Feasibility of intraoperative assessment of safe surgical margins during laryngectomy with confocal laser endomicroscopy: A pilot study

Sievert M, Oetter N, Aubreville M, Stelzle F, Maier A, Eckstein M, Mantsopoulos K, Gostian AO, Müller SK, Koch M, Agaimy A, Iro H, Goncalves M (2021)

Publication Type: Journal article

Publication year: 2021

Journal

Auris Nasus Larynx Elsevier

DOI: 10.1016/j.anl.2021.01.005

Abstract

Objective: This pilot study aimed to assess the feasibility of intraoperative assessment of safe margins with Confocal Laser Endomicroscopy (CLE) during planned partial or total laryngectomy. Methods: Eight patients with confirmed larynx squamous cell carcinoma (SCC) and planned partial or total laryngectomy were included in this study in March 2020. Two head and neck surgeons and one pathologist were asked to classify carcinoma or healthy epithelium in a sample of 94 representative sequences (5.640 images), blinded to the histological results (H&E staining). Results: Healthy mucosa areas showed epithelium with cells of uniform size and shape with distinct cytoplasmic membranes and regular vessel architecture. CLE optical biopsy of SCC demonstrated a disorganized arrangement of variable cellular morphology. We calculated an accuracy, sensitivity, specificity, PPV, and NPV of 80.1%, 72.3%, 87.9%, 85.7%, and 76.1%, respectively. A distinct transition between healthy appearing tissue and suspicious lesions could also be detected. Conclusion: CLE can be easily integrated into the intraoperative setting, generate real-time, in-vivo microscopic images of the larynx for evaluation and demarcation of cancer. If validated in further studies, CLE could eventually contribute to a less radical approach by enabling a more precise evaluation of the cancer margin.

Authors with CRIS profile

Matti Sievert Department of Otorhinolaryngology – Head and Neck Surgery (HNO-Klinik) Nicolai Oetter Department of Oral and Cranio-Maxillofacial Surgery Marc Aubreville Lehrstuhl für Informatik 14 (Bild- und Sprachverarbeitung) (LME) Florian Stelzle Department of Oral and Cranio-Maxillofacial Surgery Andreas Maier Lehrstuhl für Informatik 5 (Mustererkennung) Markus Eckstein Institute of Pathology Konstantinos Mantsopoulos Department of Otorhinolaryngology – Head and Neck Surgery (HNO-Klinik) Sarina Müller-Hübner Department of Otorhinolaryngology – Head and Neck Surgery (HNO-Klinik) Abbas Agaimy Lehrstuhl für Allgemeine Pathologie und Pathologische Anatomie Heinrich Iro Lehrstuhl für Hals-, Nasen- und Ohrenheilkunde Miguel Goncalves Department of Otorhinolaryngology – Head and Neck Surgery (HNO-Klinik)

How to cite

APA:

Sievert, M., Oetter, N., Aubreville, M., Stelzle, F., Maier, A., Eckstein, M.,... Goncalves, M. (2021). Feasibility of intraoperative assessment of safe surgical margins during laryngectomy with confocal laser endomicroscopy: A pilot study. Auris Nasus Larynx. https://doi.org/10.1016/j.anl.2021.01.005

MLA:

Sievert, Matti, et al. "Feasibility of intraoperative assessment of safe surgical margins during laryngectomy with confocal laser endomicroscopy: A pilot study." Auris Nasus Larynx (2021).

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