detection of oral potentially malignant disorders (OPMD) allow delivery of interventions to reduce the evolution of these disorders to malignancy. A variety of new and emerging diagnostic aids and adjunctive techniques are currently available to potentially assist in the detection of OPMD. The objective of the present study was to evaluate the accuracy of autofluorescence against conventional oral examination and surgical biopsy.
The Journal of Contemporary Dental Practice, 2015
Background Oral cancer is a serious global issue and early diagnosis of oral cancer is the key in reducing the high mortality rate. Autofluorescence properties of oral mucosa have been gaining interest in the field of early diagnosis of oral premalignant lesions. Objective The aim of the study was to evaluate the clinical usefulness of an autofluorescence based imaging system to detect oral premalignant and malignant lesions. Materials and methods A systematic review of the Englishlanguage literature to evaluate the effectiveness of visually enhanced lesion scope (VELscope) published between 1966 and March, 2014 was undertaken. Data relating to study design, sampling and characteristics of the study group, interventions, and reported outcomes and diagnostic value of VELscope were abstracted from articles meeting inclusion and exclusion criteria. Results Eleven articles that met the inclusion criteria were included. In nine studies, all the lesions underwent histological assessment, ...
Autofluorescence-Guided Surveillance for Oral Cancer
Cancer Prevention Research, 2009
Early detection of oral premalignant lesions (OPL) and oral cancers (OC) is critical for improved survival. We evaluated if the addition of autofluorescence visualization (AFV) to conventional white-light examination (WLE) improved the ability to detect OPLs/OCs. Sixty high-risk patients, with suspicious oral lesions or recently diagnosed untreated OPLs/OCs, underwent sequential surveillance with WLE and AFV. Biopsies were obtained from all suspicious areas identified on both examinations (n = 189) and one normal-looking control area per person (n = 60). Sensitivity, specificity, and predictive values were calculated for WLE, AFV, and WLE + AFV. Estimates were calculated separately for lesions classified by histopathologic grades as low-grade lesions, high-grade lesions (HGL), and OCs. Sequential surveillance with WLE + AFV provided a greater sensitivity than WLE in detecting low-grade lesions (75% versus 44%), HGLs (100% versus 71%), and OCs (100% versus 80%). The specificity in detecting OPLs/OCs decreased from 70% with WLE to 38% with WLE + AFV. Thirteen of the 76 additional biopsies (17%) obtained based on AFV findings were HGLs/OCs. Five patients (8%) were diagnosed with a HGL/OC only because of the addition of AFV to WLE. In seven patients, additional HGL/OC foci or wider OC margins were detected on AFV. Additionally, AFV aided in the detection of metachronous HGL/ OC in 6 of 26 patients (23%) with a history of previously treated head and neck cancer. Overall, the addition of AFV to WLE improved the ability to detect HGLs/OCs. In spite of the lower
Oral Oncology, 2014
Objective: Narrow band imaging (NBI) is an endoscopic technique that enhances the mucosal surface texture, and mucosal and submucosal vascular morphology. This paper systematically reviews the available literature regarding the efficacy of NBI for the detection and monitoring of potentially malignant and malignant lesions in the oral cavity and oropharynx. Methods: Databases searched included PubMed, EMBASE, Web of Science and Scopus (to September 2013). Additional articles were found by conducting an author publication search using PubMed and by scanning the reference lists of relevant articles. Only trials that investigated and evaluated the effectiveness of both white light (WL) and NBI for aiding the detection of only oral potentially malignant lesions, oral squamous cell carcinomas and/or oropharyngeal squamous cell carcinomas were considered for this review. Two reviewers (ANV and CSF) independently assessed retrieved articles against the criteria, and included articles underwent data extraction and risk of bias assessment. Results: Two studies, one retrospective and one prospective, met the inclusion criteria. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy for WL ranged between 56-96%, 60-100%, 33-100%, 87-99% and 66-89% respectively, whereas it was 87-96%, 94-98%, 73-96%, 97-98% and 92-97% respectively for NBI. Conclusion: While more research is required to determine the full value of NBI, it has great potential in accurately aiding the detection and assessment of neoplastic lesions, and influencing how these lesions are managed.
