scholarly journals Validation of the European Laryngological Society classification of glottic vascular changes as seen by narrow band imaging in the optical biopsy setting

2021 ◽  
Author(s):  
Francesco Missale ◽  
Stefano Taboni ◽  
Andrea Luigi Camillo Carobbio ◽  
Francesco Mazzola ◽  
Giulia Berretti ◽  
...  
Keyword(s):  
Test Performance ◽  
Predictive Value ◽  
Interobserver Agreement ◽  
Narrow Band ◽  
Narrow Band Imaging ◽  
Intraepithelial Neoplasia ◽  
Optical Biopsy ◽  
Vascular Changes ◽  
Laryngeal Lesions ◽  
European Laryngological Society

Abstract Purpose In 2016, the European Laryngological Society (ELS) proposed a classification for vascular changes occurring in glottic lesions as visible by narrow band imaging (NBI), based on the dichotomic distinction between longitudinal vessels (not suspicious) and perpendicular ones (suspicious). The aim of our study was to validate this classification assessing the interobserver agreement and diagnostic test performance in detecting the final histopathology. Methods A retrospective study was carried out by reviewing clinical charts, preoperative videos, and final pathologic diagnosis of patients submitted to transoral microsurgery for laryngeal lesions in two Italian referral centers. In each institution, two physicians, independently re-assessed each case applying the ELS classification. Results The cohort was composed of 707 patients. The pathologic report showed benign lesions in 208 (29.5%) cases, papillomatosis in 34 (4.8%), squamous intraepithelial neoplasia (SIN) up to carcinoma in situ in 200 (28.2%), and squamous cell carcinoma (SCC) in 265 (37.5%). The interobserver agreement was extremely high in both institutions (k = 0.954, p < 0.001 and k = 0.880, p < 0.001). Considering the diagnostic performance for identification of at least SIN or SCC, the sensitivity was 0.804 and 0.902, the specificity 0.793 and 0.581, the positive predictive value 0.882 and 0.564, and the negative predictive value 0.678 and 0.908, respectively. Conclusion The ELS classification for NBI vascular changes of glottic lesions is a highly reliable tool whose systematic use allows a better diagnostic evaluation of suspicious laryngeal lesions, reliably distinguishing benign ones from those with a diagnosis of papillomatosis, SIN or SCC, thus paving the way towards confirmation of the optical biopsy concept.

scholarly journals Evaluation of Vascular Patterns Using Contact Endoscopy and Narrow-Band Imaging (CE-NBI) for the Diagnosis of Vocal Fold Malignancy

Cancers ◽  
2020 ◽  
Vol 12 (1) ◽  
pp. 248 ◽  
Author(s):  
Nikolaos Davaris ◽  
Anke Lux ◽  
Nazila Esmaeili ◽  
Alfredo Illanes ◽  
Axel Boese ◽  
...  
Keyword(s):  
Vocal Fold ◽  
Interobserver Agreement ◽  
Narrow Band ◽  
Narrow Band Imaging ◽  
Vocal Folds ◽  
Premalignant Lesions ◽  
Vascular Changes ◽  
Real Time Visualization ◽  
European Laryngological Society ◽  
Level Of Agreement

The endoscopic detection of perpendicular vascular changes (PVC) of the vocal folds has been associated with vocal fold cancer, dysplastic lesions, and papillomatosis, according to a classification proposed by the European Laryngological Society (ELS). The combination of contact endoscopy with narrow-band imaging (NBI-CE) allows intraoperatively a highly contrasted, real-time visualization of vascular changes of the vocal folds. Aim of the present study was to determine the association of PVC to specific histological diagnoses, the level of interobserver agreement in the detection of PVC, and their diagnostic effectiveness in diagnosing laryngeal malignancy. The evaluation of our data confirmed the association of PVC to vocal fold cancer, dysplastic lesions, and papillomatosis. The level of agreement between the observers in the identification of PVC was moderate for the less-experienced observers and almost perfect for the experienced observers. The identification of PVC during NBI-CE proved to be a valuable indicator for diagnosing malignant and premalignant lesions.

scholarly journals Diagnostic Value and Pathological Correlation of Narrow Band Imaging Classification in Laryngeal Lesions

