TY - JOUR A1 - Goncalves, Miguel A1 - Aubreville, Marc A1 - Müller, Sarina K. A1 - Sievert, Matti A1 - Maier, Andreas A1 - Iro, Heinrich A1 - Bohr, Christopher T1 - Probe-based confocal laser endomicroscopy in detecting malignant lesions of vocal folds JF - ACTA Otorhinolaryngologica Italica N2 - Probe-based confocal laser endomicroscopy (CLE) is an innovative technique for real-time, non-invasive analysis of the surface epithelium. While being successfully used for diagnosis by experts, this method has not yet been established in clinical routine, partly due to the lack of standards and criteria for classifying various lesions. Our aim was to determine the diagnostic value and inter-rater reliability of CLE in detecting malignant lesions of the vocal cords. 58 video sequences were extracted from the probe-based CLE (GastroFlex probe with a Cellvizio® laser system) examinations of 3 patients with squamous cell carcinomas and 4 patients with benign alterations of the vocal folds. Two ENT surgeons, who were blinded to the histological result, were asked to identify the sequences representing a carcinoma. We showed an accuracy, sensitivity, specificity, PPV and NPV of 91.38-96.55%, 100%, 87.8-95.2%, 77.27-89.47% and 100%, respectively, with an inter-rater reliability of k = 0.89 (“almost perfect agreement”). Probe-based CLE is a promising method for diagnosis and assessment of vocal fold lesions in vivo. Our results suggest that, with adequate training, the diagnostic value of this technique can be improved and potentially provide important information during oncological surgery. UR - https://doi.org/10.14639/0392-100X-2121 KW - Confocal laser endomicroscopy KW - Laryngeal cancer KW - Non-invasive histological imaging KW - Vocal folds Y1 - 2019 UR - https://doi.org/10.14639/0392-100X-2121 UR - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:573-11824 SN - 1827-675X VL - 39 IS - 6 SP - 389 EP - 395 PB - Pacini CY - Pisa 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 - 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 - Aubreville, Marc A1 - Ganz, Jonathan A1 - Ammeling, Jonas A1 - Rosbach, Emely A1 - Gehrke, Thomas A1 - Scherzad, Agmal A1 - Hackenberg, Stephan A1 - Goncalves, Miguel T1 - Prediction of tumor board procedural recommendations using large language models JF - European Archives of Oto-Rhino-Laryngology UR - https://doi.org/10.1007/s00405-024-08947-9 Y1 - 2024 UR - https://doi.org/10.1007/s00405-024-08947-9 SN - 1434-4726 SN - 0937-4477 VL - 282 IS - 3 SP - 1619 EP - 1629 PB - Springer CY - Berlin ER - TY - JOUR A1 - Frenken, Ann‐Kathrin A1 - Sievert, Matti A1 - Panuganti, Bharat A1 - Aubreville, Marc A1 - Meyer, Till A1 - Scherzad, Agmal A1 - Gehrke, Thomas A1 - Scheich, Matthias A1 - Hackenberg, Stephan A1 - Goncalves, Miguel T1 - Feasibility of Optical Biopsy During Endoscopic Sinus Surgery With Confocal Laser Endomicroscopy: A Pilot Study JF - The Laryngoscope UR - https://doi.org/10.1002/lary.31503 Y1 - 2024 UR - https://doi.org/10.1002/lary.31503 SN - 1531-4995 VL - 134 IS - 10 SP - 4217 EP - 4224 PB - Wiley CY - Malden ER - TY - JOUR A1 - Sievert, Matti A1 - Aubreville, Marc A1 - Mueller, Sarina Katrin A1 - Eckstein, Markus A1 - Breininger, Katharina A1 - Iro, Heinrich A1 - Goncalves, Miguel T1 - Diagnosis of malignancy in oropharyngeal confocal laser endomicroscopy using GPT 4.0 with vision JF - European Archives of Oto-Rhino-Laryngology UR - https://doi.org/10.1007/s00405-024-08476-5 Y1 - 2024 UR - https://doi.org/10.1007/s00405-024-08476-5 SN - 1434-4726 SN - 0937-4477 VL - 281 IS - 4 SP - 2115 EP - 2122 PB - Springer CY - Berlin 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 - TY - JOUR A1 - Sievert, Matti A1 - Eckstein, Markus A1 - Mantsopoulos, Konstantinos A1 - Müller, Sarina K. A1 - Stelzle, Florian A1 - Aubreville, Marc A1 - Oetter, Nicolai A1 - Maier, Andreas A1 - Iro, Heinrich A1 - Goncalves, Miguel T1 - Impact of intraepithelial capillary loops and atypical vessels in confocal laser endomicroscopy for 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 surface imaging of the laryngeal and pharyngeal