Interobserver agreement of confocal laser endomicroscopy for detection of head and neck neoplasia

Charles Moore, Vikas Mehta, Xiaohui Ma, Shabnum Chaudhery, Runhua Shi, Tara Moore-Medlin, Timothy Lian, Cherie Ann O Nathan

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Objectives/Hypothesis We have described the feasibility of using the probe-based confocal laser endomicroscopy (pCLE) in differentiating benign from malignant lesions of the head and neck. Therefore, we wanted to determine the interobserver agreement of pCLE offline images of noncancerous, precancerous, and cancerous lesions of the head and neck. Study Design Single tertiary referral center. Methods In the feasibility study, image criteria for nondysplasia, dysplasia, and cancer were defined. The pCLE was performed before lesions were biopsied. Fifty offline images and 10 videos of good quality were selected. Seven surgeons and one pathologist were asked to review and categorize the images into the three categories above. The overall accuracy of 29 offline pCLE images and six videos were compared with histopathology. Interobserver agreement and accuracy kappa (κ) scores were measured with 95% confidence intervals (CI). Results There were six nondysplasia, seven dysplasia, and 11 squamous cell carcinoma (SCCA) cases, each with multiple images. There was substantial agreement between the eight reviewers on the pCLE images and videos (κ = 0.66; 95% CI 0.51-0.82 and κ = 0.71; 95% CI 0.42-0.97, respectively). The overall agreement with the final histopathology was also substantial for both the images and video sequences (κ = 0.70; 95% CI 0.50-0.88 and κ = 0.73; 95% CI 0.39-1.00, respectively). Conclusion The ability to differentiate normal mucosa, dysplasia, and invasive SCCA using pCLE with high accuracy and reliability was demonstrated. This technology has the potential to decrease sampling error of lesions in the head and neck. This is the first study to test the reliability of this technology in mucosal lesions of the head and neck. Level of Evidence NA. Laryngoscope, 126:632-637, 2016

Original languageEnglish (US)
Pages (from-to)632-637
Number of pages6
JournalLaryngoscope
Volume126
Issue number3
DOIs
StatePublished - Mar 1 2016
Externally publishedYes

Fingerprint

Lasers
Neck
Head
Confidence Intervals
Neoplasms
Squamous Cell Carcinoma
Technology
Laryngoscopes
Selection Bias
Feasibility Studies
Tertiary Care Centers
Mucous Membrane

Keywords

  • Head and neck
  • larynx
  • oral cavity

ASJC Scopus subject areas

  • Otorhinolaryngology
  • Medicine(all)

Cite this

Moore, C., Mehta, V., Ma, X., Chaudhery, S., Shi, R., Moore-Medlin, T., ... Nathan, C. A. O. (2016). Interobserver agreement of confocal laser endomicroscopy for detection of head and neck neoplasia. Laryngoscope, 126(3), 632-637. https://doi.org/10.1002/lary.25646

Interobserver agreement of confocal laser endomicroscopy for detection of head and neck neoplasia. / Moore, Charles; Mehta, Vikas; Ma, Xiaohui; Chaudhery, Shabnum; Shi, Runhua; Moore-Medlin, Tara; Lian, Timothy; Nathan, Cherie Ann O.

In: Laryngoscope, Vol. 126, No. 3, 01.03.2016, p. 632-637.

Research output: Contribution to journalArticle

Moore, C, Mehta, V, Ma, X, Chaudhery, S, Shi, R, Moore-Medlin, T, Lian, T & Nathan, CAO 2016, 'Interobserver agreement of confocal laser endomicroscopy for detection of head and neck neoplasia', Laryngoscope, vol. 126, no. 3, pp. 632-637. https://doi.org/10.1002/lary.25646
Moore, Charles ; Mehta, Vikas ; Ma, Xiaohui ; Chaudhery, Shabnum ; Shi, Runhua ; Moore-Medlin, Tara ; Lian, Timothy ; Nathan, Cherie Ann O. / Interobserver agreement of confocal laser endomicroscopy for detection of head and neck neoplasia. In: Laryngoscope. 2016 ; Vol. 126, No. 3. pp. 632-637.
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abstract = "Objectives/Hypothesis We have described the feasibility of using the probe-based confocal laser endomicroscopy (pCLE) in differentiating benign from malignant lesions of the head and neck. Therefore, we wanted to determine the interobserver agreement of pCLE offline images of noncancerous, precancerous, and cancerous lesions of the head and neck. Study Design Single tertiary referral center. Methods In the feasibility study, image criteria for nondysplasia, dysplasia, and cancer were defined. The pCLE was performed before lesions were biopsied. Fifty offline images and 10 videos of good quality were selected. Seven surgeons and one pathologist were asked to review and categorize the images into the three categories above. The overall accuracy of 29 offline pCLE images and six videos were compared with histopathology. Interobserver agreement and accuracy kappa (κ) scores were measured with 95{\%} confidence intervals (CI). Results There were six nondysplasia, seven dysplasia, and 11 squamous cell carcinoma (SCCA) cases, each with multiple images. There was substantial agreement between the eight reviewers on the pCLE images and videos (κ = 0.66; 95{\%} CI 0.51-0.82 and κ = 0.71; 95{\%} CI 0.42-0.97, respectively). The overall agreement with the final histopathology was also substantial for both the images and video sequences (κ = 0.70; 95{\%} CI 0.50-0.88 and κ = 0.73; 95{\%} CI 0.39-1.00, respectively). Conclusion The ability to differentiate normal mucosa, dysplasia, and invasive SCCA using pCLE with high accuracy and reliability was demonstrated. This technology has the potential to decrease sampling error of lesions in the head and neck. This is the first study to test the reliability of this technology in mucosal lesions of the head and neck. Level of Evidence NA. Laryngoscope, 126:632-637, 2016",
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AU - Moore-Medlin, Tara