2020 ◽  
pp. 014556132092532 ◽  
Author(s):  
Chuanyao Lin ◽  
Sisi Zhang ◽  
Ling Lu ◽  
Maohua Wang ◽  
Xiaoyun Qian
Keyword(s):  
Predictive Value ◽  
Narrow Band ◽  
Narrow Band Imaging ◽  
Diagnostic Value ◽  
Pathological Correlation ◽  
Laryngeal Lesions ◽  
Loop Pattern ◽  
Malignant Lesions ◽  
High Consistency ◽  
Sensitivity Specificity

Objectives: To explore the diagnostic value and pathological correlation of narrow band imaging (NBI) classification in laryngeal lesions. Methods: A total of 112 patients (123 lesions) with laryngeal lesions from July 2018 to May 2019 were selected in this study. All patients were examined by NBI and white light imaging endoscopy. The NBI endoscopy was applied to classify the observed lesion sites according to intraepithelial papillary capillary loop pattern. The gold standard of diagnosis was pathological results. To evaluate the consistency of NBI classification and pathological results. Results: The sensitivity, specificity, positive predictive value, and negative predictive value of the diagnosis for benign, precancerous, and malignant lesions under the NBI endoscopy were 90.91%, 81.19%, 74.07%, 85.42%; 41.67%, 92.93%, 58.82%, 86.79%; and 93.51%, 65.22%, 91.14%, 68.18%, respectively. There was a high consistency between NBI classification and pathological results (κ = 0.679, P < .001). Conclusions: The NBI classification can improve the accuracy of the diagnosis of laryngeal lesions. It is important for early diagnosis and treatment of vocal cord leukoplakia and laryngeal cancer.

scholarly journals Narrow Band Imaging with Magnification Can Pick Up Esophageal Squamous Cell Carcinoma More Efficiently Than Lugol Chromoendoscopy in Patients after Chemoradiotherapy

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Itsuko Asada-Hirayama ◽  
Shinya Kodashima ◽  
Mitsuhiro Fujishiro ◽  
Satoshi Ono ◽  
Keiko Niimi ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Esophageal Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Predictive Value ◽  
Narrow Band ◽  
Narrow Band Imaging ◽  
Intraepithelial Neoplasia ◽  
Esophageal Neoplasia ◽  
Sensitivity Specificity

Aim. Little is known about the usefulness of narrow band imaging (NBI) for surveillance of patients after chemoradiotherapy for esophageal neoplasia. Its usefulness in detecting esophageal squamous cell carcinoma (SCC) or high-grade intraepithelial neoplasia (HGIN) in these patients was retrospectively compared to Lugol chromoendoscopy. Patients and Methods. We assessed the diagnostic ability of NBI with magnification based on the biopsy specimens obtained from iodine-unstained lesions. Seventy-two iodine-unstained lesions were biopsied and consecutively enrolled for this study. The lesions were divided into NBI positive and NBI negative. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of NBI with magnification and PPV of Lugol chromoendoscopy was calculated using histological assessment as a gold standard. Results. Forty-six endoscopic examinations using NBI with magnification followed by Lugol chromoendoscopy were performed to 28 patients. The prevalence of SCC and HGIN was 21.4%. Sensitivity, specificity, PPV, NPV, and accuracy of NBI were 100.0%, 98.5%, 85.7%, 100%, and 98.6%, respectively. On the contrary, PPV of Lugol chromoendoscopy were 8.3%. Compared to Lugol chromoendoscopy, NBI with magnification showed equal sensitivity and significantly higher PPV (). Conclusion. NBI with magnification would be able to pick up esophageal neoplasia more efficiently than Lugol chromoendoscopy in patients after chemoradiotherapy.

