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European Archives of Oto-Rhino-Laryngology

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Open Access 01-02-2019 | Laryngology

Flexible transnasal endoscopy with white light or narrow band imaging for the diagnosis of laryngeal malignancy: diagnostic value, observer variability and influence of previous laryngeal surgery

Authors: Nikolaos Davaris, Susanne Voigt-Zimmermann, Siegfried Kropf, Christoph Arens

Published in: European Archives of Oto-Rhino-Laryngology | Issue 2/2019

Abstract

Purpose

Flexible transnasal endoscopy is a common examination technique for the evaluation of laryngeal lesions, while the use of narrow band imaging (NBI) has been reported to enhance the diagnostic value of white light endoscopy (WLE). The purpose of this study is to assess observer variability and diagnostic value of both modalities and investigate the possible influence of previous laryngeal surgery on the detection rates of laryngeal malignancy.

Methods

The study was based on the retrospective evaluation of 170 WLE and NBI images of laryngeal lesions by three observers in a random order. The histopathological diagnoses serve as the gold standard.

Results

In identifying laryngeal malignancy, the sensitivity of NBI proved to be higher than that of WLE (93.3% vs. 77.0%). NBI was also superior to WLE in terms of accuracy (96.3% vs. 92%) and diagnostic odds ratio (501.83 vs. 120.65). Both modalities had a specificity of 97.3%. The inter-observer agreement was substantial (kappa = 0.661) for WLE and almost perfect (kappa = 0.849) for NBI. Both WLE and NBI showed a high level of intra-observer agreement. The sensitivity was significantly lower in images with history of previous laryngeal surgery compared to those without.

Conclusions

Flexible transnasal endoscopy has been proved to be a valuable tool in the diagnosis of laryngeal malignancy. The use of NBI can increase the sensitivity and observer reliability in that context and can also provide a diagnostic gain in cases with previous laryngeal surgery

Gono K (2015) Narrow band imaging. technology basis and research and development history. Clin Endosc 48(6):476–480. https://doi.org/10.5946/ce.2015.48.6.476 CrossRefPubMedPubMedCentral

Piazza C, Del Bon F, Peretti G, Nicolai P (2012) Narrow band imaging in endoscopic evaluation of the larynx. Curr Opin Otolaryngol Head Neck Surg 20(6):472–476. https://doi.org/10.1097/MOO.0b013e32835908ac CrossRefPubMed

Pliske G, Voigt-Zimmermann S, Glaßer S, Arens C (2016) Objective quantification of the vocal fold vascular pattern: comparison of narrow band imaging and white light endoscopy. Eur Arch Otorhinolaryngol 273(9):2599–2605CrossRefPubMed

Muto M, Nakane M, Katada C, Sano Y, Ohtsu A, Esumi H, Ebihara S, Yoshida S (2004) Squamous cell carcinoma in situ at oropharyngeal and hypopharyngeal mucosal sites. Cancer 101:1375–1381CrossRefPubMed

Piazza C, D Bon F, Peretti G, Nicolai P (2011) ‘Biologic endoscopy’: optimization of upper aerodigestive tract cancer evaluation. Curr Opin Otolaryngol Head Neck Surg 19(2):67–76. https://doi.org/10.1097/MOO.0b013e328344b3ed CrossRefPubMed

Arens C, Betz C, Kraft M, Voigt-Zimmermann S (2017) Narrow band imaging for early diagnosis of epithelial dysplasia and microinvasive tumors in the upper aerodigestive tract. HNO 65(Suppl 1):5–12. https://doi.org/10.1007/s00106-016-0284-x CrossRefPubMed

Sun C, Han X, Li X, Zhang Y, Du X (2017) Diagnostic performance of narrow band imaging for laryngeal cancer: a systematic review and meta-analysis. Otolaryngol Head Neck Surg 156(4):589–597. https://doi.org/10.1177/0194599816685701 CrossRefPubMed

Zwakenberg MA, Dikkers FG, Wedman J, Halmos GB, van der Laan BFAM, Plaat BEC (2016) Narrow band imaging improves observer reliability in evaluation of upper aerodigestive tract lesions. Laryngoscope 126(10):2276–2281. https://doi.org/10.1002/lary.26008 CrossRefPubMed

Mehlum CS, Rosenberg T, Dyrvig AK, Groentved AM, Kjaergaard T, Godballe C (2018) Can the Ni classification of vessels predict neoplasia? A systematic review and meta-analysis. Laryngoscope 128(1):168–176CrossRefPubMed

10.

