| Discrimination of benign and neoplastic mucosa with a high-resolution microendoscope (HRME) in head and neck cancer. | |
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MedLine Citation:
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PMID: 22492225 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: The efficacy of ablative surgery for head and neck squamous cell carcinoma (HNSCC) depends critically on obtaining negative margins. Although intraoperative "frozen section" analysis of margins is a valuable adjunct, it is expensive, time-consuming, and highly dependent on pathologist expertise. Optical imaging has potential to improve the accuracy of margins by identifying cancerous tissue in real time. Our goal was to determine the accuracy and inter-rater reliability of head and neck cancer specialists using high-resolution microendoscopic (HRME) images to discriminate between cancerous and benign mucosa. METHODS: Thirty-eight patients diagnosed with head and neck squamous cell carcinoma (HNSCC) were enrolled in this single-center study. HRME was used to image each specimen after application of proflavine, with concurrent standard histopathologic analysis. Images were evaluated for quality control, and a training set containing representative images of benign and neoplastic tissue was assembled. After viewing training images, seven head and neck cancer specialists with no previous HRME experience reviewed 36 test images and were asked to classify each. RESULTS: The mean accuracy of all reviewers in correctly diagnosing neoplastic mucosa was 97% (95% confidence interval (CI), 94-99%). The mean sensitivity and specificity were 98% (97-100%) and 92% (87-98%), respectively. The Fleiss kappa statistic for inter-rater reliability was 0.84 (0.77-0.91). CONCLUSIONS: Medical professionals can be quickly trained to use HRME to discriminate between benign and neoplastic mucosa in the head and neck. With further development, the HRME shows promise as a method of real-time margin determination at the point of care. |
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Authors:
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Peter M Vila; Chan W Park; Mark C Pierce; Gregg H Goldstein; Lauren Levy; Vivek V Gurudutt; Alexandros D Polydorides; James H Godbold; Marita S Teng; Eric M Genden; Brett A Miles; Sharmila Anandasabapathy; Ann M Gillenwater; Rebecca Richards-Kortum; Andrew G Sikora |
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Publication Detail:
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Type: Clinical Trial; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't Date: 2012-04-11 |
Journal Detail:
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Title: Annals of surgical oncology Volume: 19 ISSN: 1534-4681 ISO Abbreviation: Ann. Surg. Oncol. Publication Date: 2012 Oct |
Date Detail:
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Created Date: 2012-09-14 Completed Date: 2013-04-03 Revised Date: 2013-04-16 |
Medline Journal Info:
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Nlm Unique ID: 9420840 Medline TA: Ann Surg Oncol Country: United States |
Other Details:
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Languages: eng Pagination: 3534-9 Citation Subset: IM |
Affiliation:
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Department of Otolaryngology-Head and Neck Surgery, Mount Sinai School of Medicine, New York, NY, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Carcinoma, Squamous Cell
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pathology* Endoscopes* Endoscopy Fiber Optic Technology Fluorescent Dyes / diagnostic use Head and Neck Neoplasms / pathology* Humans Image Enhancement / instrumentation* Microscopy / instrumentation Mucous Membrane / pathology* Observer Variation Predictive Value of Tests Proflavine / diagnostic use Sensitivity and Specificity Single-Blind Method |
| Grant Support | |
ID/Acronym/Agency:
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2R01CA103830-06A1/CA/NCI NIH HHS; R01 CA103830/CA/NCI NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Fluorescent Dyes; 92-62-6/Proflavine |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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