High specificity of combined narrow band imaging and autofluorescence mucosal assessment of patients with head and neck cancer (original) (raw)
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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.
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.
Medical Laser …, 2007
Head and neck (H&N) cancer patients have a high incidence of second primary tumors in the tracheobronchial tree, which affects the patient prognosis and management. Diagnostic autofluorescence endoscopy (AFB) has shown promising results in the detection of early neoplastic and pre-neoplastic changes in the bronchi. We have investigated the medical and therapeutic impact of AFB in a population of 21 H&N cancer patients using a modified commercially available AFB system. That allows both white light (WL) and autofluorescence (AF) observation. Endoscopic imaging of the tissue AF was combined with an online image analysis procedure improving the discrimination between true and false positive results. Forty-one biopsies were taken on macroscopically suspicious (WL or AF positive) bronchial sites. Histopathologic analysis confirmed pre-or early neoplastic changes in 11 of these biopsies taken from eight patients. All these lesions had been AF positive upon bronchoscopy. The sensitivity for the detection of these early lesions with the AFB was 1.6 times the sensitivity of WL bronchoscopy alone. The positive predictive value (PPV) for AF was 79% (33% for WL alone) while the PPV of both methods together was 100%. We could demonstrate that AFB is efficient for the detection of second primary lesions of the bronchi in H&N cancer patients. In conclusion, AFB can be used as a simple and minimally invasive additional procedure to pre-operative or follow-up examination in this patient population.
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, ...
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.
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
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...