AU - Lian, Timothy

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N2 - Objectives/Hypothesis We have described the feasibility of using the probe-based confocal laser endomicroscopy (pCLE) in differentiating benign from malignant lesions of the head and neck. Therefore, we wanted to determine the interobserver agreement of pCLE offline images of noncancerous, precancerous, and cancerous lesions of the head and neck. Study Design Single tertiary referral center. Methods In the feasibility study, image criteria for nondysplasia, dysplasia, and cancer were defined. The pCLE was performed before lesions were biopsied. Fifty offline images and 10 videos of good quality were selected. Seven surgeons and one pathologist were asked to review and categorize the images into the three categories above. The overall accuracy of 29 offline pCLE images and six videos were compared with histopathology. Interobserver agreement and accuracy kappa (κ) scores were measured with 95% confidence intervals (CI). Results There were six nondysplasia, seven dysplasia, and 11 squamous cell carcinoma (SCCA) cases, each with multiple images. There was substantial agreement between the eight reviewers on the pCLE images and videos (κ = 0.66; 95% CI 0.51-0.82 and κ = 0.71; 95% CI 0.42-0.97, respectively). The overall agreement with the final histopathology was also substantial for both the images and video sequences (κ = 0.70; 95% CI 0.50-0.88 and κ = 0.73; 95% CI 0.39-1.00, respectively). Conclusion The ability to differentiate normal mucosa, dysplasia, and invasive SCCA using pCLE with high accuracy and reliability was demonstrated. This technology has the potential to decrease sampling error of lesions in the head and neck. This is the first study to test the reliability of this technology in mucosal lesions of the head and neck. Level of Evidence NA. Laryngoscope, 126:632-637, 2016

AB - Objectives/Hypothesis We have described the feasibility of using the probe-based confocal laser endomicroscopy (pCLE) in differentiating benign from malignant lesions of the head and neck. Therefore, we wanted to determine the interobserver agreement of pCLE offline images of noncancerous, precancerous, and cancerous lesions of the head and neck. Study Design Single tertiary referral center. Methods In the feasibility study, image criteria for nondysplasia, dysplasia, and cancer were defined. The pCLE was performed before lesions were biopsied. Fifty offline images and 10 videos of good quality were selected. Seven surgeons and one pathologist were asked to review and categorize the images into the three categories above. The overall accuracy of 29 offline pCLE images and six videos were compared with histopathology. Interobserver agreement and accuracy kappa (κ) scores were measured with 95% confidence intervals (CI). Results There were six nondysplasia, seven dysplasia, and 11 squamous cell carcinoma (SCCA) cases, each with multiple images. There was substantial agreement between the eight reviewers on the pCLE images and videos (κ = 0.66; 95% CI 0.51-0.82 and κ = 0.71; 95% CI 0.42-0.97, respectively). The overall agreement with the final histopathology was also substantial for both the images and video sequences (κ = 0.70; 95% CI 0.50-0.88 and κ = 0.73; 95% CI 0.39-1.00, respectively). Conclusion The ability to differentiate normal mucosa, dysplasia, and invasive SCCA using pCLE with high accuracy and reliability was demonstrated. This technology has the potential to decrease sampling error of lesions in the head and neck. This is the first study to test the reliability of this technology in mucosal lesions of the head and neck. Level of Evidence NA. Laryngoscope, 126:632-637, 2016

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