{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T07:56:32Z","timestamp":1783065392147,"version":"3.54.6"},"reference-count":46,"publisher":"MDPI AG","issue":"14","license":[{"start":{"date-parts":[[2023,7,22]],"date-time":"2023-07-22T00:00:00Z","timestamp":1689984000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Medical University of Lodz"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>The aim of the study was to utilize a quantitative assessment of the vibratory characteristics of vocal folds in diagnosing benign and malignant lesions of the glottis using high-speed videolaryngoscopy (HSV). Methods: Case-control study including 100 patients with unilateral vocal fold lesions in comparison to 38 normophonic subjects. Quantitative assessment with the determination of vocal fold oscillation parameters was performed based on HSV kymography. Machine-learning predictive models were developed and validated. Results: All calculated parameters differed significantly between healthy subjects and patients with organic lesions. The first predictive model distinguishing any organic lesion patients from healthy subjects reached an area under the curve (AUC) equal to 0.983 and presented with 89.3% accuracy, 97.0% sensitivity, and 71.4% specificity on the testing set. The second model identifying malignancy among organic lesions reached an AUC equal to 0.85 and presented with 80.6% accuracy, 100% sensitivity, and 71.1% specificity on the training set. Important predictive factors for the models were frequency perturbation measures. Conclusions: The standard protocol for distinguishing between benign and malignant lesions continues to be clinical evaluation by an experienced ENT specialist and confirmed by histopathological examination. Our findings did suggest that advanced machine learning models, which consider the complex interactions present in HSV data, could potentially indicate a heightened risk of malignancy. Therefore, this technology could prove pivotal in aiding in early cancer detection, thereby emphasizing the need for further investigation and validation.<\/jats:p>","DOI":"10.3390\/cancers15143716","type":"journal-article","created":{"date-parts":[[2023,7,24]],"date-time":"2023-07-24T01:12:28Z","timestamp":1690161148000},"page":"3716","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["High-Speed Videoendoscopy Enhances the Objective Assessment of Glottic Organic Lesions: A Case-Control Study with Multivariable Data-Mining Model Development"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4942-3413","authenticated-orcid":false,"given":"Jakub","family":"Malinowski","sequence":"first","affiliation":[{"name":"Department of Otolaryngology, Head and Neck Oncology, Medical University of Lodz, 90-419 Lodz, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5109-3911","authenticated-orcid":false,"given":"Wioletta","family":"Pietruszewska","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Head and Neck Oncology, Medical University of Lodz, 90-419 Lodz, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6550-3384","authenticated-orcid":false,"given":"Konrad","family":"Stawiski","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA 02115, USA"},{"name":"Department of Biostatistics and Translational Medicine, Medical University of Lodz, 90-419 Lodz, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6284-9865","authenticated-orcid":false,"given":"Magdalena","family":"Pietrzak","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Head and Neck Oncology, Medical University of Lodz, 90-419 Lodz, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2674-9197","authenticated-orcid":false,"given":"Magda","family":"Bara\u0144ska","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Head and Neck Oncology, Medical University of Lodz, 90-419 Lodz, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aleksander","family":"Rycerz","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Translational Medicine, Medical University of Lodz, 90-419 Lodz, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ewa","family":"Niebudek-Bogusz","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Head and Neck Oncology, Medical University of Lodz, 90-419 Lodz, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,7,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"439","DOI":"10.1097\/MOO.0000000000000584","article-title":"Occupational Voice Is a Work in Progress: Active Risk Management, Habilitation and Rehabilitation","volume":"27","author":"Phyland","year":"2019","journal-title":"Curr. Opin. Otolaryngol. Head. Neck Surg."