Validity of tissue homogeneity in confocal laser endomicroscopy on the diagnosis of laryngeal and hypopharyngeal squamous cell carcinoma

Sievert M, Aubreville M, Mantsopoulos K, Koch M, Müller-Hübner S, Eckstein M, Rupp R, Stelzle F, Oetter N, Maier A, Iro H, Goncalves M, Gostian AO (2022)

Publication Type: Journal article

Publication year: 2022

Journal

European Archives of Oto-Rhino-Laryngology Springer

DOI: 10.1007/s00405-022-07304-y

Abstract

Purpose: Confocal laser endomicroscopy (CLE) allows imaging of the laryngeal mucosa in a thousand-fold magnification. This study analyzes differences in tissue homogeneity between healthy mucosa and squamous cell carcinoma (SCC) via CLE. Materials and methods: We included five SCC patients with planned total laryngectomy in this study between October 2020 and February 2021. We captured CLE scans of the tumor and healthy mucosa. Analysis of image homogeneity to diagnose SCC was performed by measuring the signal intensity in four regions of interest (ROI) in each frame in a total of 60 sequences. Each sequence was assigned to the corresponding histological pattern, derived from hematoxylin and eosin staining. In addition, we recorded the subjective evaluation of seven investigators regarding tissue homogeneity. Results: Out of 3600 images, 1620 (45%) correlated with benign mucosa and 1980 (55%) with SCC. ROIs of benign mucosa and SCC had a mean and standard deviation (SD) of signal intensity of, respectively, 232.1 ± 3.34 and 467.3 ± 9.72 (P < 0.001). The mean SD between the four different ROIs was 39.1 ± 1.03 for benign and 101.5 ± 2.6 for SCC frames (P < 0.001). In addition, homogeneity yielded a sensitivity and specificity of 81.8% and 86.2%, respectively, regarding the investigator-dependent analysis. Conclusions: SCC shows a significant tissue inhomogeneity in comparison to the healthy epithelium. The results support this feature’s importance in identifying malignant mucosa areas during CLE examination. However, the examiner-dependent evaluation emphasizes that homogeneity is a sub-criterion that must be considered in a broad context.

Authors with CRIS profile

Matti Sievert Department of Otorhinolaryngology – Head and Neck Surgery Konstantinos Mantsopoulos Department of Otorhinolaryngology – Head and Neck Surgery Michael Koch Medizinische Fakultät Sarina Müller-Hübner Department of Otorhinolaryngology – Head and Neck Surgery Markus Eckstein Institute of Pathology Robin Rupp Department of Otorhinolaryngology – Head and Neck Surgery Florian Stelzle Department of Oral and Cranio-Maxillofacial Surgery Nicolai Oetter Department of Oral and Cranio-Maxillofacial Surgery Andreas Maier Lehrstuhl für Informatik 5 (Mustererkennung) Heinrich Iro Lehrstuhl für Hals-, Nasen- und Ohrenheilkunde Antoniu-Oreste Gostian Department of Otorhinolaryngology – Head and Neck Surgery

Involved external institutions

Technische Hochschule Ingolstadt DE Germany (DE) Universitätsklinikum Aachen (UKA) DE Germany (DE)

How to cite

APA:

Sievert, M., Aubreville, M., Mantsopoulos, K., Koch, M., Müller-Hübner, S., Eckstein, M.,... Gostian, A.-O. (2022). Validity of tissue homogeneity in confocal laser endomicroscopy on the diagnosis of laryngeal and hypopharyngeal squamous cell carcinoma. European Archives of Oto-Rhino-Laryngology. https://dx.doi.org/10.1007/s00405-022-07304-y

MLA:

Sievert, Matti, et al. "Validity of tissue homogeneity in confocal laser endomicroscopy on the diagnosis of laryngeal and hypopharyngeal squamous cell carcinoma." European Archives of Oto-Rhino-Laryngology (2022).

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