Clinical value of optical coherence tomography in laryngology

Kraft, Marcel; Glanz, H.; Gerlach, Susanne von; Wisweh, Henning; Lubatschowski, Holger; Arens, Christoph

doi:10.1002/hed.20914

Cited by 61 publications

(51 citation statements)

References 18 publications

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“…Smaller cancers (Tis, T1 <3 mm) and their precursor lesions can be better assessed through optical coherence tomography (OCT), whereas advanced tumors (T2-T4) still require additional imaging techniques such as CT or MRI (250). Moreover, it permits observation of vocal cord mobility in real time (154,160162).…”

Section: Authormentioning

confidence: 99%

Laryngeal preneoplastic lesions and cancer: challenging diagnosis. Qualitative literature review and meta-analysis.

Mannelli

Cecconi

Gallo

2016

Critical Reviews in Oncology/Hematology

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Abstract.Background: Multi-step cancerogenesis guides laryngeal cancer onset and it includes a wide variety of pre-cancerous lesions that are macroscopically challenging to identify and distinguish from initial cancerous foci. Since the treatment of laryngeal cancer and its precursor lesions has a great impact on important laryngeal basic functions, early detection and preoperative assessment are important for a curative and function-preserving therapy. Nowadays, despite the high number of more advanced diagnostic techniques and methods, unfortunately, it is not uncommon for different clinicians to use different nomenclature or to identify different stage for the same laryngeal lesion. From these observations, it is obvious that an instrument offering the possibility to detect precancerous lesions, early cancerous lesions, and satellite foci or second primaries would be the key to improving management and outcome in laryngeal patients. Object. Different modalities of diagnostic techniques of laryngeal lesions exist. Rather than difference between benign and obvious malignant diseases, more difficult is to detect the presence of precancerous epithelial alterations. Not all tests achieve the same diagnostic accuracy, hence this meta-analysis of literature aimed to synthesize the validity of each single diagnostic technique in identifying and staging laryngeal disease. Methods: A systematic review of literature was led searching for articles mentioning the following terms including their various combinations to maximize the yield: larynx, laryngeal precancerous lesions, laryngeal cancer, white light (WL) endoscopy, stroboscopy, contact endoscopy (CE), autofluorescence (AF), ultrasound (US), narrow band imaging (NBI), computed axial tomography (CAT), magnetic resonance imaging (MRI), positron emission tomography (PET), CAT/PET. Then, a quantitative analysis was carried on for paper published after 2005 onward, reporting a minumun series of 10 patients each study, declaring sensitivity and specificity of each diagnostic system. Results: The search identified 7215 publications, of which 3616 published after 2005, with a final results of a total of 214 articles stratified and included by our selection criteria. 42 out of 214 articles were selected for quantitative synthesis. 25 out of 41 studies had a quality score of ≥ 6 (good), 16 presented a score between 4 and 5 (fair). While objections can be raised about the pooling of different diagnostic procedures under the same group and the high level of heterogeneity in the meta-analyses, the inclusion of over 4400 laryngeal lesions makes the results fairly robust. Conclusions: A comprehensive overview of the most recent advances in laryngeal imaging technology combined with all of the information needed to interpret findings and successfully manage patients with voice disorders can be found herein. With these data, clinicians can riskstratify patients and select proper examination modalities in order to provide appropriate care. Moreover, study limitations, together with p...

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Section: Authormentioning

confidence: 99%

Laryngeal preneoplastic lesions and cancer: challenging diagnosis. Qualitative literature review and meta-analysis.

