共聚焦激光内镜的系统解释:喉和咽共聚焦成像评分。

Matti Sievert, Konstantinos Mantsopoulos, Sarina K Mueller, Markus Eckstein, Robin Rupp, Marc Aubreville, Florian Stelzle, Nicolai Oetter, Andreas Maier, Heinrich Iro, Miguel Goncalves
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引用次数: 6

摘要

目的:建立和验证一种用于喉部和咽部的共聚焦激光内镜(CLE)分类评分方法。方法:在2020年10月至2021年2月期间,将13例喉或咽SCC患者(154个视频序列,9240张图像)纳入这项前瞻性研究。每个CLE序列与组织病理学检查的金标准相关。基于94个视频序列(5640张图像)的数据集,开发了一个评分系统。在剩下的60个序列(3600张图像)中,由4名CLE专家和4名不熟悉CLE的头颈外科医生验证评分。结果:组织均匀性、细胞大小、边界和簇状、毛细血管袢和核/细胞质比被定义为评分标准。使用该评分,CLE专家的准确率、灵敏度和特异性分别为90.8%、95.1%和86.4%,CLE非专家的准确率、灵敏度和特异性分别为86.2%、86.4%和86.1%。观察者间一致Fleiss的kappa分别为0.8和0.6。结论:基于清晰、可重复的影像学特征,可对CLE进行可靠评估,具有较高的诊断价值。CLE可以很容易地融入术中环境,并生成实时的活体显微图像来区分恶性病变。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Systematic interpretation of confocal laser endomicroscopy: larynx and pharynx confocal imaging score.

Systematic interpretation of confocal laser endomicroscopy: larynx and pharynx confocal imaging score.

Systematic interpretation of confocal laser endomicroscopy: larynx and pharynx confocal imaging score.

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.

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