Narrow Band Imaging Technology Research Articles

A Comprehensive Study on the Digestive Endoscopic Technique and Narrow-Band Imaging for Early Gastric Cancer Screening

Objective: To explore the implementation of gastrointestinal endoscopy technology and endoscopic narrow-band imaging (NBI) in the early screening of gastric cancer and to observe and study their application effects. Methods: During the period from March 2023 to August 2023, 312 patients who received gastroscopy in the Kunming Guandu District People’s Hospital were selected, and they underwent both conventional gastroscopy and endoscopic NBI, with clinicopathological tissue biopsy serving as the gold standard. The application value for early screening of gastric cancer was observed and analyzed. Results: The scoring data showed that the clarity of gastric mucosal glandular tube structure, microvascular structure clarity, and lesion contour scoring data of conventional gastroscopy were lower than those of the NBI technology (P < 0.05). The screening rate of pathological biopsy in 312 patients was 18.59% (58 cases). Conventional gastroscopy showed a screening rate of 11.53% (36 cases), while NBI technology examined a screening rate of 17.63% (55 cases), and the two-by-two comparison of the screening rate data of the three groups was not statistically significant (P > 0.05). The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of conventional gastroscopy appeared to be lower than those of NBI technology (P < 0.05). Conclusion: In the early screening of gastric cancer, endoscopic NBI technology can be applied to patients. Compared with conventional gastroscopy, it provides a clearer visualization of the structure of the gastric mucosal glandular structure and microvascular structure, with a certain screening rate. Additionally, its sensitivity, specificity, accuracy, positive predictive value, and negative predictive value are higher, demonstrating outstanding effectiveness.

Narrow Band Imaging Technology: Role in the Detection of Recurrent Laryngeal and Hypopharyngeal Cancers Post-radiotherapy.

To assess the diagnostic accuracy of NBI endoscopy for the diagnosis of early recurrent laryngeal and hypopharyngeal cancers after radiotherapy. The study was conducted over a period of two and a half years from June 2019 to February 2022 and included 123 post-RT patients with laryngeal and hypopharyngeal cancers. The patients were planned for endoscopy with white light and narrow-band imaging. The biopsy was carried out in NBI suspected lesions and sent for histopathological examination. The pathologist was blinded to the outcome of NBI and WLE results to eliminate observer bias. The age group most commonly affected in our study was 40-50 years. Out of the 123 patients, 106 were males and 17 were females. The overall Sensitivity, Specificity, Positive predictive value and Negative predictive value of NBI for malignant lesions were 90.6%, 99%, 95.2% and 98% respectively. NBI Technology is a first-rate diagnostic tool that can help in diagnosing early recurrent cancer lesions, especially after RT, in which the recurrence is otherwise difficult to differentiate from post-radiotherapy oedema. This technology can significantly reduce the rates of failure to detect cancers in early stages.

Diagnostic Value of Electron Laryngoscopy and Narrow-band Imaging Technology for Early Malignant Lesions of the Larynx

Diagnostic Value of Electron Laryngoscopy and Narrow-band Imaging Technology for Early Malignant Lesions of the Larynx

Diagnostic Value of Endoscopic Narrow-Band Imaging Technique in Early Gastric Cancer and Precancerous Lesions.