The status of in vivo autofluorescence spectroscopy and imaging for oral oncology
Oral oncology, 2005
Autofluorescence spectroscopy and imaging have been studied for the early detection and classification of (pre)malignancies of the oral mucosa. In the present review we will give an overview of the literature on autofluorescence imaging and spectroscopy for various clinical questions. From the studies performed so far we hope to conclude whether autofluorescence spectroscopy and imaging are helpful in the diagnosis of lesions of the oral mucosa, and if this is the case: for which clinical questions they are suitable. A strong emphasis is put on in vivo human studies of the oral mucosa.
Objective Detection and Delineation of Oral Neoplasia Using Autofluorescence Imaging
Cancer Prevention Research, 2009
Although the oral cavity is easily accessible to inspection, patients with oral cancer most often present at a late stage, leading to high morbidity and mortality. Autofluorescence imaging has emerged as a promising technology to aid clinicians in screening for oral neoplasia and as an aid to resection, but current approaches rely on subjective interpretation. We present a new method to objectively delineate neoplastic oral mucosa using autofluorescence imaging. Autofluorescence images were obtained from 56 patients with oral lesions and 11 normal volunteers. From these images, 276 measurements from 159 unique regions of interest (ROI) sites corresponding to normal and confirmed neoplastic areas were identified. Data from ROIs in the first 46 subjects were used to develop a simple classification algorithm based on the ratio of red-to-green fluorescence; performance of this algorithm was then validated using data from the ROIs in the last 21 subjects. This algorithm was applied to pa...
Clinico-pathological correlation of optical fluorescence imaging in oral mucosal lesions
Oral Diseases, 2020
This study aimed to identify clinical and pathological characteristics of oral mucosal lesions that may be predictive of optical autofluorescence imaging patterns. Methods: Clinical data and archival histopathological material were collected from patients who presented with at least one oral mucosal lesion and underwent assessment via conventional oral examination, optical autofluorescence imaging and histopathological analysis. An open source digital pathology image analysis software was used to perform
Acta otorhinolaryngologica Italica : organo ufficiale della Società italiana di otorinolaringologia e chirurgia cervico-facciale, 2008
Head and neck squamous cell carcinoma of the upper aerodigestive tract is well known for its frequently late presentation and diagnosis at an advanced stage. In addition, it is well recognized that it may arise in multiple sites, either synchronously or metachronously. Thus it should be imperative to endoscopically screen the upper aerodigestive tract of patients at risk for head and neck squamous cell carcinoma with a new diagnostic tool, especially due to the fact that early lesions are very difficult to detect even by multiple passes with a standard endoscopy, if they are < or = 1 cm in diameter. Lugol chromoendoscopy, which is mainly used in the oesophagus, is not suitable for the head and neck region due to severe mucosal irritation. Herein, narrow-band imaging is described, a diagnostic tool already proved as a useful screening method in other endoscopic fields, and its application in the early detection of head and neck squamous cell carcinoma is reviewed, as reported by p...
Intra and interobserver agreement of narrow band imaging for the detection of head and neck tumors
European Archives of Oto-Rhino-Laryngology, 2018
Background Narrow band imaging (NBI) in combination with white light endoscopy (WLE) has improved the accuracy for the diagnosis and follow-up of head and neck carcinomas by identifying changes in the vascular patterns of the mucosa. However, NBI evaluation is explorer-dependent and may be influenced by the learning curve. The aim of this study is to assess the intra and interobserver agreement of NBI and WLE at the office, under local anaesthesia, by either experienced or non-experienced observers. Methods Eighty-seven images of head and neck lesions were routinely collected under WLE and NBI. A group of three experienced otolaryngologists and three medical students assessed the images after a brief training. No additional patient information was provided. The same protocol was repeated after three weeks. Intra and interobserver agreement were calculated with the kappa index. Results NBI intraobserver agreement was substantial (κ = 0.62) and better than with WLE alone, which was moderate (κ = 0.57) in both groups. Interobserver agreement was moderate with WLE (κ = 0.58) and substantial with NBI (κ = 0.63). Both groups improved intraobserver and interobserver agreement with the implementation of NBI. Conclusions Intra and interobserver agreement with NBI for the evaluation of head and neck lesions are substantial, and improve the results of WLE alone in both, professionals and trainees.
