Current Intraoperative Imaging Techniques to Improve Surgical Resection of Laryngeal Cancer: A Systematic Review

Lorraine J Lauwerends, Hidde A Galema, José A U Hardillo, Aniel Sewnaik, Dominiek Monserez, Pieter B A A van Driel, Cornelis Verhoef, Robert J Baatenburg de Jong, Denise E Hilling, Stijn Keereweer

Research output: Contribution to journalReview articleAcademicpeer-review

27 Citations (Scopus)
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Abstract

Laryngeal cancer is a prevalent head and neck malignancy, with poor prognosis and low survival rates for patients with advanced disease. Treatment consists of unimodal therapy through surgery or radiotherapy in early staged tumors, while advanced stage tumors are generally treated with multimodal chemoradiotherapy or (total) laryngectomy followed by radiotherapy. Still, the recurrence rate for advanced laryngeal cancer is between 25 and 50%. In order to improve surgical resection of laryngeal cancer and reduce local recurrence rates, various intraoperative optical imaging techniques have been investigated. In this systematic review, we identify these technologies, evaluating the current state and future directions of optical imaging for this indication. Narrow-band imaging (NBI) and autofluorescence (AF) are established tools for early detection of laryngeal cancer. Nonetheless, their intraoperative utility is limited by an intrinsic inability to image beyond the (sub-)mucosa. Likewise, contact endoscopy (CE) and optical coherence tomography (OCT) are technically cumbersome and only useful for mucosal margin assessment. Research on fluorescence imaging (FLI) for this application is sparse, dealing solely with nonspecific fluorescent agents. Evidently, the imaging modalities that have been investigated thus far are generally unsuitable for deep margin assessment. We discuss two optical imaging techniques that can overcome these limitations and suggest how they can be used to achieve adequate margins in laryngeal cancer at all stages.

Original languageEnglish
Article number1895
JournalCancers
Volume13
Issue number8
DOIs
Publication statusPublished - 2 Apr 2021

Bibliographical note

Funding Information:
Funding: This research was funded by the Bas Mulder Award from the Dutch Cancer Society (12175) and the Daniel den Hoed Award from the Erasmus Medical Center Foundation.

Funding Information:
This research was funded by the Bas Mulder Award from the Dutch Cancer Society (12175) and the Daniel den Hoed Award from the Erasmus Medical Center Foundation. The authors wish to thank S. Meertens-Gunput from the Medical Library of the Erasmus Medical Center for developing and updating the search strategies.

Publisher Copyright:
© 2021 by the authors. Licensee MDPI, Basel, Switzerland.

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