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Noninvasive histological imaging of head and neck squamous cell carcinomas using confocal laser endomicroscopy

  • Head and Neck
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Abstract

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.

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Acknowledgments

We thank Samira Daali, Mehreen Javed, Ulrike Bechtel and Monika Hoffmann for their excellent technical assistance. This study was supported by a HOMFORexzellent grant to M.L. and by Siemens AG.

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Authors and Affiliations

  1. Department of Otorhinolaryngology, Head and Neck Surgery, Saarland University Medical Center, Kirrbergerstr. 100, building 6, 66421, Homburg/Saar, Germany

    Maximilian Linxweiler, Basel Al Kadah, Alessandro Bozzato, Victoria Bozzato & Bernhard Schick

  2. Department of General and Surgical Pathology, Saarland University Medical Center, Kirrbergerstr. 100, 66421, Homburg/Saar, Germany

    Andrea Hasenfus, Yoo-Jin Kim & Mathias Wagner

  3. Department of Neurosurgery, Merheim Hospital, Ostmerheimerstr. 200, 51109, Cologne, Germany

    Alhadi Igressa & Patra Charalampaki

  4. Department of Neurosurgery, University Hospital Düsseldorf, Moorenstr. 5, 40255, Düsseldorf, Germany

    Patra Charalampaki

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  1. Maximilian Linxweiler
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  2. Basel Al Kadah
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  3. Alessandro Bozzato
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  4. Victoria Bozzato
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  10. Patra Charalampaki
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Correspondence to Maximilian Linxweiler.

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Conflicts of interest

This study was funded by a HOMFOR grant to M.L. and Siemens AG. Both sponsors had no influence on the study design, the collection, analysis and interpretation of data, writing of the report, and the decision to submit the article for publication.

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All procedures performed in this study were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Linxweiler, M., Kadah, B.A., Bozzato, A. et al. Noninvasive histological imaging of head and neck squamous cell carcinomas using confocal laser endomicroscopy. Eur Arch Otorhinolaryngol 273, 4473–4483 (2016). https://doi.org/10.1007/s00405-016-4145-8

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