Oral cancer ranks as the sixth most common cancer in the world, and despite advances in surgical techniques over the past 30 years, has a five year survival rate of only 50%. The poor survival rate is partly attributed to the fact that the majority of patients are diagnosed at advanced stages of the disease. Early detection and intervention is therefore important for improving patient prognosis as invasive and disfiguring treatment that has high morbidity and mortality can be avoided. Ideally, oral potentially malignant disorders (OPMDs) are detected and monitored before they can progress to cancer. However, OPMDs can be difficult to detect using standard operatory lights, as some V Publications during candidature Peer-reviewed Papers Vu AN, Matias MAT, Farah CS. Diagnostic accuracy of Narrow Band Imaging for detecting oral potentially malignant disorders. Oral Dis. (In submission) Vu AN, Farah CS. Efficacy of narrow band imaging for detection and surveillance of potentially malignant and malignant lesions in the oral cavity and oropharynx: A systematic review. Oral
Annals of Surgical Oncology, 2012
Background. The efficacy of ablative surgery for head and neck squamous cell carcinoma (HNSCC) depends critically on obtaining negative margins. Although intraoperative ''frozen section'' analysis of margins is a valuable adjunct, it is expensive, time-consuming, and highly dependent on pathologist expertise. Optical imaging has potential to improve the accuracy of margins by identifying cancerous tissue in real time. Our goal was to determine the accuracy and inter-rater reliability of head and neck cancer specialists using high-resolution microendoscopic (HRME) images to discriminate between cancerous and benign mucosa. Methods. Thirty-eight patients diagnosed with head and neck squamous cell carcinoma (HNSCC) were enrolled in this single-center study. HRME was used to image each specimen after application of proflavine, with concurrent standard histopathologic analysis. Images were evaluated for quality control, and a training set containing representative images of benign and neoplastic tissue was assembled. After viewing training images, seven head and neck cancer specialists with no previous HRME experience reviewed 36 test images and were asked to classify each.
Oral Oncology, 2011
Oral potentially malignant disorders Sensitivity and specificity VELscope Early detection s u m m a r y Early detection of oral cancer is crucial in improving survival rate. Identification and detection of oral potentially malignant disorders (OPMD) allow delivery of interventions to reduce the evolution of these disorders to malignancy. A variety of new and emerging diagnostic aids and adjunctive techniques are currently available to potentially assist in the detection of OPMD. The objective of the present study was to evaluate the accuracy of autofluorescence against conventional oral examination and surgical biopsy.
Molecular Imaging and Biology, 2021
Purpose Intra-operative management of the surgical margin in patients diagnosed with head and neck squamous cell carcinoma (HNSCC) remains challenging as surgeons still have to rely on visual and tactile information. Fluorescence-guided surgery using tumor-specific imaging agents can assist in clinical decision-making. However, a standardized imaging methodology is lacking. In this study, we determined whether a standardized, specimen-driven, fluorescence imaging framework using ONM-100 could assist in clinical decision-making during surgery. Procedures Thirteen patients with histologically proven HNSCC were included in this clinical study and received ONM-100 24 ± 8 h before surgery. Fluorescence images of the excised surgical specimen and of the surgical cavity were analyzed. A fluorescent lesion with a tumor-to-background ratio (TBR) > 1.5 was considered fluorescence-positive and correlated to standard of care (SOC) histopathology. Results All six tumor-positive surgical margi...
Journal of bronchology & interventional pulmonology, 2010
Background and Objectives: Autofluorescence (AF) techniques improve the diagnostic yield of white light inspection for preneoplastic lesions in the bronchus and head and neck region. Although highly sensitive, AF has poor specificity, particularly in situations where there have been earlier biopsies or treatments such as radiotherapy. Narrow band imaging (NBI) is a newer imaging technique that enhances the early abnormal angiogenesis seen in preneoplastic lesions. NBI has higher specificity when compared with AF. We aimed to combine these imaging modalities, using AF as an effective screening tool and NBI to confirm AF findings. We also used computer-assisted image analysis techniques to give objective confirmation to our visual inspection.