Oral, Pharyngeal and Laryngeal Lesions in Mucous Membrane Pemphigoid and Usefulness of Narrow Band Imaging

2017 ◽  
Vol 1 (1) ◽  
Author(s):  
Ohki Masafumi ◽  
Kikuchi Shigeru ◽  
Ohata Atsushi ◽  
Sugiki Tsukasa ◽  
Kitano Yuka ◽  
...  
Keyword(s):  
Mucous Membrane ◽  
Narrow Band ◽  
Narrow Band Imaging ◽  
Mucous Membrane Pemphigoid ◽  
Laryngeal Lesions

scholarly journals The Impact of Narrow-band Imaging on the Pre- and Intra- operative Assessments of Neoplastic and Preneoplastic Laryngeal Lesions. A Systematic Review

2020 ◽  
Author(s):  
Carmelo Saraniti ◽  
Enzo Chianetta ◽  
Giuseppe Greco ◽  
Norhafiza Mat Lazim ◽  
Barbara Verro
Keyword(s):  
White Light ◽  
Diagnostic Tool ◽  
Narrow Band ◽  
Narrow Band Imaging ◽  
Resection Margins ◽  
Predictive Values ◽  
White Light Endoscopy ◽  
Laryngeal Lesions ◽  
Sensitivity Specificity ◽  
The Impact

Introduction Narrow-band imaging is an endoscopic diagnostic tool that, focusing on superficial vascular changes, is useful to detect suspicious laryngeal lesions, enabling their complete excision with safe and tailored resection margins. Objectives To analyze the applications and benefits of narrow-band imaging in detecting premalignant and malignant laryngeal lesions through a comparison with white-light endoscopy. Data Synthesis A literature search was performed in the PubMed, Scopus and Web of Science databases using strict keywords. Then, two authors independently analyzed the articles, read the titles and abstracts, and read completely only the relevant studies according to certain eligibility criteria. In total, 14 articles have been included in the present review; the sensitivity, specificity, positive and negative predictive values, and accuracy of pre- and/or intraoperative narrow-band imaging were analyzed. The analysis showed that narrow-band imaging is better than white-light endoscopy in terms of sensitivity, specificity, positive and negative predictive values, and accuracy regarding the ability to identify cancer and/or precancerous laryngeal lesions. Moreover, the intraoperative performance of narrow-band imaging resulted more effective than the in-office performance. Conclusion Narrow-band imaging is an effective diagnostic tool to detect premalignant and malignant laryngeal lesions and to define proper resection margins. Moreover, narrow-band imaging is useful in cases of leukoplakia that may cover a possible malignant lesion and that cannot be easily assessed with white-light endoscopy. Finally, a shared, simple and practical classification of laryngeal lesions, such as that of the European Laryngological Society, is required to identify a shared lesion management strategy. Key Points

scholarly journals Manual versus Automatic Classification of Laryngeal Lesions based on Vascular Patterns in CE+NBI Images

2020 ◽  
Vol 6 (3) ◽  
pp. 70-73
Author(s):  
Nazila Esmaeili ◽  
Alfredo Illanes ◽  
Axel Boese ◽  
Nikolaos Davaris ◽  
Christoph Arens ◽  
...  
Keyword(s):  
Vocal Fold ◽  
Narrow Band ◽  
Narrow Band Imaging ◽  
Automatic Classification ◽  
Vascular Pattern ◽  
Objective Interpretation ◽  
Laryngeal Lesions ◽  
Malignant Lesions ◽  
Manual Classification

AbstractLongitudinal and perpendicular changes in the blood vessels of the vocal fold have been related to the advancement from benign to malignant laryngeal cancer stages. The combination of Contact Endoscopy (CE) and Narrow Band Imaging (NBI) provides intraoperative realtime visualization of vascular pattern in Larynx. The evaluation of these vascular patterns in CE+NBI images is a subjective process leading to differentiation difficulty and subjectivity between benign and malignant lesions. The main objective of this work is to compare multi-observer classification versus automatic classification of laryngeal lesions. Six clinicians visually classified CE+NBI images into benign and malignant lesions. For the automatic classification of CE+NBI images, we used an algorithm based on characterizing the level of the vessel’s disorder. The results of the manual classification showed that there is no objective interpretation, leading to difficulties to visually distinguish between benign and malignant lesions. The results of the automatic classification of CE+NBI images on the other hand showed the capability of the algorithm to solve these issues. Based on the observed results we believe that, the automatic approach could be a valuable tool to assist clinicians to classifying laryngeal lesions.

scholarly journals Diagnosis of Laryngeal Pemphigus Vulgaris Can Be Facilitated Using Advanced Endoscopic Methods