mucosa in vivo at a thousand-fold magnification. This study aims to compare irregular blood vessels and intraepithelial capillary loops in healthy mucosa and squamous cell carcinoma (SCC) via CLE. Materials and methods We included ten patients with confirmed SCC and planned total laryngectomy in this study between March 2020 and February 2021. CLE images of these patients were collected and compared with the corresponding histology in hematoxylin and eosin staining. We analyzed the characteristic endomicroscopic patterns of blood vessels and intraepithelial capillary loops for the diagnosis of SCC. Results In a total of 54 sequences, we identified 243 blood vessels which were analyzed regarding structure, diameter, and Fluorescein leakage, confirming that irregular, corkscrew-like vessels (24.4% vs. 1.3%; P < .001), dilated intraepithelial capillary loops (90.8% vs. 28.7%; P < .001), and increased capillary leakage (40.7% vs. 2.5%; P < .001), are significantly more frequently detected in SCC compared to the healthy epithelium. We defined a vessel diameter of 30 μm in capillary loops as a cut-off value, obtaining a sensitivity, specificity, PPV, and NPV and accuracy of 90.6%, 71.3%, 57.4%, 94.7%, and 77.1%, respectively, for the detection of malignancy based solely on capillary architecture. Conclusion Capillaries within malignant lesions are fundamentally different from those in healthy mucosa regions. The capillary architecture is a significant feature aiding the identification of malignant mucosa areas during in-vivo, real-time CLE examination. UR - https://doi.org/10.1007/s00405-021-06954-8 KW - confocal laser endomicroscopy KW - head and neck squamous cell carcinoma KW - capillary loops KW - malignant vascularization KW - head and neck malignancies Y1 - 2021 UR - https://doi.org/10.1007/s00405-021-06954-8 UR - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:573-23196 SN - 1434-4726 SN - 0937-4477 VL - 279 IS - 4 SP - 2029 EP - 2037 PB - Springer Nature CY - Cham ER - TY - JOUR A1 - Pan, Zhaoya A1 - Breininger, Katharina A1 - Aubreville, Marc A1 - Stelzle, Florian A1 - Oetter, Nicolai A1 - Maier, Andreas A1 - Mantsopoulos, Konstantinos A1 - Iro, Heinrich A1 - Goncalves, Miguel A1 - Sievert, Matti T1 - Defining a baseline identification of artifacts in confocal laser endomicroscopy in head and neck cancer imaging JF - American Journal of Otolaryngology UR - https://doi.org/10.1016/j.amjoto.2022.103779 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/10.1016/j.amjoto.2022.103779 SN - 1532-818X SN - 0196-0709 VL - 44 IS - 2 PB - Elsevier CY - Amsterdam ER - TY - JOUR A1 - Sievert, Matti A1 - Aubreville, Marc A1 - Oetter, Nicolai A1 - Stelzle, Florian A1 - Maier, Andreas A1 - Mantsopoulos, Konstantinos A1 - Iro, Heinrich A1 - Goncalves, Miguel T1 - Konfokale Laser-Endomikroskopie des Kopf-Hals-Plattenepithelkarzinoms: eine systematische Übersicht JF - Laryngo-Rhino-Otologie T2 - Confocal laser endomicroscopy of head and neck squamous cell carcinoma: a systematic review UR - https://doi.org/10.1055/a-1339-1635 KW - konfokale Laser-Endomikroskopie KW - CLE KW - Kopf-Hals-Malignom KW - Larynxkarzinom KW - Bildanalyse KW - confocal laser endomicroscopy KW - head and neck malignancy KW - laryngeal carcinoma KW - image analysis Y1 - 2021 UR - https://doi.org/10.1055/a-1339-1635 SN - 0935-8943 VL - 100 IS - 11 SP - 875 EP - 881 PB - Thieme CY - Stuttgart ER - TY - JOUR A1 - Sievert, Matti A1 - Stelzle, Florian A1 - Aubreville, Marc A1 - Müller, Sarina K. A1 - Eckstein, Markus A1 - Oetter, Nicolai A1 - Maier, Andreas A1 - Mantsopoulos, Konstantinos A1 - Iro, Heinrich A1 - Goncalves, Miguel T1 - Intraoperative free margins assessment of oropharyngeal squamous cell carcinoma with confocal laser endomicroscopy: a pilot study JF - European Archives of Oto-Rhino-Laryngology and Head & Neck N2 - Purpose This pilot study aimed to assess the feasibility of intraoperative assessment of safe margins with confocal laser endomicroscopy (CLE) during oropharyngeal squamous cell carcinoma (OPSCC) surgery. Methods We included five consecutive patients confirmed OPSCC