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1159\/000452127","article-title":"Factors Involved in Vocal Fatigue: A Pilot Study","volume":"68","author":"Behlau","year":"2016","journal-title":"Folia Phoniatr. Et. Logop."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"am Zehnhoff-Dinnesen, A., Wiskirska-Woznica, B., Neumann, K., and Nawka, T. (2020). Principles of Physiology and Biomechanics of Voice: Aerodynamics of Voice. Phoniatrics I Fundamentals\u2014Voice Disorders\u2014Disorders of Language and Hearing Development, Springer.","DOI":"10.1007\/978-3-662-46780-0"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1016\/j.jvoice.2013.02.001","article-title":"Objective Measures of Laryngeal Imaging: What Have We Learned Since Dr. Paul Moore","volume":"28","author":"Woo","year":"2014","journal-title":"J. Voice"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"73","DOI":"10.3109\/14015439.2016.1174293","article-title":"Quantitative Assessment of Videolaryngostroboscopic Images in Patients with Glottic Pathologies","volume":"42","author":"Kopczynski","year":"2017","journal-title":"Logop. Phoniatr. Vocol"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1097\/01.mlg.0000157830.38627.85","article-title":"Stroboscopy as a Research Instrument: Development of a Perceptual Evaluation Tool","volume":"115","author":"Rosen","year":"2005","journal-title":"Laryngoscope"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1007\/s004050000299","article-title":"A Basic Protocol for Functional Assessment of Voice Pathology, Especially for Investigating the Efficacy of (Phonosurgical) Treatments and Evaluating New Assessment Techniques","volume":"258","author":"Dejonckere","year":"2001","journal-title":"Eur. Arch. Oto-Rhino-Laryngol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"513.e1","DOI":"10.1016\/j.jvoice.2016.12.003","article-title":"Voice-Vibratory Assessment with Laryngeal Imaging (VALI) Form: Reliability of Rating Stroboscopy and High-Speed Videoendoscopy","volume":"31","author":"Poburka","year":"2017","journal-title":"J. Voice"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1085","DOI":"10.1007\/s00106-005-1285-3","article-title":"High Speed Glottographic Diagnostics in Laryngology","volume":"53","author":"Schade","year":"2005","journal-title":"HNO"},{"key":"ref_10","unstructured":"Chao, S., and Song, S.A. (2022). Videostroboscopy. StatPearls, StatPearls Publishing."},{"key":"ref_11","first-page":"25","article-title":"Objective Measures of Stroboscopy and High-Speed Video","volume":"85","author":"Woo","year":"2020","journal-title":"Adv. Otorhinolaryngol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1016\/j.jvoice.2017.05.002","article-title":"Utility of Laryngeal High-Speed Videoendoscopy in Clinical Voice Assessment","volume":"32","author":"Zacharias","year":"2018","journal-title":"J. Voice"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1016\/j.bspc.2014.11.007","article-title":"Experimental Investigation on Minimum Frame Rate Requirements of High-Speed Videoendoscopy for Clinical Voice Assessment","volume":"17","author":"Deliyski","year":"2015","journal-title":"Biomed. Signal Process Control"},{"key":"ref_14","first-page":"4575437","article-title":"Laryngeal High-Speed Videoendoscopy: Sensitivity of Objective Parameters towards Recording Frame Rate","volume":"2016","author":"Kunduk","year":"2016","journal-title":"Biomed. Res. Int."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"636","DOI":"10.1016\/j.jvoice.2019.12.005","article-title":"Analysis Method for Laryngeal High-Speed Videoendoscopy: Development of the Criteria for the Measurement Input","volume":"35","author":"Ahmad","year":"2021","journal-title":"J. Voice"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1177\/000348941112000104","article-title":"Differential Vibratory Characteristics of Adductor Spasmodic Dysphonia and Muscle Tension Dysphonia on High-Speed Digital Imaging","volume":"120","author":"Patel","year":"2011","journal-title":"Ann. Otol. Rhinol. Laryngol."