Objective To investigate the diagnostic value of endoscopic narrow-band imaging technique in early gastric cancer and precancerous lesions. Methods A total of 100 patients with recurrent upper gastrointestinal symptoms in our hospital from January 2017 to January 2022 were selected and divided into group A and group B according to the random number table method, with 50 cases in each group. Group A received white light endoscopy, and group B received narrow-band imaging technology combined with endoscopy. Narrow-band imaging combined with magnifying endoscopy was used to stain the area with suspicious mucosal lesions with indigo carmine and magnified observation. Results The endoscopic image clarity of group B was significantly better than that of group A in terms of lesion outline, gastric pit, and microvascular morphology (P < 0.05). There were 10 cases of early gastric cancer, 18 cases of benign lesions, and 9 cases of gastric cancer (nonearly stage); 17 cases of precancerous lesions, 12 cases of early gastric cancer, 13 cases of benign lesions, and 6 cases of gastric cancer (nonearly stage) were diagnosed by ordinary white light endoscopy. Pathological results confirmed that among the 50 patients in group B, there were 15 cases of precancerous lesions, 11 cases of early gastric cancer, 17 cases of benign lesions, and 7 cases of gastric cancer (nonearly stage). Among the 50 patients in group A, 16 were precancerous lesions, 11 were early gastric cancer, 15 were benign lesions, and 8 were gastric cancer (non early stage). In the diagnosis of precancerous lesions and early gastric cancer, the diagnostic consistency, sensitivity, and specificity of group B were better than those of group A (P < 0.05); NBI combined with endoscopy in the diagnosis of precancerous lesions and early gastric cancer (kappa = 0.860, kappa = 0.883) was more consistent with pathological diagnosis than common white light endoscopy (kappa = 0.433, kappa = 0.535). Conclusion The value of narrow-band imaging technology combined with endoscopy in the diagnosis of precancerous lesions and early gastric cancer is better than that of ordinary white light endoscopy, and it can be widely used in clinical practice.

Usefulness of artificial intelligence in gastric neoplasms.

Recently, studies in many medical fields have reported that image analysis based on artificial intelligence (AI) can be used to analyze structures or features that are difficult to identify with human eyes. To diagnose early gastric cancer, related efforts such as narrow-band imaging technology are on-going. However, diagnosis is often difficult. Therefore, a diagnostic method based on AI for endoscopic imaging was developed and its effectiveness was confirmed in many studies. The gastric cancer diagnostic program based on AI showed relatively high diagnostic accuracy and could differentially diagnose non-neoplastic lesions including benign gastric ulcers and dysplasia. An AI system has also been developed that helps to predict the invasion depth of gastric cancer through endoscopic images and observe the stomach during endoscopy without blind spots. Therefore, if AI is used in the field of endoscopy, it is expected to aid in the diagnosis of gastric neoplasms and determine the application of endoscopic therapy by predicting the invasion depth.

Role of Narrow Band Imaging Technology in the Diagnosis and Follow up of Laryngeal Lesions: Assessment of Diagnostic Accuracy and Reliability in a Large Patient Cohort.

Background: The aim of this study was to assess diagnostic accuracy and reliability of narrow band imaging (NBI) in the differential diagnosis of laryngeal premalignant lesion, early cancers and recurrences. Material and methods: We enrolled 231 patients who underwent endoscopic examination with white light endoscopy (WLE) + NBI and divided them into two groups, group A, without previous radiochemotherapy and group B, with previous radiochemotherapy. When indicated, we performed surgical biopsies to evaluate sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), accuracy and likelihood of endoscopic examination comparing WLE alone and WLE + NBI. Results: A positive NBI lesion, compared with a negative NBI lesion, had a 29.68 (group A) and 13.96 (group B) times higher probability to be histologically positive (i.e., confirmed) compared with WLE alone improving the diagnostic accuracy. In group A, the NBI mode showed excellent sensitivity (95.0%), which was higher than WLE 2 mode (77.5%). However, the greatest differences were recorded regarding specificity (96.8% vs. 40.6%). In group B, both NBI alone and WLE + NBI mode showed a 94.1% specificity compared with WLE alone, which had a maximum specificity of 85.3%. The mode comparison between NBI and WLE in both groups showed a statistically significant difference, with p-values <0.0001. Conclusions: NBI represents a reliable technology in challenging situations, especially in the context of post-radiotherapy or post-surgical mucosal changes showing a high NPV. NBI could reduce the number of unnecessary biopsies related to increased microvascular anomaly revelation, which could help to identify early-stage lesions suitable for minimally invasive surgery and, consequently, decrease hospital admissions.

