{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T18:32:13Z","timestamp":1778610733316,"version":"3.51.4"},"reference-count":24,"publisher":"MDPI AG","issue":"14","license":[{"start":{"date-parts":[[2020,7,19]],"date-time":"2020-07-19T00:00:00Z","timestamp":1595116800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Sensors"],"abstract":"<jats:p>Longitudinal and perpendicular changes in the vocal fold\u2019s blood vessels are associated with the development of benign and malignant laryngeal lesions. The combination of Contact Endoscopy (CE) and Narrow Band Imaging (NBI) can provide intraoperative real-time visualization of the vascular changes in the laryngeal mucosa. However, the visual evaluation of vascular patterns in CE-NBI images is challenging and highly depends on the clinicians\u2019 experience. The current study aims to evaluate and compare the performance of a manual and an automatic approach for laryngeal lesion\u2019s classification based on vascular patterns in CE-NBI images. In the manual approach, six observers visually evaluated a series of CE+NBI images that belong to a patient and then classified the patient as benign or malignant. For the automatic classification, an algorithm based on characterizing the level of the vessel\u2019s disorder in combination with four supervised classifiers was used to classify CE-NBI images. The results showed that the manual approach\u2019s subjective evaluation could be reduced by using a computer-based approach. Moreover, the automatic approach showed the potential to work as an assistant system in case of disagreements among clinicians and to reduce the manual approach\u2019s misclassification issue.<\/jats:p>","DOI":"10.3390\/s20144018","type":"journal-article","created":{"date-parts":[[2020,7,20]],"date-time":"2020-07-20T10:59:38Z","timestamp":1595242778000},"page":"4018","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Laryngeal Lesion Classification Based on Vascular Patterns in Contact Endoscopy and Narrow Band Imaging: Manual Versus Automatic Approach"],"prefix":"10.3390","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9741-9788","authenticated-orcid":false,"given":"Nazila","family":"Esmaeili","sequence":"first","affiliation":[{"name":"INKA-Application Driven Research, Otto-von-Guericke University Magdeburg, 39120 Magdeburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0118-0483","authenticated-orcid":false,"given":"Alfredo","family":"Illanes","sequence":"additional","affiliation":[{"name":"INKA-Application Driven Research, Otto-von-Guericke University Magdeburg, 39120 Magdeburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5874-7145","authenticated-orcid":false,"given":"Axel","family":"Boese","sequence":"additional","affiliation":[{"name":"INKA-Application Driven Research, Otto-von-Guericke University Magdeburg, 39120 Magdeburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0283-9216","authenticated-orcid":false,"given":"Nikolaos","family":"Davaris","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Head and Neck Surgery, Magdeburg University Hospital, 39120 Magdeburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8072-1438","authenticated-orcid":false,"given":"Christoph","family":"Arens","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Head and Neck Surgery, Magdeburg University Hospital, 39120 Magdeburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nassir","family":"Navab","sequence":"additional","affiliation":[{"name":"Chair for Computer Aided Medical Procedures and Augmented Reality, Technical University Munich, 85748 Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8624-0800","authenticated-orcid":false,"given":"Michael","family":"Friebe","sequence":"additional","affiliation":[{"name":"INKA-Application Driven Research, Otto-von-Guericke University Magdeburg, 39120 Magdeburg, Germany"},{"name":"IDTM GmbH, 45657 Recklinghausen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2020,7,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"7","DOI":"10.3322\/caac.21590","article-title":"Cancer statistics, 2020","volume":"70","author":"Siegel","year":"2020","journal-title":"CA Cancer J. Clin."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1002\/hed.24862","article-title":"AHNS Series: Do you know your guidelines? Review of current knowledge on laryngeal cancer","volume":"40","author":"Tamaki","year":"2018","journal-title":"Head Neck"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"288","DOI":"10.1017\/S0022215110002033","article-title":"Endoscopic diagnosis of laryngeal cancer and precancerous lesions by narrow band imaging","volume":"125","author":"Ni","year":"2011","journal-title":"J. Laryngol. Otol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1600","DOI":"10.1002\/lary.25124","article-title":"Enhanced contact endoscopy for the detection of neoangiogenesis in tumors of the larynx and hypopharynx","volume":"125","author":"Puxeddu","year":"2015","journal-title":"Laryngoscope"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1207","DOI":"10.1007\/s00405-015-3851-y","article-title":"Proposal for a descriptive guideline of vascular changes in lesions of the vocal folds by the committee on endoscopic laryngeal imaging of the European Laryngological Society","volume":"273","author":"Arens","year":"2016","journal-title":"Eur. Arch. Otorhinolaryngol."