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Warhurst, S., McCabe, P., Heard, R., Yiu, E., Wang, G., and Madill, C. (2014). Quantitative Measurement of Vocal Fold Vibration in Male Radio Performers and Healthy Controls Using High-Speed Videoendoscopy. PLoS ONE, 9.","DOI":"10.1371\/journal.pone.0101128"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"769","DOI":"10.1016\/j.jvoice.2019.03.012","article-title":"Efficacy of Videostroboscopy and High-Speed Videoendoscopy to Obtain Functional Outcomes From Perioperative Ratings in Patients with Vocal Fold Mass Lesions","volume":"34","author":"Powell","year":"2020","journal-title":"J. Voice"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1148","DOI":"10.1044\/2014_JSLHR-S-12-0076","article-title":"Spatiotemporal Analysis of High-Speed Videolaryngoscopic Imaging of Organic Pathologies in Males","volume":"57","author":"Bohr","year":"2014","journal-title":"J. Speech Lang. Hear. Res."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"282","DOI":"10.1016\/j.jvoice.2016.09.026","article-title":"High-Speed Videolaryngoscopy: Quantitative Parameters of Glottal Area Waveforms and High-Speed Kymography in Healthy Individuals","volume":"31","author":"Tsutsumi","year":"2017","journal-title":"J. Voice"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1007\/s00405-011-1780-y","article-title":"Quantitative Analysis of Videokymography in Normal and Pathological Vocal Folds: A Preliminary Study","volume":"269","author":"Piazza","year":"2012","journal-title":"Eur. Arch. Oto-Rhino-Laryngol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1016\/j.jvoice.2015.04.016","article-title":"Quantification of Vocal Fold Vibration in Various Laryngeal Disorders Using High-Speed Digital Imaging","volume":"30","author":"Yamauchi","year":"2016","journal-title":"J. Voice"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"576","DOI":"10.1044\/2016_AJSLP-15-0050","article-title":"Comparison of Videostroboscopy to Stroboscopy Derived from High-Speed Videoendoscopy for Evaluating Patients with Vocal Fold Mass Lesions","volume":"25","author":"Powell","year":"2016","journal-title":"Am. J. Speech Lang. Pathol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"256.e1","DOI":"10.1016\/j.jvoice.2017.05.014","article-title":"Temporal Segmentation for Laryngeal High-Speed Videoendoscopy in Connected Speech","volume":"32","author":"Naghibolhosseini","year":"2018","journal-title":"J. Voice"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1","DOI":"10.5604\/01.3001.0015.2575","article-title":"Laryngeal High-Speed Videoendoscopy with Laser Illumination: A Preliminary Report","volume":"75","author":"Malinowski","year":"2021","journal-title":"Otolaryngol. Pol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"20480","DOI":"10.1038\/s41598-021-99948-9","article-title":"Comparative Analysis of High-Speed Videolaryngoscopy Images and Sound Data Simultaneously Acquired from Rigid and Flexible Laryngoscope: A Pilot Study","volume":"11","author":"Pietruszewska","year":"2021","journal-title":"Sci. Rep."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Fehling, M.K., Grosch, F., Schuster, M.E., Schick, B., and Lohscheller, J. (2020). Fully Automatic Segmentation of Glottis and Vocal Folds in Endoscopic Laryngeal High-Speed Videos Using a Deep Convolutional LSTM Network. PLoS ONE, 15.","DOI":"10.1371\/journal.pone.0227791"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"182","DOI":"10.3109\/14015439.2012.731083","article-title":"Vocal Fold Vibration Amplitude, Open Quotient, Speed Quotient and Their Variability along Glottal Length: Kymographic Data from Normal Subjects","volume":"38","author":"Lohscheller","year":"2013","journal-title":"Logop. Phoniatr. Vocol."},{"key":"ref_29","unstructured":"Ma, E., and You, E. (2011). Videokymographic Examination of Voice. Handbook of Voice Assessments, Plural Publishing."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1686","DOI":"10.1002\/lary.23783","article-title":"Quantitative Analysis of Organic Vocal Fold Pathologies in Females by High-Speed Endoscopy","volume":"123","author":"Bohr","year":"2013","journal-title":"Laryngoscope"},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Stawiski, K., Kaszkowiak, M., Mikulski, D., Hogendorf, P., Durczy\u0144ski, A., Strzelczyk, J., Chowdhury, D., and Fendler, W. (2022). OmicSelector: Automatic Feature Selection and Deep Learning Modeling for Omic Experiments. bioRxiv.","DOI":"10.1101\/2022.06.01.494299"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1013","DOI":"10.1007\/s10822-020-00314-0","article-title":"Interpretation of Machine Learning Models Using Shapley Values: Application to Compound Potency and Multi-Target Activity Predictions","volume":"34","author":"Bajorath","year":"2020","journal-title":"J. Comput. Aided Mol. Des."