TY - JOUR A1 - Aubreville, Marc A1 - Knipfer, Christian A1 - Oetter, Nicolai A1 - Jaremenko, Christian A1 - Rodner, Erik A1 - Denzler, Joachim A1 - Bohr, Christopher A1 - Neumann, Helmut A1 - Stelzle, Florian A1 - Maier, Andreas T1 - Automatic classification of cancerous tissue in laserendomicroscopy images of the oral cavity using deep learning JF - Scientific Reports N2 - Oral Squamous Cell Carcinoma (OSCC) is a common type of cancer of the oral epithelium. Despite their high impact on mortality, sufficient screening methods for early diagnosis of OSCC often lack accuracy and thus OSCCs are mostly diagnosed at a late stage. Early detection and accurate outline estimation of OSCCs would lead to a better curative outcome and a reduction in recurrence rates after surgical treatment. Confocal Laser Endomicroscopy (CLE) records sub-surface micro-anatomical images for in vivo cell structure analysis. Recent CLE studies showed great prospects for a reliable, real-time ultrastructural imaging of OSCC in situ. We present and evaluate a novel automatic approach for OSCC diagnosis using deep learning technologies on CLE images. The method is compared against textural feature-based machine learning approaches that represent the current state of the art. For this work, CLE image sequences (7894 images) from patients diagnosed with OSCC were obtained from 4 specific locations in the oral cavity, including the OSCC lesion. The present approach is found to outperform the state of the art in CLE image recognition with an area under the curve (AUC) of 0.96 and a mean accuracy of 88.3% (sensitivity 86.6%, specificity 90%). UR - https://doi.org/10.1038/s41598-017-12320-8 Y1 - 2017 UR - https://doi.org/10.1038/s41598-017-12320-8 UR - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:573-12464 SN - 2045-2322 VL - 7 PB - Springer Nature CY - London ER - TY - JOUR A1 - Aubreville, Marc A1 - Stoeve, Maike A1 - Oetter, Nicolai A1 - Goncalves, Miguel A1 - Knipfer, Christian A1 - Neumann, Helmut A1 - Bohr, Christopher A1 - Stelzle, Florian A1 - Maier, Andreas T1 - Deep learning-based detection of motion artifacts in probe-based confocal laser endomicroscopy images JF - International Journal of Computer Assisted Radiology and Surgery UR - https://doi.org/10.1007/s11548-018-1836-1 KW - Deep convolutional neural networks KW - Confocal laser endomicroscopy KW - Motion artifact detection Y1 - 2019 UR - https://doi.org/10.1007/s11548-018-1836-1 SN - 1861-6429 VL - 14 IS - 1 SP - 31 EP - 42 PB - Springer CY - Berlin ER - TY - CHAP A1 - Aubreville, Marc A1 - Goncalves, Miguel A1 - Knipfer, Christian A1 - Oetter, Nicolai A1 - Würfl, Tobias A1 - Neumann, Helmut A1 - Stelzle, Florian A1 - Bohr, Christopher A1 - Maier, Andreas ED - Wiebe, Sheldon ED - Gamboa, Hugo ED - Fred, Ana ED - Bermúdez i Badia, Sergi T1 - Patch-based Carcinoma Detection on Confocal Laser Endomicroscopy Images BT - A Cross-Site Robustness Assessment T2 - Proceedings of the 11th International Joint Conference on Biomedical Engineering Systems and Technologies N2 - Deep learning technologies such as convolutional neural networks (CNN) provide powerful methods for image recognition and have recently been employed in the field of automated carcinoma detection in confocal laser endomicroscopy (CLE) images. CLE is a (sub-)surface microscopic imaging technique that reaches magnifications of up to 1000x and is thus suitable for in vivo structural tissue analysis. In this work, we aim to evaluate the prospects of a priorly developed deep learning-based algorithm targeted at the identification of oral squamous cell carcinoma with regard to its generalization to further anatomic locations of squamous cell carcinomas in the area of head and neck. We applied the algorithm on images acquired from the vocal fold area of five patients with histologically verified squamous cell carcinoma and presumably healthy control images of the clinically normal contra-lateral vocal cord. We find that the network trained on the oral cavity data reaches an accurac y of 89.45% and an area-under-the-curve (AUC) value of 0.955, when