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Mehlum, C.S., D\u00f8ssing, H., Davaris, N., Giers, A., Gr\u00f8ntved, \u00c5.M., Kjaergaard, T., M\u00f6ller, S., Godballe, C., and Arens, C. (2020). Interrater variation of vascular classifications used in enhanced laryngeal contact endoscopy. Eur. Arch. Otorhinolaryngol., 1\u20138.","DOI":"10.1007\/s00405-020-06000-z"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"589","DOI":"10.1177\/0194599816685701","article-title":"Diagnostic performance of narrow band imaging for laryngeal cancer: A systematic review and meta-analysis","volume":"156","author":"Sun","year":"2017","journal-title":"Otolaryngol. Head Neck Surg."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1177\/000348949510400501","article-title":"Contact endoscopy during microlaryngeal surgery: A new technique for endoscopic examination of the larynx","volume":"104","author":"Andrea","year":"1995","journal-title":"Ann. Otol. Rhinol. Laryngol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1177\/000348940311200203","article-title":"Compact endoscopy of the larynx","volume":"112","author":"Arens","year":"2003","journal-title":"Ann. Otol. Rhinol. Laryngol."},{"key":"ref_10","first-page":"70","article-title":"Narrow band imaging and high definition television in the endoscopic evaluation of upper aero-digestive tract cancer","volume":"31","author":"Piazza","year":"2011","journal-title":"Acta Otorhinolaryngol. Ital."},{"key":"ref_11","first-page":"150","article-title":"Contact endoscopy of the vocal folds in combination with narrow band imaging (compact endoscopy)","volume":"94","author":"Arens","year":"2015","journal-title":"Laryngo-Rhino-Otologie"},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Davaris, N., Lux, A., Esmaeili, N., Illanes, A., Boese, A., Friebe, M., and Arens, C. (2020). Evaluation of vascular patterns using contact endoscopy and narrow-band imaging (CE-NBI) for the diagnosis of vocal fold malignancy. Cancers, 12.","DOI":"10.3390\/cancers12010248"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1007\/s00405-017-4791-5","article-title":"Evaluation of vascular features of vocal cords proposed by the European Laryngological Society","volume":"275","author":"Rijken","year":"2018","journal-title":"Eur. Arch. Otorhinolaryngol."},{"key":"ref_14","first-page":"1","article-title":"The diagnostic value of perpendicular vascular patterns of vocal cords defined by narrow-band imaging","volume":"277","author":"Gale","year":"2020","journal-title":"Eur. Arch. Otorhinolaryngol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1016\/j.critrevonc.2016.07.004","article-title":"Laryngeal preneoplastic lesions and cancer: Challenging diagnosis. Qualitative literature review and meta-analysis","volume":"106","author":"Mannelli","year":"2016","journal-title":"Crit. Rev. Oncol."},{"key":"ref_16","unstructured":"Puxeddu, R., Carta, F., Ferreli, C., Chuchueva, N., and Gerosa, C. (2018). Enhanced Contact Endoscopy (ECE) in Head and Neck Surgery, Endo-Press."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Esmaeili, N., Illanes, A., Boese, A., Davaris, N., Arens, C., and Friebe, M. (2019, January 23\u201327). A Preliminary Study on Automatic Characterization and Classification of Vascular Patterns of Contact Endoscopy Images. Proceedings of the 2019 41st Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC), Berlin, Germany.","DOI":"10.1109\/EMBC.2019.8857145"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1751","DOI":"10.1007\/s11548-019-02034-9","article-title":"Novel automated vessel pattern characterization of larynx contact endoscopic video images","volume":"14","author":"Esmaeili","year":"2019","journal-title":"Int. J. Comput. Assist. Radiol. Surg."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"E91","DOI":"10.1002\/lary.27813","article-title":"Regarding Laryngeal precursor lesions: Interrater and intrarater reliability of histopathological assessment","volume":"129","author":"Gale","year":"2019","journal-title":"Laryngoscope"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1515\/cdbme-2018-0019","article-title":"Vascular pattern detection and recognition in endoscopic imaging of the vocal folds","volume":"4","author":"Boese","year":"2018","journal-title":"Curr. Dir. Biomed. Eng."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"2107","DOI":"10.1109\/TMI.2016.2550102","article-title":"Enhancement of vascular structures in 3D and 2D angiographic images","volume":"35","author":"Jerman","year":"2016","journal-title":"IEEE Trans. Med. Imaging"},{"key":"ref_22","unstructured":"Hsu, C.W., Chang, C.C., and Lin, C.J. (2003). A Practical Guide to Support Vector Classification, National Taiwan University."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1883","DOI":"10.4249\/scholarpedia.1883","article-title":"K-nearest neighbor","volume":"4","author":"Peterson","year":"2009","journal-title":"Scholarpedia"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1023\/A:1010933404324","article-title":"Random forests","volume":"45","author":"Breiman","year":"2001","journal-title":"Mach. Learn."}],"container-title":["Sensors"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1424-8220\/20\/14\/4018\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T09:49:51Z","timestamp":1760176191000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1424-8220\/20\/14\/4018"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,7,19]]},"references-count":24,"journal-issue":{"issue":"14","published-online":{"date-parts":[[2020,7]]}},"alternative-id":["s20144018"],"URL":"https:\/\/doi.org\/10.3390\/s20144018","relation":{},"ISSN":["1424-8220"],"issn-type":[{"value":"1424-8220","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,7,19]]}}}