Barnes L, Eveson JW, Reichart PA, Sidransky D (2005) Pathology and genetics of head and neck tumours. World Health Organization classification of tumours. IARC Press, Lyon

11.

Watanabe A, Taniguchi M, Tsujie H, Hosokawa M, Fujita M, Sasaki S (2009) The value of narrow band imaging for early detection of laryngeal cancer. Eur Arch Otorhinolaryngol 266(7):1017–1023CrossRefPubMed

12.

Kraft M, Fostiropoulos K, Gurtler N, Arnoux A, Davaris N, Arens C (2016) Value of narrow band imaging in the early diagnosis of laryngeal cancer. Head neck 38(1):15–20. https://doi.org/10.1002/hed.23838 CrossRefPubMed

13.

Arens C, Piazza C, Andrea M, Dikkers FG, Tjon Pian Gi REA, Voigt-Zimmermann S, Peretti G (2016) Proposal for a descriptive guideline of vascular changes in lesions of the vocal folds by the committee on endoscopic laryngeal imaging of the European Laryngological Society. Eur Arch Otorhinolaryngol 273(5):1207–1214. https://doi.org/10.1007/s00405-015-3851-y CrossRefPubMed

14.

Davaris N, Voigt-Zimmermann S, Roessner A, Arens C (2017) Narrow band imaging for the evaluation of laryngeal mucosal lesions. HNO. German. https://doi.org/10.1007/s00106-017-0336-x

15.

Glas AS, Lijmer JG, Prins MH, Bonsel GJ, Bossuyt PM (2003) The diagnostic odds ratio: a single indicator of test performance. J Clin Epidemiol 56(11):1129–1135CrossRefPubMed

16.

Cohen J (1960) A coefficient of agreement for nominal scales. Educ Psychol Meas 20:37–60CrossRef

17.

Hallgren KA (2012) Computing inter-rater reliability for observational data. An overview and tutorial. Tutor Quant Methods Psychol 8 (1), 23–34CrossRefPubMedPubMedCentral

18.

Landis JR, Koch GG (1977) The measurement of observer agreement for categorical data. Biometrics 33(1):159–174CrossRefPubMed

19.

Ferlay J, Steliarova-Foucher E, Lortet-Tieulent J, Rosso S, Coebergh JWW, Comber H, Forman D, Bray F (2013) Cancer incidence and mortality patterns in Europe. Estimates for 40 countries in 2012. Eur J Cancer 49(6):1374–1403. https://doi.org/10.1016/j.ejca.2012.12.027 CrossRefPubMed

20.

Schultz P (2011) Vocal fold cancer. Eur Ann Otorhinolaryngol Head Neck Dis 128(6):301–308CrossRefPubMed

21.

Chatenoud L, Garavello W, Pagan E, Bertuccio P, Gallus S, La Vecchia C, Negri E, Bosetti C (2016) Laryngeal cancer mortality trends in European countries. Int J Cancer 15 138(4):833–842CrossRefPubMed

22.

Mannelli G, Cecconi L, Gallo O (2016) Laryngeal preneoplastic lesions and cancer. Challenging diagnosis. Qualitative literature review and meta-analysis. Crit Rev Oncol/Hematol 106:64–90. https://doi.org/10.1016/j.critrevonc.2016.07.004 CrossRef

23.

Piazza C, Cocco D, De Benedetto L, Del Bon F, Nicolai P, Peretti G (2010) Narrow band imaging and high definition television in the assessment of laryngeal cancer. A prospective study on 279 patients. Eur Arch Otorhinolaryngol 267(3):409–414. https://doi.org/10.1007/s00405-009-1121-6 CrossRefPubMed

24.