Utility of Japan Narrow Band Imaging Expert Team Classification Using Narrow Band Imaging for Evaluation of Colonic Polyps

Abstract Background Narrow band imaging (NBI) is an advanced endoscopic imaging technique that enhances visualization of the mucosal surface and is used as a screening tool for colonic polyps. Its usefulness is currently explored to a lesser extent in India. So, we assessed the utility of Japan NBI Expert Team (JNET) classification for characterization of colorectal polyps. Methods A prospective observational study was performed from January 2018 to June 2019 of patients undergoing colonoscopy at a tertiary care hospital. NBI image of polyps was captured followed by either polypectomy/biopsy. Histopathology results were correlated with the pattern revealed by NBI on polyps using the JNET classification. Results A total of 80 patients, 61(76.25%) male with a mean (standard deviation [SD]) age of 58.41 ± 14.59 years were included. Out of the 90 lesions, 23 (25.5%) had type-1 pattern, 45 (50%) had 2A, 13 (14.4%) had 2B, and 9 (10%) had type-3 pattern. On histopathology, majority 51 (59.3%) were found to be adenomatous with low-grade intramucosal neoplasia. When correlating our results with JNET category type 1 and hyperplastic polyps, the sensitivity was 90%, specificity was 97%, negative predictive value was 97%, positive predictive value was 90%, and diagnostic accuracy was 96%. Correlating type 2A and low-grade intramucosal neoplasia had results of 78, 87, 76, 90, and 82%, respectively. Correlating type 2B and high-grade intramucosal neoplasia had results of 83, 90, 99, 38, and 90%, respectively. Correlating type 3 and deep submucosal cancer had results of 88, 98, 99, 78, and 97%, respectively. Conclusion NBI shows excellent probability to exclude carcinoma possibilities based on the changes in colonic mucosal features. Owing to slightly lower sensitivity for type 2B, it needs additional investigation using pit pattern diagnosis. We demonstrated the high-diagnostic performance of NBI in making an accurate diagnosis of early colorectal cancers in colonoscopy. Further refinement in the NBI technology might add to the current evidence for characterization of polyps.

Application of Narrow-Band Imaging thoracoscopy in diagnosis of pleural diseases

ABSTRACT Background Patients with undiagnostic pleural effusions are routinely examined by conventional medical thoracoscopy under the white light (WL). The endoscopic appearance of pleural diseases under WL could be misleading. Narrow-Band Imaging (NBI) has been applied as an interesting and effective diagnostic tool for endoscopy. However, there is also controversy about its value in the application of thoracoscopy. Objective The objective of this study was to investigate the diagnostic value of NBI technology during thoracoscopy. Methods Patients with undiagnosed pleural effusions admitted to our hospital between September 2017 and September 2019 were enrolled. During the thoracoscopy, we performed WL mode first and then NBI. Pictures of endoscopic real-time lesions were recorded under two modes, and at least five pieces of tissue were taken, respectively, on pleura lesions. Biopsy specimens were respectively taken for pathologic analysis. Diagnostic sensitivity, specificity were calculated to compare with pathologic results. Results 100 eligible patients were enrolled, including 63 with malignancy, 23 with tuberculous pleurisy, 3 with systemic disease and 11 with the negative condition. Compared with pathological results, the sensitivity of WL was 91.01%, and NBI 84.27%; while the specificity of WL was 27.27%, and NBI 81.82%. Compared NBI with WL, the former’s specificity is superior to the latter’s, which is statistically significant (P < 0.05). Conclusions The advantage of NBI lies in its high specificity. It’s useful to diagnose unknown pleural effusions in clinical practice. With better visualization of blood vessels, we can enhance the accuracy of biopsy and reduce the risk of unexpected bleeding arose from the biopsy.

Narrow Band Imaging for lingual tonsil hypertrophy and inflammation, in laryngo-pharyngeal reflux disease.