applied on the vocal cords data. Compared to the state of the art, we achieve very similar results, yet with an algorithm that was trained on a completely disjunct data set. Concatenating both data sets yielded further improvements in cross-validation with an accuracy of 90.81% and AUC of 0.970. In this study, for the first time to our knowledge, a deep learning mechanism for the identification of oral carcinomas using CLE Images could be applied to other disciplines in the area of head and neck. This study shows the prospect of the algorithmic approach to generalize well on other malignant entities of the head and neck, regardless of the anatomical location and furthermore in an examiner-independent manner. UR - https://doi.org/10.5220/0006534700270034 KW - Automatic Carcinoma Detection KW - Confocal Laser Endomicroscopy KW - Deep Convolutional Networks KW - Squamous Cell Carcinoma Y1 - 2018 UR - https://doi.org/10.5220/0006534700270034 UR - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:573-26277 SN - 978-989-758-278-3 SP - 27 EP - 34 PB - SciTePress CY - Setúbal ER - TY - JOUR A1 - Sievert, Matti A1 - Oetter, Nicolai A1 - Aubreville, Marc A1 - Stelzle, Florian A1 - Maier, Andreas A1 - Eckstein, Markus A1 - Mantsopoulos, Konstantinos A1 - Gostian, Antoniu-Oreste A1 - Müller, Sarina K. A1 - Koch, Michael A1 - Agaimy, Abbas A1 - Iro, Heinrich A1 - Goncalves, Miguel T1 - Feasibility of intraoperative assessment of safe surgical margins during laryngectomy with confocal laser endomicroscopy BT - a pilot study JF - Auris Nasus Larynx UR - https://doi.org/10.1016/j.anl.2021.01.005 Y1 - 2021 UR - https://doi.org/10.1016/j.anl.2021.01.005 SN - 1879-1476 VL - 48 IS - 4 SP - 764 EP - 769 PB - Elsevier Science CY - Amsterdam ER - TY - CHAP A1 - Aubreville, Marc A1 - Goncalves, Miguel A1 - Knipfer, Christian A1 - Oetter, Nicolai A1 - Würfl, Tobias A1 - Neumann, Helmut A1 - Stelzle, Florian A1 - Bohr, Christopher A1 - Maier, Andreas T1 - Transferability of deep learning algorithms for malignancy detection in confocal laser endomicroscopy images from different anatomical locations of the upper gastrointestinal tract T2 - Biomedical Engineering Systems and Technologies UR - https://doi.org/10.1007/978-3-030-29196-9_4 KW - Confocal Laser Endomicroscopy KW - Transfer learning KW - Head and neck squamous cell carcinoma Y1 - 2019 UR - https://doi.org/10.1007/978-3-030-29196-9_4 SN - 978-3-030-29195-2 SN - 978-3-030-29196-9 SN - 1865-0929 N1 - Access to this content is enabled by Nationallizenz Ebooks Medicine SP - 67 EP - 85 PB - Springer CY - Cham ER - TY - CHAP A1 - Stoeve, Maike A1 - Aubreville, Marc A1 - Oetter, Nicolai A1 - Knipfer, Christian A1 - Neumann, Helmut A1 - Stelzle, Florian A1 - Maier, Andreas ED - Maier, Andreas ED - Deserno, Thomas Martin ED - Handels, Heinz ED - Maier-Hein, Klaus H. ED - Palm, Christoph ED - Tolxdorff, Thomas T1 - Motion Artifact Detection in Confocal Laser Endomicroscopy Images T2 - Bildverarbeitung für die Medizin 2018: Algorithmen - Systeme - Anwendungen UR - https://doi.org/10.1007/978-3-662-56537-7_85 Y1 - 2018 UR - https://doi.org/10.1007/978-3-662-56537-7_85 SN - 978-3-662-56537-7 SP - 328 EP - 333 PB - Springer Vieweg CY - Berlin ER - TY - INPR A1 - Stoeve, Maike A1 - Aubreville, Marc A1 - Oetter, Nicolai A1 - Knipfer, Christian A1 - Neumann, Helmut A1 - Stelzle, Florian A1 - Maier, Andreas T1 - Motion Artifact Detection in Confocal Laser Endomicroscopy Images N2 - Confocal Laser Endomicroscopy (CLE), an optical imaging technique allowing non-invasive examination of the mucosa on a (sub)- cellular level, has proven to be a valuable diagnostic tool in gastroenterology and shows promising results in various anatomical regions including the oral cavity. Recently, the feasibility of automatic carcinoma detection for CLE images of sufficient quality was shown. However, in real world data sets a high amount of CLE images is corrupted by artifacts. Amongst the most prevalent artifact types are motion-induced image deteriorations. In the scope of this work, algorithmic approaches for the automatic detection of