Mannelli

Cecconi

Gallo

2016

Critical Reviews in Oncology/Hematology

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“…2 Measurement of epithelial thickness and integrity of the basement membrane can be used to discriminate vocal cord pathologies. 5 To validate the potential of OCT for vocal cord diagnosis Kraft et al 6 applied OCT additionally to conventional microlaryngoscopy in a prospective study in 193 patients. Performing a direct laryngoscopy procedure, each suspicious lesion was diagnosed based on both conventional microlaryngoscopy and OCT imaging.…”

Section: Introductionmentioning

confidence: 99%

“…This is a significantly higher accuracy than microlaryngoscopy alone which only identified 80% of the cases correctly. 6 Epithelial thicknesses can be measured in OCT scans for tumor staging. 6,7 These OCT studies with direct laryngoscopy were carried out with fiber-based OCT probes in contact mode influencing the accuracy of epithelial thickness measurements due to compression of the epithelium.…”

Section: Introductionmentioning

confidence: 99%

Automated working distance adjustment enables optical coherence tomography of the human larynx in awake patients

et al. 2015

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Abstract. Optical coherence tomography (OCT) provides structural information of laryngeal tissue which is comparable to histopathological analysis of biopsies taken under general anesthesia. In awake patients, movements impede clinically useful OCT acquisition. Therefore, an automatic compensation of movements was implemented into a swept source OCT-laryngoscope. Video and OCT beam path were combined in one tube of 10-mm diameter. Segmented OCT images served as distance sensor and a feedback control adjusted the working distance between 33 and 70 mm by synchronously translating the reference mirror and focusing lens. With this motion compensation, the tissue was properly visible in up to 88% of the acquisition time. During quiet respiration, OCT contrasted epithelium and lamina propria. Mean epithelial thickness was measured to be 109 and 135 μm in female and male, respectively. Furthermore, OCT of mucosal wave movements during phonation enabled estimation of the oscillation frequency and amplitude. Regarding clinical issues, the OCT-laryngoscope with automated working distance adjustment may support the estimation of the depth extent of epithelial lesions and contribute to establish an indication for a biopsy. Moreover, OCT of the vibrating vocal folds provides functional information, possibly giving further insight into mucosal behavior during the vibratory cycle.

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“…UADT), flexible OCT probes provide resolutions on the order of 10 mm and penetration depths of 2 mm into soft tissues. The predominant diagnostic feature is the recognition of the integrity of the basement membrane, identifying early invasive lesions by the loss of contrast between the epithelial and connective tissue layers with a high sensitivity [12][13][14].…”

Section: Sectional Imaging Methodsmentioning

confidence: 99%

Confocal laser endomicroscopy in head and neck cancer

Volgger¹,

Conderman

Betz³

2013

Current Opinion in Otolaryngology & Head and Neck Surgery

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Purpose of reviewConfocal laser endomicroscopy (CLE) is a novel, noninvasive technique used to obtain microanatomical images of the inner lining of hollow organs. It has been used in a variety of clinical specialties to aid in the diagnosis and treatment planning of inflammatory and neoplastic processes. Our intent is to provide an up-to-date review of the literature in the setting of head and neck diseases as well as describing our own initial results and areas of future research. Recent findingsWith increasing experience using CLE in the upper aerodigestive tract (UADT), evidence is mounting that this method can be a useful adjunct to standard endoscopy and other diagnostic techniques. Recent publications have shown that by using CLE, microanatomical structures of healthy and diseased mucosa can easily be identified, allowing for a differentiation of dysplastic/neoplastic and benign mucosal lesions. Standardized diagnostic protocols as well as clinically relevant classification systems for the UADT have not yet been described. SummaryCLE is an imaging modality that allows real-time visualization of mucosal cellular architecture and other histologic characteristics. First reports on its use in the UADT have yielded promising results, but the true value of this method is yet to be determined.

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Clinical value of optical coherence tomography in laryngology

Abstract: OCT is a simple, rapid, and reliable aid in the diagnostic investigation and intraoperative monitoring of laryngeal disease.

Cited by 61 publications

References 18 publications

Laryngeal preneoplastic lesions and cancer: challenging diagnosis. Qualitative literature review and meta-analysis.

Laryngeal preneoplastic lesions and cancer: challenging diagnosis. Qualitative literature review and meta-analysis.

Automated working distance adjustment enables optical coherence tomography of the human larynx in awake patients

Confocal laser endomicroscopy in head and neck cancer

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