Diagnosis of Laryngeal Pemphigus Vulgaris Can Be Facilitated Using Advanced 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.

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Narrow band imaging in early diagnosis of laryngopharyngeal malignant and premalignant lesions

Auris Nasus Larynx ◽

10.1016/j.anl.2021.11.008 ◽

2021 ◽

Author(s):

Mohabbat Ali ◽

Gaurav Gupta ◽

Manju Silu ◽

Deep Chand ◽

Vivek Samor

Keyword(s):

Early Diagnosis ◽

Narrow Band ◽

Narrow Band Imaging ◽

Premalignant Lesions

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Narrow band imaging for early diagnosis of epithelial dysplasia and microinvasive tumors in the upper aerodigestive tract

HNO ◽

10.1007/s00106-016-0284-x ◽

2016 ◽

Vol 65 (S1) ◽

pp. 5-12 ◽

Cited By ~ 9

Author(s):

C. Arens ◽

C. Betz ◽

M. Kraft ◽

S. Voigt-Zimmermann

Keyword(s):

Early Diagnosis ◽

Narrow Band ◽

Narrow Band Imaging ◽

Aerodigestive Tract ◽

Epithelial Dysplasia ◽

Upper Aerodigestive Tract

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Role of narrow band imaging in the detection of mucosal lesions of head and neck

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20203572 ◽

2020 ◽

Vol 6 (9) ◽

pp. 1678

Author(s):

Pranay Bhandari ◽

Kavita Sachdeva

Keyword(s):

Early Detection ◽

Head And Neck ◽

Narrow Band ◽

Narrow Band Imaging ◽

Early Stage ◽

Early Screening ◽

White Light Endoscopy ◽

Promising Tool ◽

Mucosal Lesions

Background: Head and neck mucosal lesions are difficult to diagnose at early stage; therefore, they usually present at an advance phase. Narrow Band imaging (NBI) first came to use around 2005 and became one of the most used technologies for image enhanced endoscopy.Material and method: In order to identify best method for early detection of mucosal lesion of head and neck, we examined patients with suspected lesions first under white light endoscopy then under NBI endoscopy. Patients under-went biopsy thereafter, and results were compared. Our aim was to evaluate the role of NBI as a screening tool in the early detection of mucosal lesions of head and neck.Result: It was observed that NBI is useful tool in identifying mucosal lesions of head and neck early. 71 patients were included in our study and it was observed that NBI endoscopy shows 100% sensitivity, 96.36% specificity and 97.18% accuracy in identifying benign lesions. It shows 100% sensitivity, 94.74% specificity and 98.59% accuracy in identifying malignant lesions.Conclusion: In our study we came to conclusion that NBI is very promising tool for early screening purposes of mucosal lesions of head and neck which were missed in routine examination.

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ROLE OF NARROW BAND IMAGING SYSTEM IN EARLY DIAGNOSIS OF POTENTIALLY MALIGNANT LESIONS OF ORAL CAVITY

Journal of Evidence Based Medicine and Healthcare ◽

10.18410/jebmh/2016/651 ◽

2016 ◽

Vol 3 (57) ◽

pp. 2988-2991

Author(s):

Laveena P Mehta ◽

Yessukrishna Prabhakar Shetty ◽

Sharad B Bhalekar ◽

Yogesh G Dabholkar ◽

Haritosh K Velankar

Keyword(s):

Early Diagnosis ◽

Oral Cavity ◽

Imaging System ◽

Narrow Band ◽

Narrow Band Imaging ◽

Potentially Malignant ◽

Malignant Lesions

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Demographics and targeted biopsy with NBI in head and neck mucosal lesions

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20204633 ◽

2020 ◽

Vol 6 (11) ◽

pp. 2064

Author(s):

Pranay Bhandari ◽

Kavita Sachdeva

Keyword(s):