motion artifact-tainted image regions were developed. Hence, this work provides an important step towards clinical applicability of automatic carcinoma detection. Both, conventional machine learning and novel, deep learning-based approaches were assessed. The deep learning-based approach outperforms the conventional approaches, attaining an AUC of 0.90. UR - https://doi.org/10.48550/arXiv.1711.01117 Y1 - 2018 UR - https://doi.org/10.48550/arXiv.1711.01117 UR - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:573-12588 PB - arXiv CY - Ithaca ER - TY - INPR A1 - Aubreville, Marc A1 - Pan, Zhaoya A1 - Sievert, Matti A1 - Ammeling, Jonas A1 - Ganz, Jonathan A1 - Oetter, Nicolai A1 - Stelzle, Florian A1 - Frenken, Ann-Kathrin A1 - Breininger, Katharina A1 - Goncalves, Miguel T1 - Few Shot Learning for the Classification of Confocal Laser Endomicroscopy Images of Head and Neck Tumors N2 - The surgical removal of head and neck tumors requires safe margins, which are usually confirmed intraoperatively by means of frozen sections. This method is, in itself, an oversampling procedure, which has a relatively low sensitivity compared to the definitive tissue analysis on paraffin-embedded sections. Confocal laser endomicroscopy (CLE) is an in-vivo imaging technique that has shown its potential in the live optical biopsy of tissue. An automated analysis of this notoriously difficult to interpret modality would help surgeons. However, the images of CLE show a wide variability of patterns, caused both by individual factors but also, and most strongly, by the anatomical structures of the imaged tissue, making it a challenging pattern recognition task. In this work, we evaluate four popular few shot learning (FSL) methods towards their capability of generalizing to unseen anatomical domains in CLE images. We evaluate this on images of sinunasal tumors (SNT) from five patients and on images of the vocal folds (VF) from 11 patients using a cross-validation scheme. The best respective approach reached a median accuracy of 79.6% on the rather homogeneous VF dataset, but only of 61.6% for the highly diverse SNT dataset. Our results indicate that FSL on CLE images is viable, but strongly affected by the number of patients, as well as the diversity of anatomical patterns. UR - https://doi.org/10.48550/arXiv.2311.07216 Y1 - 2023 UR - https://doi.org/10.48550/arXiv.2311.07216 UR - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:573-41522 PB - arXiv CY - Ithaca ER - TY - JOUR A1 - Sievert, Matti A1 - Mantsopoulos, Konstantinos A1 - Müller, Sarina K. A1 - Eckstein, Markus A1 - Rupp, Robin A1 - Aubreville, Marc A1 - Stelzle, Florian A1 - Oetter, Nicolai A1 - Maier, Andreas A1 - Iro, Heinrich A1 - Goncalves, Miguel T1 - Systematic interpretation of confocal laser endomicroscopy: larynx and pharynx confocal imaging score JF - Acta otorhinolaryngologica italica N2 - Objective. Development and validation of a confocal laser endomicroscopy (CLE) classification score for the larynx and pharynx. Methods. Thirteen patients (154 video sequences, 9240 images) with laryngeal or pharyngeal SCC were included in this prospective study between October 2020 and February 2021. Each CLE sequence was correlated with the gold standard of histopathological examination. Based on a dataset of 94 video sequences (5640 images), a scoring system was developed. In the remaining 60 sequences (3600 images), the score was validated by four CLE experts and four head and neck surgeons who were not familiar with CLE. Results. Tissue homogeneity, cell size, borders and clusters, capillary loops and the nucleus/ cytoplasm ratio were defined as the scoring criteria. Using this score, the CLE experts obtained an accuracy, sensitivity, and specificity of 90.8%, 95.1%, and 86.4%, respectively, and the CLE non-experts of 86.2%, 86.4%, and 86.1%. Interobserver agreement Fleiss’ kappa was 0.8 and 0.6, respectively. Conclusions. CLE can be reliably evaluated based on defined and reproducible imaging features, which demonstrate a high diagnostic value. CLE can be easily integrated into the intraoperative