The objective of this study is to analyse the relationship between the endoscopic signs of laryngo-pharyngeal reflux, the lingual tonsil hypertrophy (LTH) and its inflammation, adopting Narrow Band Imaging (NBI) technology. We enrolled, as cases, patients with clinical diagnosis of laryngopharyngeal reflux disease (LPRD), a Reflux Symptom Index (RSI) ≥ 13, and a Reflux Finding Score (RFS) ≥ 7. Controls were enrolled among patients who underwent the same transnasal endoscopy, equipped with NBI, with a RSI < 13 and a RFS < 7. Nasopharynx, Lingual Tonsils (LT), Hypopharynx and Larynx were evaluated by two experienced otolaryngologists, who calculated the Reflux Finding Scale (RFS) score and focused their attention on the base of the tongue, observing its surface with NBI technology. 82 patients with diagnosis of laryngopharyngeal reflux were enrolled as cases. Mean RFS was 11.7 (SD = 2.9). As controls, we enrolled 80 patients. Mean RFS was 2.7 (SD = 1.63). We found that RFS positivity was associated with a significant increase in LT dimension (2.5 vs 1.1, p < 0.001), with a higher LT crypt inflammation grading (1.8 vs 0.09, p < 0.001) and with a higher Roman Cobblestone pattern grading (1.48 vs 0.11, p < 0.001). A significant correlation between the crypt inflammation and the hyperemia subscore of RFS was present (r = 0.696, p < 0.0001), while it was not possible to find a correlation between crypt inflammation and either diffuse laryngeal edema (r = 0.166, p = 0.135) and posterior commissure hypertrophy (r = 0.089, p = 0.427). NBI allowed us to identify endoscopically the presence of enlarged lingual tonsil, crypt inflammation and superficial mucosal changes, in patients affected by LPRD. 2 (prospective, case-control study).

Use OF NBI for the assessment of clinical signs of rhino-pharyngo-laryngeal reflux in pediatric age: Preliminary results

ObjectivesLaryngopharyngeal reflux (LPR) is a complex problem in pediatric population: diagnosis and clinical presentation are still controversial.Classic white light endoscopy shows some pathognomonic signs of LPR in children, such as thickening of pharyngo-laryngeal mucus, the cobblestoning aspect of pharyngeal mucosa, arytenoid edema/hyperemia, nodular thickening/true vocal cord edema, hypertrophy of the posterior commissure, subglottic edema.The NBI (Narrow Band Imaging) technology, generally used in oncology, allows to study neoangiogenesis and hypervascularization of the mucosa, common aspects in both chronic inflammation and neoplastic transformation. The aim of our study was to evaluate the added value of this technology in identifying the main laryngopharyngeal reflux sign in a pediatric population. MethodsWe evaluated at the Otolaryngology Unit of the “Fondazione Policlinico A. Gemelli” hospital and the Airway Surgery Unit of the “Bambino Gesù” Children's Hospital 35 patients aged from 2 months to 16 years divided into two groups in the period between November 2017 and May 2018. Group A included patients with clinical suspicion of LPR after gastroenterologist evaluation and Group B included patients who underwent an endoscopic evaluation for the assessment of recurrent respiratory symptoms such as stridor, recurrent croup, wheezing and persistent cough. We performed an endoscopic evaluation by white light and NBI for each patient, comparing the results of both methods to evaluate signs of pharyngo-laryngeal reflux and to calculate the value of reflux finding score (RFS). ResultsThe analysis of the data showed: for Group A an average value of RFS with white light of 11,84 (range 8–17, standard deviation 2,52 ± 0,57) and with NBI of 13,63 (range 10–17, standard deviation 2,13 ± 0,49); for Group B the analysis of the data showed an average value of RFS with white light of 10,06 (range 8–14, standard deviation 2,32 ± 0,58) and with NBI of 12,50 (range 9–18, standard deviation 2,63 ± 0,65). The comparison between the two methods resulted significant.Furthermore evaluation by NBI allowed to highlight other signs of pharyngo-laryngeal reflux, characteristic of pediatric age and not included in RFS, in particular cobblestone aspect of the hypopharingeal mucosa, phlogosis of the tonsillar crypts and adenoid surface, hyperemia and hypervascularization of subglottic and tracheal mucosa. ConclusionAlthough still preliminary our results represent an interesting starting point for further studies, because they underline the potentiality of NBI endoscopy in LPR evaluation and how this technology could improve the identification of reflux signs.