Oral Cavity ◽

Head And Neck ◽

Narrow Band ◽

Narrow Band Imaging ◽

Correct Diagnosis ◽

Age Distribution ◽

Targeted Biopsy ◽

Female Ratio ◽

Malignant Lesions ◽

Mucosal Lesions

Background: It is estimated that by the end of year 2020 over 10 million people worldwide would die of cancer every year and about 66% of these would be from developing world like India (WHO-UCC 2003). Our aim in present study was to evaluate the use of targeted biopsy of mucosal lesions of head and neck cancer using narrow band imaging technique, in order to yield more accurate specimen of lesion which will result in correct diagnosis of disease early and to study different demographics of patients.Methods: Patients lesions were examined under NBI endoscope, best site of biopsy were identified on the basis of increase vascularity, neo-angiogenesis and superficial capillary vessels. Biopsy were taken from this site and sent for histopathological examinations. Considering histopathological report as standard, results from NBI endoscopy were compared to the results of previous studies and conclusion was done. We also studied different demographics of these patients under site of lesion, age distribution, sex distribution, and locality, histopathology type. Results: Maximum lesions were found in oral cavity (56.33%). Malignancy was also more common in oral cavity (63.46%), mostly belong to squamous cell carcinoma on histopathology. Mean age of presentation of head and neck mucosal lesion was found to be 48 year and of malignant lesions is 54 years.Conclusions: We conclude that up to an extent with progression of age malignant lesions increase. Male to female ratio of mucosal lesions is 1.7:1 and of malignancy is 2.25:1. Narrow band imaging endoscopy helps us to identify best site of biopsy, helping in early diagnosis of disease and ultimately reducing morbidity and mortality of patient.

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Narrow-Band Imaging in the Diagnosis of Colorectal Mucosal Lesions: A Pilot Study

Endoscopy ◽

10.1055/s-2004-826040 ◽

2004 ◽

Vol 36 (12) ◽

pp. 1094-1098 ◽

Cited By ~ 356

Author(s):

H. Machida ◽

Y. Sano ◽

Y. Hamamoto ◽

M. Muto ◽

T. Kozu ◽

...

Keyword(s):

Pilot Study ◽

Narrow Band ◽

Narrow Band Imaging ◽

Mucosal Lesions

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Laryngeal Lesion Classification Based on Vascular Patterns in Contact Endoscopy and Narrow Band Imaging: Manual Versus Automatic Approach

Sensors ◽

10.3390/s20144018 ◽

2020 ◽

Vol 20 (14) ◽

pp. 4018

Author(s):

Nazila Esmaeili ◽

Alfredo Illanes ◽

Axel Boese ◽

Nikolaos Davaris ◽

Christoph Arens ◽

...

Keyword(s):

Narrow Band ◽

Narrow Band Imaging ◽

Subjective Evaluation ◽

Vascular Changes ◽

Visual Evaluation ◽

Laryngeal Lesion ◽

Laryngeal Mucosa ◽

Supervised Classifiers ◽

Real Time Visualization ◽

Computer Based

Longitudinal and perpendicular changes in the vocal fold’s blood vessels are associated with the development of benign and malignant laryngeal lesions. The combination of Contact Endoscopy (CE) and Narrow Band Imaging (NBI) can provide intraoperative real-time visualization of the vascular changes in the laryngeal mucosa. However, the visual evaluation of vascular patterns in CE-NBI images is challenging and highly depends on the clinicians’ experience. The current study aims to evaluate and compare the performance of a manual and an automatic approach for laryngeal lesion’s classification based on vascular patterns in CE-NBI images. In the manual approach, six observers visually evaluated a series of CE+NBI images that belong to a patient and then classified the patient as benign or malignant. For the automatic classification, an algorithm based on characterizing the level of the vessel’s disorder in combination with four supervised classifiers was used to classify CE-NBI images. The results showed that the manual approach’s subjective evaluation could be reduced by using a computer-based approach. Moreover, the automatic approach showed the potential to work as an assistant system in case of disagreements among clinicians and to reduce the manual approach’s misclassification issue.

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

European Archives of Oto-Rhino-Laryngology ◽

10.1007/s00405-021-06723-7 ◽

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.

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

Cancers ◽

10.3390/cancers12010248 ◽

2020 ◽

Vol 12 (1) ◽

pp. 248 ◽

Cited By ~ 3

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.

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