and planned tumor resection in September and October 2020. Healthy appearing mucosa in the marginal zone, and the tumor margin, were examined with CLE and biopsy during tumor resection. A total of 12,809 CLE frames were correlated with the gold standard of hematoxylin and eosin staining. Three head and neck surgeons and one pathologist were asked to identify carcinoma in a sample of 169 representative images, blinded to the histological results. Results Healthy mucosa showed epithelium with uniform size and shape with distinct cytoplasmic membranes and regular vessel architecture. CLE optical biopsy of OPSCC demonstrated a disorganized arrangement of variable cellular morphology. We calculated an accuracy, sensitivity, specificity, PPV, and NPV of 86%, 90%, 79%, 88%, and 82%, respectively, with inter-rater reliability and κ-value of 0.60. Conclusion CLE can be easily integrated into the intraoperative setting, generate real-time, in-vivo microscopic images of the oropharynx for evaluation and demarcation of cancer. It can eventually contribute to a less radical approach by enabling a more precise evaluation of the cancer margin. UR - https://doi.org/10.1007/s00405-021-06659-y KW - Confocal laser endomicroscopy KW - Oropharyngeal squamous cell carcinoma KW - Safe surgical margins KW - Head and neck malignancies Y1 - 2021 UR - https://doi.org/10.1007/s00405-021-06659-y UR - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:573-10914 SN - 1434-4726 SN - 0937-4477 VL - 278 IS - 11 SP - 4433 EP - 4439 PB - Springer Nature CY - Cham ER - TY - JOUR A1 - Oetter, Nicolai A1 - Pröll, Jonas A1 - Sievert, Matti A1 - Goncalves, Miguel A1 - Rohde, Maximilian A1 - Nobis, Christopher-Philipp A1 - Knipfer, Christian A1 - Aubreville, Marc A1 - Pan, Zhaoya A1 - Breininger, Katharina A1 - Maier, Andreas A1 - Kesting, Marco A1 - Stelzle, Florian T1 - Oral mucosa - an examination map for confocal laser endomicroscopy within the oral cavity: an experimental clinical study JF - Clinical Oral Investigations N2 - Objectives Confocal laser endomicroscopy (CLE) is an optical method that enables microscopic visualization of oral mucosa. Previous studies have shown that it is possible to differentiate between physiological and malignant oral mucosa. However, differences in mucosal architecture were not taken into account. The objective was to map the different oral mucosal morphologies and to establish a “CLE map” of physiological mucosa as baseline for further application of this powerful technology. Materials and methods The CLE database consisted of 27 patients. The following spots were examined: (1) upper lip (intraoral) (2) alveolar ridge (3) lateral tongue (4) floor of the mouth (5) hard palate (6) intercalary line. All sequences were examined by two CLE experts for morphological differences and video quality. Results Analysis revealed clear differences in image quality and possibility of depicting tissue morphologies between the various localizations of oral mucosa: imaging of the alveolar ridge and hard palate showed visually most discriminative tissue morphology. Labial mucosa was also visualized well using CLE. Here, typical morphological features such as uniform cells with regular intercellular gaps and vessels could be clearly depicted. Image generation and evaluation was particularly difficult in the area of the buccal mucosa, the lateral tongue and the floor of the mouth. Conclusion A physiological “CLE map” for the entire oral cavity could be created for the first time. Clinical relevance This will make it possible to take into account the existing physiological morphological features when differentiating between normal mucosa and oral squamous cell carcinoma in future work. UR - https://doi.org/10.1007/s00784-024-05664-9 KW - Confocal laser endomicroscopy KW - Oral cavity KW - Oral carcinoma KW - Optical methods KW - Oral cavity squamous cell carcinoma KW - Head and neck cancer Y1 - 2024 UR - https://doi.org/10.1007/s00784-024-05664-9 UR - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:573-56000 SN - 1436-3771 VL - 28 IS - 5 PB - Springer CY - Berlin ER -