A novel integrated platform for the identification of surgical margins in oral squamous cell carcinoma: results from a prospective single-institution series

BackgroundThe optimal surgical margins assessment is capital in oral squamous cell carcinoma (OSCC) management. We evaluated the clinical benefits of integrating intraoperative macroscopic margin (MM) assessment and narrow band imaging (NBI).MethodsSixteen OSCC patients eligible for surgery were prospectively enrolled. For each patient, 2 to 6 bioptic samples of MM and NBI margins were obtained and histologically analyzed for the presence of dysplasia and lymphocytes. Microvessel density was investigated by CD34 immunohistochemistry.ResultsTaken together, 104 specimens were analyzed, including 15% tumors, 33% MM, 33% NBI margins, and 19% MM-NBI overlapping margins. The NBI margins were closer to the lesion in 50% cases, while the same number of MM were more conservative than NBI, irrespective of the tumor site. The rate of histologically positive margins was similar among the two methods, akin to the microvessel density.ConclusionsMM assessment should be integrated but not replaced with the NBI technology to allow for more conservative surgery.

Effect of narrow-band imaging (NBI) combined with magnifying endoscopy in early diagnosis of gastric cancer

Objective To explore the effect of narrow-band imaging (NBI) combined with magnifying endoscopy (ME) in early diagnosis of gastric cancer, and to observe whether it is helpful for inexperienced endoscopists to diagnose. Methods From April 2015 to October 2017, a total of 480 lesions were selected as research objects which were detected in the normal white light endoscopy (WLE). Pathological examination was used as the gold standard for diagnosis. 3 experienced doctors were selected to read the endoscopy films. 40 intern endoscopy doctors were selected to read the endoscopy filins at the same time after simple training. 80 WLE images and narrowband imaging technology combined with magnifying endoscopy (ME-NBI) images were randomly selected to hold a film reading meeting. Real-time voting was used to judge the nature of lesions. Results The accuracy, sensitivity, specificity false positive rate and false negative rate of ME-NBI were 97.9%(470/480), 96.8%(120/124), 98.3%(350/356), 1.7%(6/356), 3.2%(4/124). And WLE values were 91.7%(440/480), 80.6%(100/124), 89.9%(320/356), 10.1%(36/356), 19.4%(24/124), respectively. The diagnostic accuracy, sensitivity and specificity of ME-NBI were significantly higher than those of WLE (χ2=18.989, 16.104, 15.859, P<0.05), and the false positive rate and false negative rate were significantly lower than those of WLE (χ2=22.772, 16.104, P<0.05). The diagnostic results of ME-NBI of 40 endoscopy interns were significantly better than those of WLE (t=11.467, 16.188, P<0.05). The diagnostic results of NBI by 40 interns were significantly better than that of WLE (t=11.467, 16.188, P<0.05). Conclusions The accuracy of ME-NBI in screening early gastric cancer is satisfactory, and it has certain diagnostic value for inexperienced doctors. Key words: Stomach neoplasms; Early detection of cancer; Gastroscopy

Application of narrow band imaging in laryngeal tumor

Objective:To explore the application of narrow band imaging(NBI) technology in laryngeal tumor.Method:From Appril 2014 to Otober 2016, three hundred and twenty-two patients with suspected laryngeal cancer or precancerous lesions were enrolled in the First Central Hospital of Tianjin. Each patient was examined by electronic nasopharyngolaryngoscope under white light and NBI model. The sensitivity, specificity and accuracy of laryngeal tumor diagnosis under white light mode and NBI mode was compared based on pathological results. Result:The sensitivity, specificity and accuracy of white light mode in laryngeal tumor diagnosis were 77.17%,62.07% and 74.36%, respectively whereas the NBI model were 92.91%,77.59% and 90.06%, respectively.The sensitivity and accuracy of NBI model in laryngeal tumor diagnosis were significantly higer than white light model(P<0.05),but not the specificity. Conclusion:The electronic nasopharyngolaryngoscope of NBI technology not only found early lesions of laryngeal cancer, but also can improve the sensitivity and accuracy of laryngeal tumor diagnosis.

Narrow Band Imaging as an Efficient and Economical Tool in Diagnosing Colorectal Polyps.

Narrow Band Imaging as an Efficient and Economical Tool in Diagnosing Colorectal Polyps.