Medicina ◽  
2021 ◽  
Vol 57 (7) ◽  
pp. 686
Author(s):  
Lucia Staníková ◽  
Martin Formánek ◽  
Pavel Hurník ◽  
Peter Kántor ◽  
Pavel Komínek ◽  
...  
Keyword(s):  
Early Diagnosis ◽  
Retrospective Analysis ◽  
Narrow Band ◽  
Narrow Band Imaging ◽  
Pemphigus Vulgaris ◽  
Tertiary Hospital ◽  
Specific Pattern ◽  
Vascular Changes ◽  
Mucosal Lesions ◽  
Endoscopic Methods

Background: Isolated laryngeal pemphigus vulgaris (LPV) is rare; however, early diagnosis is crucial in determining its course and prognosis. This paper aims to describe mucosal vascular changes typical for LPV using advanced endoscopic methods, which include Narrow Band Imaging (NBI), IMAGE1-S video-endoscopy and enhanced contact endoscopy (ECE). Materials and Methods: Retrospective analysis of all laryngeal mucosal lesion examined using advanced endoscopic methods during 2018–2020 at tertiary hospital was performed. Results: Videolaryngoscopy examination records of 278 patients with laryngeal mucosal lesions were analyzed; three of them were diagnosed with LPV. Epithelial vascularization of LPV included specific pattern. Intraepithelial papillary capillary loops were symmetrically stratified and were organized into “contour-like lines”. This specific vascularization associated with LPV were different from other laryngeal mucosal pathologies. Conclusions: Using advanced endoscopic methods supports early diagnosis of LPV and accelerate the diagnosis and treatment.

scholarly journals In vivo optical cellular diagnosis for uterine cervical or vaginal intraepithelial neoplasia using flexible gastrointestinal endocytoscopy -a prospective pilot study-

BMC Cancer ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Shoko Ono ◽  
Ayako Nozaki ◽  
Kana Matsuda ◽  
Emi Takakuwa ◽  
Naoya Sakamoto ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Predictive Value ◽  
Intraepithelial Neoplasia ◽  
Observer Agreement ◽  
Optical Biopsy ◽  
Link Type ◽  
Guided Biopsy ◽  
Vaginal Intraepithelial Neoplasia ◽  
High Level

Abstract Backgrouund For patients with any kind of atypical squamous intraepithelial lesion of the uterine cervix or vagina, colposcopy and punch biopsy are common procedures for histological determination following cytology. However, colposcopy-guided biopsy does not provide a high level of diagnostic accuracy. The aim of this study was to determine the usefulness of optical biopsy in vivo using endocytoscopy compared with conventional procedures using colposcopy. Methods Between May 2018 and March 2019, patients who were scheduled for cervical conization or mapping biopsies of the vagina were prospectively enrolled. Endocytoscopy was performed by senior endoscopists prior to scheduled procedures, and endocytoscopic images and biopsy samples were taken from the most prominent site and surrounding area of the cervical or vaginal lesions. The collection process of images was randomized and anonymous, and three doctors separately evaluated the images according to the ECA classification. ECA 4 and 5 are indicative of endoscopic malignancy. The primary endpoint was diagnostic accuracy (benign or malignant: cervical intraepithelial neoplasia (CIN) 3 or vaginal intraepithelial neoplasia (VAIN) 3 or worse) of cell images at the most prominent site in each patient. Results A total of 28 consecutive patients were enrolled. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy of endocytoscopic images were 95.0% (84.8–98.6%), 87.5% (61.9–96.5%), 95.0% (84.8–98.6%), 87.5% (61.9–96.5%) and 92.9% (78.2–98.0%), respectively. Inter-observer agreement among three reviewers was 0.78 (0.08–9.88, P < 0.01). On the other hand, the accuracy of colposcopy-guided biopsy was 74.1% (64.0–84.0%). Conclusions Optical cell diagnosis of cervical or vaginal intraepithelial neoplasia using endocytoscopy provides a high level of diagnostic accuracy. Trial registration The study was registered with the UMIN database (ID: 000031712). UMIN000031712. Registered 16 March 2017,

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