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Oetter N, Pröll J, Sievert M, Goncalves M, Rohde M, Nobis CP, Knipfer C, Aubreville M, Pan Z, Breininger K, Maier A, Kesting M, Stelzle F. Oral mucosa - an examination map for confocal laser endomicroscopy within the oral cavity: an experimental clinical study. Clin Oral Investig 2024; 28:266. [PMID: 38652317 DOI: 10.1007/s00784-024-05664-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Accepted: 04/16/2024] [Indexed: 04/25/2024]
Abstract
OBJECTIVES Confocal laser endomicroscopy (CLE) is an optical method that enables microscopic visualization of oral mucosa. Previous studies have shown that it is possible to differentiate between physiological and malignant oral mucosa. However, differences in mucosal architecture were not taken into account. The objective was to map the different oral mucosal morphologies and to establish a "CLE map" of physiological mucosa as baseline for further application of this powerful technology. MATERIALS AND METHODS The CLE database consisted of 27 patients. The following spots were examined: (1) upper lip (intraoral) (2) alveolar ridge (3) lateral tongue (4) floor of the mouth (5) hard palate (6) intercalary line. All sequences were examined by two CLE experts for morphological differences and video quality. RESULTS Analysis revealed clear differences in image quality and possibility of depicting tissue morphologies between the various localizations of oral mucosa: imaging of the alveolar ridge and hard palate showed visually most discriminative tissue morphology. Labial mucosa was also visualized well using CLE. Here, typical morphological features such as uniform cells with regular intercellular gaps and vessels could be clearly depicted. Image generation and evaluation was particularly difficult in the area of the buccal mucosa, the lateral tongue and the floor of the mouth. CONCLUSION A physiological "CLE map" for the entire oral cavity could be created for the first time. CLINICAL RELEVANCE This will make it possible to take into account the existing physiological morphological features when differentiating between normal mucosa and oral squamous cell carcinoma in future work.
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Affiliation(s)
- Nicolai Oetter
- Department of Oral and Maxillofacial Surgery, Friedrich‑Alexander University Erlangen‑Nürnberg (FAU), University Hospital Erlangen, Glückstraße 11, 91054, Erlangen, Germany.
- SAOT‑Erlangen Graduate School in Advanced Optical Technologies, Friedrich‑Alexander University Erlangen‑Nürnberg (FAU), Paul Gordan Straße 6, 91052, Erlangen, Germany.
| | - Jonas Pröll
- Department of Oral and Maxillofacial Surgery, Friedrich‑Alexander University Erlangen‑Nürnberg (FAU), University Hospital Erlangen, Glückstraße 11, 91054, Erlangen, Germany
| | - Matti Sievert
- Department of Otorhinolaryngology, Head and Neck Surgery, Friedrich‑Alexander University Erlangen‑Nürnberg (FAU), University Hospital Erlangen, Waldstraße 1, 91054, Erlangen, Germany
| | - Miguel Goncalves
- Department of Otorhinolaryngology, Head and Neck Surgery, Julius-Maximilians University Würzburg, University Hospital Würzburg, Josef-Schneider-Straße 11, 97080, Würzburg, Germany
| | - Maximilian Rohde
- Department of Oral and Maxillofacial Surgery, Friedrich‑Alexander University Erlangen‑Nürnberg (FAU), University Hospital Erlangen, Glückstraße 11, 91054, Erlangen, Germany
- SAOT‑Erlangen Graduate School in Advanced Optical Technologies, Friedrich‑Alexander University Erlangen‑Nürnberg (FAU), Paul Gordan Straße 6, 91052, Erlangen, Germany
| | - Christopher-Philipp Nobis
- Department of Oral and Maxillofacial Surgery, Friedrich‑Alexander University Erlangen‑Nürnberg (FAU), University Hospital Erlangen, Glückstraße 11, 91054, Erlangen, Germany
| | - Christian Knipfer
- Department of Oral and Maxillofacial Surgery, University Hamburg, University Medical Center Hamburg- Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - Marc Aubreville
- Technische Hochschule Ingolstadt, Esplanade 10, 85049, Ingolstadt, Germany
| | - Zhaoya Pan
- Pattern Recognition Lab, Department of Computer Science, Friedrich‑Alexander University Erlangen‑Nürnberg (FAU), Martensstraße 3, 91058, Erlangen, Germany
| | - Katharina Breininger
- Department Artificial Intelligence in Biomedical Engineering, Friedrich‑Alexander University Erlangen‑Nürnberg (FAU), Henkestraße 91, 91052, Erlangen, Germany
| | - Andreas Maier
- Pattern Recognition Lab, Department of Computer Science, Friedrich‑Alexander University Erlangen‑Nürnberg (FAU), Martensstraße 3, 91058, Erlangen, Germany
| | - Marco Kesting
- Department of Oral and Maxillofacial Surgery, Friedrich‑Alexander University Erlangen‑Nürnberg (FAU), University Hospital Erlangen, Glückstraße 11, 91054, Erlangen, Germany
- SAOT‑Erlangen Graduate School in Advanced Optical Technologies, Friedrich‑Alexander University Erlangen‑Nürnberg (FAU), Paul Gordan Straße 6, 91052, Erlangen, Germany
| | - Florian Stelzle
- Department of Oral and Maxillofacial Surgery, Friedrich‑Alexander University Erlangen‑Nürnberg (FAU), University Hospital Erlangen, Glückstraße 11, 91054, Erlangen, Germany
- SAOT‑Erlangen Graduate School in Advanced Optical Technologies, Friedrich‑Alexander University Erlangen‑Nürnberg (FAU), Paul Gordan Straße 6, 91052, Erlangen, Germany
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Vaculová J, Kroupa R, Kala Z, Dolina J, Grolich T, Vlažný J, Said D, Izakovičová Hollá L, Bořilová Linhartová P, Procházka V, Joukal M, Jabandžiev P, Slabý O, Kunovský L. The Use of Confocal Laser Endomicroscopy in Diagnosing Barrett’s Esophagus and Esophageal Adenocarcinoma. Diagnostics (Basel) 2022; 12:1616. [PMID: 35885521 PMCID: PMC9317308 DOI: 10.3390/diagnostics12071616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 06/26/2022] [Accepted: 06/29/2022] [Indexed: 11/17/2022] Open
Abstract
Confocal laser endomicroscopy (CLE) is a diagnostic technique that enables real-time microscopic imaging during microscopic examination and evaluation of epithelial structures with 1000-fold magnification. CLE can be used in the diagnosis of various pathologies, in pneumology, and in urology, and it is very widely utilized in gastroenterology, most importantly in the diagnosis of Barrett’s esophagus (BE), esophageal adenocarcinoma (EAC), biliary strictures, and cystic pancreatic lesions. A literature search was made in MEDLINE/PubMed and Google Scholar databases while focusing on diagnostics using CLE of BE and EAC. We then examined randomized and observational studies, systematic reviews, and meta-analyses relating to the utilization of CLE in BE and EAC diagnostics. Here, we discuss whether CLE can be a suitable diagnostic method for surveillance of BE. Even though many studies have proven that CLE increases diagnostic accuracy in detecting neoplastic transformation of BE, CLE is still not used as a standard diagnostic tool in BE surveillance due to a deficiency of scientific evidence. More studies and data are needed if CLE is to find a place as a new technique in BE surveillance.
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