Noninvasive histological imaging of head and neck squamous cell carcinomas using confocal laser endomicroscopy.
Confocal laser endomicroscopy (CLE) is an imaging technique that uses miniaturized fiberoptic probes to allow real-time histological imaging of human tissue. An application of CLE in otorhinolaryngology has hardly been investigated so far. In our study, we analyzed the applicability of CLE to visualize cancerous and healthy tissue of the head and neck region. Formalin-fixed tissue specimens from 135 head and neck squamous cell carcinoma (HNSCC) patients and 50 healthy controls were investigated using CLE with and without topical application of acriflavine. Four head and neck surgeons, four pathologists, and four laymen evaluated the CLE images of the HNSCC cases regarding the tumor localization and its border to healthy tissue. The tumor localization and the tumor border were correctly identified in 97 % by the pathologists, 85 % by the head and neck surgeons, and 70 % by the laymen. The main difference in evaluation results was seen in the correct identification of the tumor site (p < 0.05), while there was no significant difference in the identification of the tumor border. CLE is a valuable tool for real-time histological imaging of HNSCCs. It can help to visualize the tumor border and, thereby, facilitate a more precise tumor surgery.
Department of Otorhinolaryngology, Head and Neck Surgery, Saarland University Medical Center, Kirrbergerstr. 100, building 6, 66421, Homburg/Saar, Germany. maximilian.linxweiler@uks.eu.
Maximilian
M
Linxweiler
Department of Otorhinolaryngology, Head and Neck Surgery, Saarland University Medical Center, Kirrbergerstr. 100, building 6, 66421, Homburg/Saar, Germany.
Basel Al
BA
Kadah
Department of Otorhinolaryngology, Head and Neck Surgery, Saarland University Medical Center, Kirrbergerstr. 100, building 6, 66421, Homburg/Saar, Germany.
Alessandro
A
Bozzato
Department of Otorhinolaryngology, Head and Neck Surgery, Saarland University Medical Center, Kirrbergerstr. 100, building 6, 66421, Homburg/Saar, Germany.
Victoria
V
Bozzato
Department of General and Surgical Pathology, Saarland University Medical Center, Kirrbergerstr. 100, 66421, Homburg/Saar, Germany.
Andrea
A
Hasenfus
Department of General and Surgical Pathology, Saarland University Medical Center, Kirrbergerstr. 100, 66421, Homburg/Saar, Germany.
Yoo-Jin
YJ
Kim
Department of General and Surgical Pathology, Saarland University Medical Center, Kirrbergerstr. 100, 66421, Homburg/Saar, Germany.
Mathias
M
Wagner
Department of Neurosurgery, Merheim Hospital, Ostmerheimerstr. 200, 51109, Cologne, Germany.
Alhadi
A
Igressa
Department of Otorhinolaryngology, Head and Neck Surgery, Saarland University Medical Center, Kirrbergerstr. 100, building 6, 66421, Homburg/Saar, Germany.
Bernhard
B
Schick
Department of Neurosurgery, Merheim Hospital, Ostmerheimerstr. 200, 51109, Cologne, Germany.|Department of Neurosurgery, University Hospital Düsseldorf, Moorenstr. 5, 40255, Düsseldorf, Germany.
Patra
P
Charalampaki
D000167:Acriflavine; D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D005456:Fluorescent Dyes; D006258:Head and Neck Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D006801:Humans; D008297:Male; D018613:Microscopy, Confocal / Q000379:methods*; D061848:Optical Imaging; D000077195:Squamous Cell Carcinoma of Head and Neck
D005456:Fluorescent Dyes; D000167:Acriflavine
Confocal laser endomicroscopy; Head and neck cancer; Noninvasive histological imaging; Optical biopsies; Tumor surgery