Optical imaging with a high-resolution microendoscope to identify sinonasal pathology

Kidwai, Sarah; Parasher, Arjun K.; Schorn, Victor J.; Demicco, Elizabeth G.; Richards‐Kortum, Rebecca; Iloreta, Alfred Marc; Govindaraj, Satish; Miles, Brett A.

doi:10.1016/j.amjoto.2018.03.025

Cited by 4 publications

(3 citation statements)

References 30 publications

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“…The use of optical coherence tomography and confocal laser scanning microscopy, as well as high-resolution microendoscopy using a specific contrast agent, proflavine, are being proposed for the differentiation of the SNIP from nasal polyps. 21,22 Li et al 23 have also found that the Storz Professional Image Enhancement System (SPIES) is a rapid and noninvasive live-imaging technique that can detect the SNIP by examining the sinonasal mucosa and the submucosal and micro vasculature. These techniques have shown promising results, but their roles remain to be confirmed.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors for Recurrence after Surgical Resection of Sinonasal Inverted Papilloma

Delaine,

Gorostidi,

Guilcher

et al. 2024

Int Arch Otorhinolaryngol

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Introduction Sinonasal inverted papilloma (SNIP) is a rare benign epithelial tumor of the nasal cavity and paranasal sinuses that accounts for 0.4% and 4.7% respectively, of all tumors of this anatomical region. Objective To analyze the outcomes after surgical resection of SNIP and identify the risk factors for recurrence in a Swiss tertiary center. Methods We conducted a retrospective review of all cases of SNIP treated at the Lausanne university hospital between 2005 and 2018. All data available on the patients and tumors were collected for analysis. We studied the recurrence rate and looked for risk factors. Results We included 57 patients with a mean age of 55.5 years. There were 46 primary cases (80.7%) and 11 recurrences (19.3%). Maxillary sinus was the most frequent location (33.3%). Approximately half of the patients (52.6%) presented with a T3 tumor according to the Krouse classification. The mean recurrence rate after surgery was of 17.5% and it was more frequent among the patients in the recurrence group (45.5%) than among the primary cases (10.9%), reaching statistical significance (odds ratio [OR] = 6.8; 95% confidence interval [95%CI]: 1.5–30.8; p = 0.0165). Most patients were treated endoscopically (94.7%). Frontal sinus location, higher Krouse stage, and combined approach seemed to increase the risk of recurrence, but without statistical significance. Conclusion Difficult surgical access, as in the case of tumors located in the frontal sinus, higher stage of the disease, and previously operated cases carry the higher risk of incomplete resection and recurrence.

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Section: Discussionmentioning

confidence: 99%

Risk Factors for Recurrence after Surgical Resection of Sinonasal Inverted Papilloma

Delaine,

Gorostidi,

Guilcher

et al. 2024

Int Arch Otorhinolaryngol

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“…Other studies that address the clinical problem of incomplete resection of SNIP have also reported the use of alternative imaging techniques to discriminate between SNIP and uninvolved tissue [ 29 , 30 ]. Yet, these imaging methods are mainly limited to morphological information and therefore lack specificity to distinguish SNIP from surrounding inflammatory tissue.…”

Section: Discussionmentioning

confidence: 99%

Fluorescence grid analysis for the evaluation of piecemeal surgery in sinonasal inverted papilloma: a proof-of-concept study

