Enhanced contact endoscopy for the detection of neoangiogenesis in tumors of the larynx and hypopharynx

Puxeddu, Roberto; Sionis, Sara; Gerosa, Clara; Carta, Filippo

doi:10.1002/lary.25124

Cited by 55 publications

(71 citation statements)

References 29 publications

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“…This technique has shown a number of advantages: (1) ensures a non invasive and safe repeatable method; (2) when performed pre-operatively it provides an insight into the microscopic margins of the laryngeal mucosa lesion; (3) it can be used intra-operatively to ensure that the lesion has been completely removed; (4) it allows visualization of the microvascular net, which can assist the initial diagnosis of early laryngeal lesions. As CE supplies intraoperative information on the type of laryngeal pathology, thus significantly influencing the subsequent operative course, the criteria for malignancy are set high in order to minimize the use of unnecessary operative procedures as already demonstrated by Puxeddu et al (102), and by Ledda et al (111), confirming the significant role of ECE for more comprehensive staging and management of early cancer of the UADT. In fact, false negative result will only delay optimal operative or other therapeutic intervention until histopathology results are obtained, whereas an operative procedure performed on the basis of a false positive result may imply major and irreversible error.…”

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confidence: 85%

“…The basic technique of CE involves staining of the superficial cells of the mucosa with 1% of nontoxic methylene blue before the magnification of the suspected areas through the direct contact of the tip of an endoscope to the mucosal surface to obtain cytological images (102). CE enables visualization of the laryngeal mucosa pathology through high magnification and therefore detailed examination of cells and blood vessels without !…”

Section: Contact Endoscopymentioning

confidence: 99%

“…SPIES enhances the appearance of the mucosal surface structures and subepithelial vasculature by selected wavelengths of light, providing in addition to the standard mode using white light (WL), five different defined spectral ranges (Clara, Clara1-Chroma, Chroma, Spectra A, Spectra B). The main target of analysis of these techniques is neoangiogenesis, a prerequisite for the progression of precancerous and cancerous lesions of the upper aero-digestive tract (UADT) (102). SPIES, as well as narrow band imaging (NBI), allow for the recognition of the superficial changes of neoangiogenesis, and they require a certain degree of experience to avoid false positives, because the typical mucosal "spots" are not univocal and are challenging for clinical interpretation.…”

Section: ! 29mentioning

confidence: 99%

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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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confidence: 85%

Section: Contact Endoscopymentioning

confidence: 99%

Section: ! 29mentioning

confidence: 99%

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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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“…Digital imaging techniques develop rapidly, and multiple endoscopic tools designed for evaluation of mucosal lesions in the head and neck area are available. The use of enhancement techniques specifically designed to visualize the subepithelial vasculature and allow the recognition of specific vascular patterns such as narrow band imaging (NBI) (Olympus, Tokyo, Japan), Storz Professional Image Enhancement System (SPIES) (Karl Storz, Tuttlingen, Germany) and i‐SCAN (Pentax, Englewood, CO) is now recommended as an integrated part of the evaluation . The NBI system centers the emitted wavelengths at 415 nm (blue light) and 540 nm (green light), which limits the penetration depth and facilitates the visualization of superficial vessels as well as the delineation of the lesion .…”

Section: Introductionmentioning

confidence: 99%

Can the Ni classification of vessels predict neoplasia? A systematic review and meta‐analysis

et al. 2017

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Objectives: The Ni classification of vascular change from 2011 is well documented for evaluating pharyngeal and laryngeal lesions, primarily focusing on cancer. In the planning of surgery it may be more relevant to differentiate neoplasia from non-neoplasia. We aimed to evaluate the ability of the Ni classification to predict laryngeal or hypopharyngeal neoplasia and to investigate if a changed cutoff value would support the recent European Laryngological Society (ELS) proposal of perpendicular vascular changes as indicative of neoplasia.Data Sources: PubMed, Embase, Cochrane, and Scopus databases. Review Methods: A systematic review and meta-analysis was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement. We systematically searched for publications from 2011 until 2016. All retrieved studies were reviewed and qualitatively assessed. The pooled sensitivity and specificity of the Ni classification with two different cutoffs were calculated, and bubble and summary receiver operating characteristics plots were created.Results: The combined sensitivity of five studies (n 5 687) with Ni type IV-V defined as test-positive was 0.89 (95% confidence interval [CI]: 0.76-0.95), and specificity was 0.82 (95% CI: 0.72-0.89). The equivalent combined sensitivity of four studies (n 5 624) with Ni type V defined as test-positive was 0.82 (95% CI: 0.75-0.87), and specificity was 0.93 (95% CI: 0.82-0.97).Conclusions: The diagnostic accuracy of the Ni classification in predicting neoplasia was high, without significant difference between the two analyzed cutoff values. Implementation of the proposed ELS classification of vascular changes seems reasonable from a clinical perspective, with comparable accuracy. Attention must be drawn to the accompanying risk of exposing patients to unnecessary surgery.

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“…Several studies suggest an additional positive effect of combining other diagnostic modalities (i.e., autofluorescence, saline infusion, brush cytology, contact endoscopy, and other imaging techniques enhancing the vascularity (i.e., narrow‐band imaging) with VS to increase diagnostic accuracy. Results are promising but not consistent, and further research is needed . VS probably remains the gold standard as a screening procedure for assessing glottic lesions, but it should be supplemented by further diagnostic procedures due to the inability to correctly identify patients without cancer.…”

Section: Discussionmentioning

confidence: 98%

Can videostroboscopy predict early glottic cancer? A systematic review and meta-analysis

et al. 2015

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Enhanced contact endoscopy for the detection of neoangiogenesis in tumors of the larynx and hypopharynx

Cited by 55 publications

References 29 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.

Can the Ni classification of vessels predict neoplasia? A systematic review and meta‐analysis

Can videostroboscopy predict early glottic cancer? A systematic review and meta-analysis

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