NBI: results review.

The narrow band imaging (NBI) is a new technology introduced to complement the traditional endoscopy in order to enhance the detection of nonmuscle-invasive bladder cancer and, consequently, to improve the management of the disease. In this review, we considered the most important studies about the use of NBI in the diagnosis and treatment of bladder cancer. Current results demonstrate a greater sensitivity in the diagnosis of bladder cancer and especially a better negative predictive value of cystoscopy enhanced by NBI technology than white light standard cystoscopy. Similarly, improving the performance of endoscopic resection, this new technology would have a positive therapeutic impact in order to decrease residual tumors and relapses. The validation of the results and diffusion of NBI in clinical practice may provide new perspectives in the management of nonmuscle-invasive bladder cancer.

Improving the Diagnosis of Upper Urinary Tract Tumors: Narrow Band Imaging Technology

Abstract Introduction: Diagnosis flexible ureteroscopy becomes a routine procedure.1 However, identifying characteristics suggestive for the malignant nature of a lesion, and consequently the indication for biopsy is difficult. In this regard, the relatively new narrow band imaging (NBI) technology allows a better detection.2 Purpose: To determine the value of digital flexible ureteroscopy combined with NBI in upper urinary tract pathology diagnosis. Materials and Methods: Between January 2010- September 2012, 64 white light and NBI digital flexible ureteroscopic procedures were performed in the Department of Urology of St. John Emergency Clinical Hospital, which were divided in two groups. Group I (50 cases) included patients in which, the procedures were performed for upper urinary tract filling defects (20 cases), unilateral hematuria (19 cases), and abnormal urinary cytology (11 cases). The second group (14 procedures in seven cases) included follow-up cases with conservatively treated upper urinary t...

A comparative study of narrow-band imaging amplification and chromoendoscopy magnifying in diagnosis of colorectal cancer and its precancerous

Objective To compare differential diagnostic value of narrowband imaging （NBI） mag nifying endoscopy and magnifying chromoendoscopy. Methods A total of 92 lesions from 75 patients were examined with conventional colonoscopy, NBI magnifying endoscopy and magnifying chromoendoscopy to e valuate pit patterns and vascular morphology patterns. Endoscopic findings were compared with the pathologi cal results. Results The detection rate of conventional endoscopy, NBI magnifying endoscopy and magnif ying chromoendoscopy were 94.6% （87/92）, 97.8% （90/92）and 100.0% （92/92）, respectively. NBI magnifying endoscopy was superior to the magnifying chromoendoscopy （ P = 0. 000） in the the lesion contour and microvessels pattern detection, but there was no difference in the pit patterns detected with the two tech niques （P = 0. 394）. Consistency, sensitivity, and specificity of NBI magnifying endoscopy in diagnosis of colorectal neoplastic lesions were 91.3% （84/92）, 83.9% （26/31）, 95.1% （58/61）, respectively, while these variables of magnifying chromoendoscopy were 89. 1% （82/92）, 80. 6% （25/31）, 93.4% （57/61）, which were not statistically significant （ P 〉 0.05）. Conclusion Differential diagnostic value of NBI magnifying endoscopy and magnifying chromoendoscopy for colorectal neoplastic and nonneoplastic le sions was similar, but NBI magnifying endoscopy displays the lesion contours and microvessels clearlier, and is easy to manipulate. Key words: Colorectal cancer; Diagnosis; Narrow-band imaging technology; Staining amplification technology

Endoscopic Detection of Early Esophageal Squamous Cell Carcinoma in Patients with Achalasia: Narrow-Band Imaging versus Lugol's Staining

