High specificity of combined narrow band imaging and autofluorescence mucosal assessment of patients with head and neck cancer

Background The purpose of this study was to evaluate combined autofluorescence (AF) and narrow band imaging (NBI) for detection of mucosal lesions additional to known primary head and neck cancers and to determine impact on management. Methods Patients with head and neck cancer requiring preoperative screening or posttreatment surveillance had white light (WL), AF and NBI inspection of the head and neck and bronchus. Known primary cancers were not analyzed, only additional lesions. Moderate dysplasia or worse was considered significant. Results In all, 73 patients were recruited. Respectively, there were 24 and 18 additional lesions in the head and neck and bronchus that had significant histopathology. In both regions, AF and NBI were more sensitive than WL for detecting significant dysplasia with NBI demonstrating better specificity than AF (p =.003); 11 of 73 patients (15.1%) had additional findings detected by AF and NBI, which had an impact on management. Conclusion Combined AF and NBI inspection is highly specific at panendoscopy and can influence management. © 2012 Wiley Periodicals, Inc. Head Neck, 201

Fluorescence investigations to classify malignant laryngeal lesions in vivo

BACKGROUND:: The extent of surgical resection for malignant laryngeal lesions influences voice quality. An instrument to estimate histopathologic grading of dysplasia in vivo may spare normal tissue without increasing the risk of local failure. METHODS: Laryngeal lesions (N = 39; 21 after administration of delta-aminolevulinic acid (ALA)) were investigated with laser-induced fluorescence, and the results correlated to histopathologic grading in 4 groups: non/mild dysplasia (I), moderate dysplasia (II), severe dysplasia/cancer in situ (III), and carcinoma. RESULTS: At 337-nm excitation, there were differences in the fluorescence ratio I(431)/I(390) between groups I/III and carcinoma. Following 405-nm excitation, I(500 nm) group I differed significantly from group III and cancer. The sensitivity for the fluorescence method was 89%, and the specificity was 100%. CONCLUSIONS: There are differences in the in vivo tissue fluorescence between tissue with different gradings of dysplasia and carcinoma. (c) 2007 Wiley Periodicals, Inc. Head Neck, 2008