Parker NP (2017) Vocal fold leukoplakia: incidence, management, and prevention. Curr Opin Otolaryngol Head Neck Surg 25(6):464–468CrossRefPubMed

25.

Staníková L, Šatanková J, Kučová H, Walderová R, Zeleník K, Komínek P (2017) The role of narrow-band imaging (NBI) endoscopy in optical biopsy of vocal cord leukoplakia. Eur Arch Otorhinolaryngol 274(1):355–359. https://doi.org/10.1007/s00405-016-4244-6 CrossRefPubMed

26.

Sharma S, Sharma MC, Sarkar C (2005) Morphology of angiogenesis in human cancer. A conceptual overview, histoprognostic perspective and significance of neoangiogenesis. Histopathology 46(5):481–489. https://doi.org/10.1111/j.1365-2559.2005.02142.x CrossRefPubMed

27.

Hanahan D, Weinberg RA (2011) Hallmarks of cancer. The next generation. Cell 144(5):646–674. https://doi.org/10.1016/j.cell.2011.02.013 CrossRefPubMed

28.

Ni XG, He S, Xu ZG, Gao L, Lu N, Yuan Z, Lai SQ, Zhang YM, Yi JL, Wang XL, Zhang L, Li XY, Wang GQ (2011) Endoscopic diagnosis of laryngeal cancer and precancerous lesions by narrow band imaging. J Laryngol Otol 125(3):288–296. https://doi.org/10.1017/S0022215110002033 CrossRefPubMed

29.

Turkmen HI, Karsligil ME, Kocak I (2015) Classification of laryngeal disorders based on shape and vascular defects of vocal folds. Comput Biol Med 62:76–85. https://doi.org/10.1016/j.compbiomed.2015.02.001 CrossRef

30.

Barbalata C, Mattos LS (2016) Laryngeal tumor detection and classification in endoscopic video. IEEE J Biomed Health Inform 20(1):322–332. https://doi.org/10.1109/JBHI.2014.2374975 CrossRefPubMed

31.

Šifrer R, Rijken JA, Leemans CR, Eerenstein SEJ, van Weert S, Hendrickx JJ, Bloemena E, Heuveling DA, Rinkel RNPM (2018) Evaluation of vascular features of vocal cords proposed by the European Laryngological Society. Eur Arch Otorhinolaryngol 275(1):147–151CrossRefPubMed

32.

Tjon Pian Gi REA, Halmos GB, van Hemel BM, van den Heuvel ER, van der Laan BFAM, Plaat BEC, Dikkers FG (2012) Narrow band imaging is a new technique in visualization of recurrent respiratory papillomatosis. Laryngoscope 122(8):1826–1830. https://doi.org/10.1002/lary.23344 CrossRefPubMed

33.

Lukes P, Zabrodsky M, Lukesova E, Chovanec M, Astl J, Betka JA, Plzak J (2014) The role of NBI HDTV magnifying endoscopy in the prehistologic diagnosis of laryngeal papillomatosis and spinocellular cancer. BioMed Res Int 2014:285–486. https://doi.org/10.1155/2014/285486 CrossRef

34.

Dippold S, Nusseck M, Richter B, Echternach M (2017) The use of narrow band imaging for the detection of benign lesions of the larynx. Eur Arch Otorhinolaryngol 274(2):919–923. https://doi.org/10.1007/s00405-016-4300-2 CrossRefPubMed

35.

Zabrodsky M, Lukes P, Lukesova E, Boucek J, Plzak J (2014) The role of narrow band imaging in the detection of recurrent laryngeal and hypopharyngeal cancer after curative radiotherapy. BioMed Res Int 2014:175–398. https://doi.org/10.1155/2014/175398 CrossRef

36.

Klimza H, Jackowska J, Tokarski M, Piersiala K, Wierzbicka M (2017) Narrow-band imaging (NBI) for improving the assessment of vocal fold leukoplakia and overcoming the umbrella effect. PLoS One 12(6):e0180590. https://doi.org/10.1371/journal.pone.0180590 CrossRefPubMedPubMedCentral

37.

