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Κυριακή 18 Ιουλίου 2021

Evaluation of Laryngeal Vascular Changes with Image1 S Enhancement System In Reference To The European Laryngological Society Guideline

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Abstract

Objectives

To assess the feasibility of using Image1 S™ endoscopic enhancement system for discrimination of the vascular patterns in laryngeal lesions.

Design

Forty patients presenting with benign, dysplastic and malignant laryngeal lesions were examined with Image1 S system. The vascular patterns were classified by a group of authors according to the European Laryngological Society (ELS) guideline, as perpendicular or longitudinal, in all lesions. The relationship between the vascular patterns and the pathological results was statistically analyzed. Endoscopic images of the lesions were evaluated through an online survey by a group of otolaryngologists with different levels of clinical expertise and asked them to choose a diagnosis and a vascular pattern. The vascular pattern evaluations of the participants were compared to the authors' evaluations to determine the inter observer reliability. The final diagnostic judgements of the participants were compared with the definitive histopathological diagnoses.

Results

Histopathological examination diagnosed 12 patients as benign, 12 dysplastic and 16 malignant. Using Image1 S, the vascular patterns were longitudinal in 11 lesions, perpendicular in 28 lesions and undetectable in 1 lesion. With white light, longitudinal pattern was observed in 14 lesions, perpendicular in 21 lesions and undetectable in 5 lesions. The correlation between the vascularization pattern and the pathological diagnosis was found to be significant (p < 0.001). The qualitative evaluation of the vascular patterns by the two groups of observers showed significant reliability (κ=0.63, p<0.001). The agreement with the final diagnoses were also significant (κ=0.56, p<0.001).

Conclusion

Image1 S endoscopic enhancement system with spectral modes provides an improved visibility of the vascular patterns defined by the ELS in laryngeal lesions. ELS classification can reliably distinguish benign lesions from suspected ones and can be applied even by less experienced clinicians but the final diagnosis needs experience and should be confirmed with histopathology.

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