Chromoendoscopy with Lugol's staining remains the gold standard technique for detecting superficial SCC. An alternative technique, such as narrow-band imaging (NBI), for “optical staining” would be desirable, since NBI is a simpler technique and has no known complications. In this study, we compare NBI without magnification and chromoendoscopy with Lugol's staining for detecting high-grade dysplasia and intramucosal esophageal squamous cell carcinoma (SCC) in patients with achalasia. This was a prospective observational study of 43 patients with achalasia referred to the Gastrointestinal Endoscopy Unit of the Hospital of Clinics, São Paulo, University Medical School, Brazil, from October 2006 to February 2007. Conventional examinations with white light, NBI, and Lugol staining were consecutively performed, and the suspected lesions were mapped, recorded, and sent for biopsy. The results of the three methods were compared regarding sensitivity, specificity, accuracy, positive predictive value, negative predictive value, positive likelihood value, and negative likelihood value. Of the 43 patients, one was diagnosed with esophageal squamous cell carcinoma, and it was detected by all of the methods. NBI technology without magnification has high sensitivity and negative predictive value for detecting superficial esophageal squamous cell carcinoma, and it has comparable results with those obtained with Lugol's staining.

Narrow band imaging diagnosis of bladder cancer: systematic review and meta‐analysis

What's known on the subject? and What does the study add? In recent years, more attention has focused on the role of narrow band imaging (NBI) in bladder cancer detection and NBI technology has spread rapidly. It is an important method for diagnosing new or recurrent bladder cancer. But its diagnostic accuracy is still uncertain. This paper summarizes the diagnostic accuracy of NBI in bladder cancer and compares NBI with white light imaging. The results show that NBI cystoscopy significantly improves the detection accuracy in bladder cancer, compared with white light imaging. However, some limitations still exist. Multicentre randomized studies are recommended to determine whether the visual advantages of NBI can translate into real therapeutic benefit for individual patients. • To assess the test performance and clinical effectiveness of narrow band imaging (NBI) cystoscopy compared with white light imaging (WLI) cystoscopy in people suspected of new or recurrent bladder cancer. • Literature on NBI cystoscopy in the diagnosis of bladder cancer was searched in PubMed, EMBASE, Cochrane Library, MEDLINE and CNKI, with hand searching of relevant congress abstracts and journals. • The literature was selected according to inclusion and exclusion criteria. The Meta-DiSc1.4 software was used to review management and analysis. • Eight studies including 1022 patients assessed test performance. • On a per-person analysis, the pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and diagnostic odds ratio of NBI and WLI were respectively 0.943 (95% CI 0.914-0.964) and 0.848 (95% CI 0.803-0.885), 0.847 (95% CI 0.812-0.878) and 0.870 (95% CI 0.831-0.903), 7.038 (95% CI 3.357-14.754) and 6.938 (95% CI 2.052-23.465), 0.054 (95% CI 0.012-0.237) and 0.181 (95% CI 0.091-0.361), and 185.32 (95% CI 45.714-751.26) and 42.931 (95% CI 8.088-227.88). • The area under the curve and Q* of NBI and WLI were respectively 0.9781 and 0.8944, and 0.9337 and 0.8253. • For the characterization of carcinoma in situ, the pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and diagnostic odds ratio of NBI were 0.927 (95% CI 0.878-0.960), 0.768 (95% CI 0.730-0.802), 4.545 (95% CI 2.820-7.325), 0.125 (95% CI 0.051-0.304) and 48.884 (95% CI 15.642-152.77) on a per-person analysis. • The area under the curve and Q* were 0.9391 and 0.8763. • NBI is an effective method for the identification of abnormal lesions including carcinoma in situ and can provide higher diagnostic precision of bladder cancer than WLI.

Surgical Treatment of Laryngeal Papillomatosis Using Narrow Band Imaging

Laryngeal papillomatosis has a high rate of recurrence after surgery. Narrow band imaging (NBI) is a novel optical enhancement technology used for the diagnosis. This is the first report to date to indicate the availability of the combination of laryngomicro surgery and videoendoscopic surgery for laryngeal papillomatosis using NBI technology. The patients were a 34-year-old man and a 30-year-old man. Both patients underwent surgery in another hospital. However, due to recurrence, they were subsequently referred to the authors' department for further evaluation. The presence of papillomas was confirmed by NBI, and the papillomas were removed using an XPS Micro Debrider and a CO2 laser. Using the NBI system, the border between the normal mucosa and the papillomas could be clearly identified, allowing precise resection. Further treatment on the lesions has been carried out several times to date using NBI. The lesions have now been eradicated without further recurrence.