Bertino G, Cacciola S, Fernandes WB Jr, Fernandes CM, Occhin A, Tinelli C, Benazzo M (2015) Effectiveness of narrow band imaging in the detection of premalignant and malignant lesions of the larynx. Validation of a new endoscopic clinical classification. Head neck 37(2):215–222. https://doi.org/10.1002/hed.23582 CrossRefPubMed

38.

De Vito A, Meccariello G, Vicini C (2017) Narrow band imaging as screening test for early detection of laryngeal cancer. A prospective study. Clin Otolaryngol 42(2):347–353. https://doi.org/10.1111/coa.12728 CrossRefPubMed

39.

Nogués-Sabaté A, Aviles-Jurado FX, Ruiz-Sevilla L, Lehrer E, Santamaría-Gadea A, Valls-Mateus M, Vilaseca I (2018) Intra and interobserver agreement of narrow band imaging for the detection of head and neck tumors. Eur Arch Otorhinolaryngol 275(9):2349–2354. https://doi.org/10.1007/s00405-018-5063-8 CrossRefPubMed

40.

Shoffel-Havakuk H, Lahav Y, Meidan B, Haimovich Y, Warman M, Hain M, Hamzany Y, Brodsky A, Landau-Zemer T, Halperin D (2017) Does narrow band imaging improve preoperative detection of glottic malignancy? A matched comparison study. Laryngoscope 127(4):894–899. https://doi.org/10.1002/lary.26263 CrossRefPubMed

41.

Friedrich G, Dikkers FG, Arens C, Remacle M, Hess M, Giovanni A, Duflo S, Hantzakos A, Bachy V, Gugatschka M (2013) Vocal fold scars: current concepts and future directions. Consensus report of the Phonosurgery Committee of the European Laryngological Society. Eur Arch Otorhinolaryngol 270(9):2491–2507. https://doi.org/10.1007/s00405-013-2498-9 CrossRefPubMed

42.

Ni XG, Zhang QQ, Wang GQ (2016) Narrow band imaging versus autofluorescence imaging for head and neck squamous cell carcinoma detection: a prospective study. J Laryngol Otol 130(11):1001–1006CrossRefPubMed

43.

Davaris N, Voigt-Zimmermann S, Cyran AM, Arens C (2018) [Endoscopic early diagnosis of carcinomas in upper respiratory and digestive tract]. Laryngorhinootologie 97(4):276–286 (German)CrossRefPubMed

44.

Andrea M, Dias O, Santos A (1995) Contact endoscopy of the vocal cord: normal and pathological patterns. Acta Otolaryngol 115(2):314–316CrossRefPubMed

45.

Volgger V, Felicio A, Lohscheller J, Englhard AS, Al-Muzaini H, Betz CS, Schuster ME (2017) Evaluation of the combined use of narrow band imaging and high-speed imaging to discriminate laryngeal lesions. Lasers Surg Med 49(6):609–618CrossRefPubMed

46.

Yang Y, Fang J, Zhong Q, Xu W, Ma H, Feng L, Shi Q, Lian M, Wang R, Hou L (2018) The value of narrow band imaging combined with stroboscopy for the detection of applanate indiscernible early-stage vocal cord cancer. Acta Otolaryngol 138(4):400–406CrossRefPubMed

Title: Flexible transnasal endoscopy with white light or narrow band imaging for the diagnosis of laryngeal malignancy: diagnostic value, observer variability and influence of previous laryngeal surgery
Authors: Nikolaos Davaris
Susanne Voigt-Zimmermann
Siegfried Kropf
Christoph Arens
Publication date: 01-02-2019
Publisher: Springer Berlin Heidelberg
Published in: European Archives of Oto-Rhino-Laryngology / Issue 2/2019
Print ISSN: 0937-4477
Electronic ISSN: 1434-4726
DOI: https://doi.org/10.1007/s00405-018-5256-1

At a glance: The STEP trials

Springer Medicine

Flexible transnasal endoscopy with white light or narrow band imaging for the diagnosis of laryngeal malignancy: diagnostic value, observer variability and influence of previous laryngeal surgery

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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