Vonk

Voskuil

Wit

et al. 2021

Eur J Nucl Med Mol Imaging

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Purpose Local recurrence occurs in ~ 19% of sinonasal inverted papilloma (SNIP) surgeries and is strongly associated with incomplete resection. During surgery, it is technically challenging to visualize and resect all SNIP tissue in this anatomically complex area. Proteins that are overexpressed in SNIP, such as vascular endothelial growth factor (VEGF), may serve as a target for fluorescence molecular imaging to guide surgical removal of SNIP. A proof-of-concept study was performed to investigate if the VEGF-targeted near-infrared fluorescent tracer bevacizumab-800CW specifically localizes in SNIP and whether it could be used as a clinical tool to guide SNIP surgery. Methods In five patients diagnosed with SNIP, 10 mg of bevacizumab-800CW was intravenously administered 3 days prior to surgery. Fluorescence molecular imaging was performed in vivo during surgery and ex vivo during the processing of the surgical specimen. Fluorescence signals were correlated with final histopathology and VEGF-A immunohistochemistry. We introduced a fluorescence grid analysis to assess the fluorescence signal in individual tissue fragments, due to the nature of the surgical procedure (i.e., piecemeal resection) allowing the detection of small SNIP residues and location of the tracer ex vivo. Results In all patients, fluorescence signal was detected in vivo during endoscopic SNIP surgery. Using ex vivo fluorescence grid analysis, we were able to correlate bevacizumab-800CW fluorescence of individual tissue fragments with final histopathology. Fluorescence grid analysis showed substantial variability in mean fluorescence intensity (FImean), with SNIP tissue showing a median FImean of 77.54 (IQR 50.47–112.30) compared to 35.99 (IQR 21.48–57.81) in uninvolved tissue (p < 0.0001), although the diagnostic ability was limited with an area under the curve of 0.78. Conclusions A fluorescence grid analysis could serve as a valid method to evaluate fluorescence molecular imaging in piecemeal surgeries. As such, although substantial differences were observed in fluorescence intensities, VEGF-A may not be the ideal target for SNIP surgery. Trial registration NCT03925285.

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“…Alternatively, a low-cost nonscanning endomicroscope can be built using widefield LED illumination delivered directly to the tissue via a fiber bundle with an image collected by the same bundle and imaged onto a camera via fluorescence filters. [9][10][11] The fiber has no distal optics and is always in direct contact with the tissue, thus the surface of the sample is essentially deformed to be in constant contact with the probe tip. Such a system has virtually no inherent optical sectioning, but this can be added using structured-illumination microscopy (SIM), [12][13][14] requiring only a modification to the illumination optics to project periodic symmetric line patterns onto the bundle, and thus onto the tissue.…”

Section: Introductionmentioning

confidence: 99%

Automatic motion compensation for structured illumination endomicroscopy using a flexible fiber bundle

Thrapp

Hughes

2020

J. Biomed. Opt.

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Significance: Confocal laser scanning enables optical sectioning in clinical fiber bundle endomicroscopes, but lower-cost, simplified endomicroscopes use widefield incoherent illumination instead. Optical sectioning can be introduced in these simple systems using structured illumination microscopy (SIM), a multiframe digital subtraction process. However, SIM results in artifacts when the probe is in motion, making the technique difficult to use in vivo and preventing the use of mosaicking to synthesize a larger effective field of view (FOV). Aim: We report and validate an automatic motion compensation technique to overcome motion artifacts and allow generation of mosaics in SIM endomicroscopy. Approach: Motion compensation is achieved using image registration and real-time pattern orientation correction via a digital micromirror device. We quantify the similarity of moving probe reconstructions to those acquired with a stationary probe using the relative mean of the absolute differences (MAD). We further demonstrate mosaicking with a moving probe in mechanical and freehand operation. Results: Reconstructed SIM images show an improvement in the MAD from 0.85 to 0.13 for lens paper and from 0.27 to 0.12 for bovine tissue. Mosaics also show vastly reduced artifacts. Conclusion: The reduction in motion artifacts in individual SIM reconstructions leads to mosaics that more faithfully represent the morphology of tissue, giving clinicians a larger effective FOV than the probe itself can provide.

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Optical imaging with a high-resolution microendoscope to identify sinonasal pathology

Cited by 4 publications

References 30 publications

Risk Factors for Recurrence after Surgical Resection of Sinonasal Inverted Papilloma

Risk Factors for Recurrence after Surgical Resection of Sinonasal Inverted Papilloma

Fluorescence grid analysis for the evaluation of piecemeal surgery in sinonasal inverted papilloma: a proof-of-concept study

Automatic motion compensation for structured illumination endomicroscopy using a flexible fiber bundle

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