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1889","DOI":"10.1044\/2021_JSLHR-20-00498","article-title":"A Deep Learning Enhanced Novel Software Tool for Laryngeal Dynamics Analysis","volume":"64","author":"Kist","year":"2021","journal-title":"J. Speech Lang. Hear. Res."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"13760","DOI":"10.1038\/s41598-021-93149-0","article-title":"OpenHSV: An Open Platform for Laryngeal High-Speed Videoendoscopy","volume":"11","author":"Kist","year":"2021","journal-title":"Sci. Rep."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"441","DOI":"10.1177\/000348940010900501","article-title":"Glottal Area Waveform Analysis of Benign Vocal Fold Lesions before and after Surgery","volume":"109","author":"Noordzij","year":"2000","journal-title":"Ann. Otol. Rhinol. Laryngol."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Yamauchi, A., Imagawa, H., Yokonishi, H., Sakakibara, K.-I., and Tayama, N. (2021). Multivariate Analysis of Vocal Fold Vibrations on Various Voice Disorders Using High-Speed Digital Imaging. Appl. Sci., 11.","DOI":"10.3390\/app11146284"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"743","DOI":"10.1044\/2013_JSLHR-S-12-0202","article-title":"Objective Quantification of Pre- and Postphonosurgery Vocal Fold Vibratory Characteristics Using High-Speed Videoendoscopy and a Harmonic Waveform Model","volume":"57","author":"Ikuma","year":"2014","journal-title":"J. Speech Lang. Hear. Res."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1119","DOI":"10.1007\/s00405-020-06433-6","article-title":"High-Speed Videolaryngoscopy in Early Glottic Carcinoma Patients Following Transoral CO2 LASER Cordectomy","volume":"278","author":"Gandhi","year":"2021","journal-title":"Eur. Arch. Oto-Rhino-Laryngol."},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Andrade-Miranda, G., Stylianou, Y., Deliyski, D.D., Godino-Llorente, J.I., and Henrich Bernardoni, N. (2020). Laryngeal Image Processing of Vocal Folds Motion. Appl. Sci., 10.","DOI":"10.3390\/app10051556"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"10517","DOI":"10.1038\/s41598-020-66405-y","article-title":"Machine Learning Based Identification of Relevant Parameters for Functional Voice Disorders Derived from Endoscopic High-Speed Recordings","volume":"10","author":"Schlegel","year":"2020","journal-title":"Sci. Rep."},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Dem\u0161ar, J., and Zupan, B. (2021). Hands-on Training about Overfitting. PLoS Comput. Biol., 17.","DOI":"10.1371\/journal.pcbi.1008671"},{"key":"ref_42","first-page":"84","article-title":"Tabular Data: Deep Learning Is Not All You Need","volume":"81","author":"Armon","year":"2021","journal-title":"Inf. Fusion"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"688969","DOI":"10.3389\/fdata.2021.688969","article-title":"Principles and Practice of Explainable Machine Learning","volume":"4","author":"Belle","year":"2021","journal-title":"Front. Big Data"},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Kaluza, J., Niebudek-Bogusz, E., Malinowski, J., Strumillo, P., and Pietruszewska, W. (2022). Assessment of Vocal Fold Stiffness by Means of High-Speed Videolaryngoscopy with Laryngotopography in Prediction of Early Glottic Malignancy: Preliminary Report. Cancers, 14.","DOI":"10.3390\/cancers14194697"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"37","DOI":"10.5604\/01.3001.0015.9501","article-title":"Endoluminal Larynx Anatomy Model\u2014towards Facilitating Deep Learning and Defining Standards for Medical Images Evaluation with Artificial Intelligence Algorithms","volume":"76","author":"Nogal","year":"2022","journal-title":"Otolaryngol. Pol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"298","DOI":"10.3389\/fonc.2018.00298","article-title":"Single Stage Transoral Laser Microsurgery for Early Glottic Cancer","volume":"8","author":"Hamzany","year":"2018","journal-title":"Front. Oncol."}],"container-title":["Cancers"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6694\/15\/14\/3716\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T20:16:56Z","timestamp":1760127416000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6694\/15\/14\/3716"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,7,22]]},"references-count":46,"journal-issue":{"issue":"14","published-online":{"date-parts":[[2023,7]]}},"alternative-id":["cancers15143716"],"URL":"https:\/\/doi.org\/10.3390\/cancers15143716","relation":{},"ISSN":["2072-6694"],"issn-type":[{"value":"2072-6694","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,7,22]]}}}