setting and generate real-time, in-vivo microscopic images to demarcate malignant changes. UR - https://doi.org/10.14639/0392-100X-N1643 KW - confocal laser endomicroscopy KW - head and neck cancer KW - classification system KW - non-invasive histological imaging KW - larynx KW - pharynx Y1 - 2022 UR - https://doi.org/10.14639/0392-100X-N1643 UR - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:573-29175 SN - 1827-675X VL - 42 IS - 1 SP - 26 EP - 33 PB - Pacini CY - Pisa ER - TY - JOUR A1 - Sievert, Matti A1 - Aubreville, Marc A1 - Gostian, Antoniu-Oreste A1 - Mantsopoulos, Konstantinos A1 - Koch, Michael A1 - Müller, Sarina K. A1 - Eckstein, Markus A1 - Rupp, Robin A1 - Stelzle, Florian A1 - Oetter, Nicolai A1 - Maier, Andreas A1 - Iro, Heinrich A1 - Goncalves, Miguel T1 - Validity of tissue homogeneity in confocal laser endomicroscopy on the diagnosis of laryngeal and hypopharyngeal squamous cell carcinoma JF - European Archives of Oto-Rhino-Laryngology and Head & Neck N2 - 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. UR - https://doi.org/10.1007/s00405-022-07304-y KW - confocal laser endomicroscopy KW - head and neck cancer KW - classification system KW - non-invasive histological imaging KW - larynx KW - pharynx Y1 - 2022 UR - https://doi.org/10.1007/s00405-022-07304-y UR - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:573-23180 SN - 1434-4726 SN - 0937-4477 VL - 279 IS - 8 SP - 4147 EP - 4156 PB - Springer Nature CY - Cham ER - TY - JOUR A1 - Sievert, Matti A1 - Mantsopoulos, Konstantinos A1 - Müller, Sarina K. A1 - Rupp, Robin A1 - Eckstein, Markus A1 - Stelzle, Florian A1 - Oetter, Nicolai A1 - Maier, Andreas A1 - Aubreville, Marc A1 - Iro, Heinrich A1 - Goncalves, Miguel T1 - Validation of a classification and scoring system for the diagnosis of laryngeal and pharyngeal squamous cell carcinomas by confocal laser endomicroscopy JF - Brazilian Journal of Otorhinolaryngology N2 - Introduction Confocal laser endomicroscopy is an optical imaging technique that allows in vivo, real-time, microscope-like images of the upper aerodigestive tract’s mucosa. The assessment of morphological tissue characteristics for the correct differentiation between healthy and malignant suspected mucosa requires strict evaluation criteria. Objective This study aims to validate an eight-point score for the correct assessment of malignancy. Methods We performed confocal laser endomicroscopy between March and October 2020 in 13 patients. 197 sequences (11.820 images) originated from the marginal area of pharyngeal and laryngeal carcinomas. Specimens were taken at corresponding locations and analyzed in H&E staining as a standard of reference. A total of six examiners evaluated the sequences based on a scoring system; they were blinded to the histopathological examination. The primary endpoints are sensitivity, specificity, and accuracy. Secondary endpoints are interrater reliability and receiver operator characteristics. Results Healthy mucosa showed epithelium with uniform size and shape with distinct cytoplasmic membranes and regular vessel architecture. Confocal laser endomicroscopy of malignant cells demonstrated a disorganized arrangement of variable cellular morphology. We calculated an accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of 83.2%, 81.3%, 85.5%, 86.7%, and 79.7%, respectively, with a κ-value of 0.64, and an area under the curve of 0.86. Conclusion The results confirm that this scoring system is applicable in the laryngeal and pharyngeal mucosa to classify benign and malignant tissue. A scoring system based on defined and reproducible characteristics can help translate this experimental method to broad clinical practice in head and neck diagnosis. UR - https://doi.org/10.1016/j.bjorl.2021.06.002 KW - confocal laser endomicroscopy KW - squamous cell carcinoma KW - head and neck cancer KW - diagnosis Y1 - 2021 UR - https://doi.org/10.1016/j.bjorl.2021.06.002 UR - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:573-20887 SN - 1808-8694 VL - 2022 IS - 88, S4 SP - 26 EP - 32 PB - Elsevier CY - Amsterdam ER -