Value Of Narrow Band Imaging Research Articles

Evaluating hypopharyngeal carcinoma using narrow band imaging and oxygen-injected laryngoscope: New technique

ObjectiveTo evaluate the diagnostic value of narrow band imaging (NBI) endoscopic classification for hypopharyngeal lesions and to lay the groundwork for practical applications of oxygen-injected laryngoscope for hypopharyngeal carcinoma (HC). MethodsA total of 140 subjects with suspected 146 hypopharyngeal lesions were selected for pathological examination. Subsequently, NBI and white light imaging (WLI) endoscopy were performed to observe and classify lesions into 7 types according to our modified NBI classification. Pathological results were used as the gold standard to assess the diagnostic value of the NBI classification. The value of oxygen-injected laryngoscope for accurate assessment of lesion extension was evaluated based on the exposure of hypopharyngeal lesions before and after use. ResultsThe accuracy, sensitivity, and negative predictive value of NBI endoscopy in diagnosing hypopharyngeal lesions were 95.9 %, 96.7 %, and 84.6 %, respectively, which were higher than those of WLI mode (p < 0.05). NBI endoscopy was more accurate than WLI in diagnosing malignant lesions (p < 0.05), especially for high-grade dysplasia (HGD) (p < 0.05). There was remarkable consistency between NBI classification and pathological results (Kappa = 0.855). Type Va and type Vb-c accounted for 72.7 % and 92.8 % of HGD and invasive carcinoma, respectively. Moreover, the oxygen-injected laryngoscope was found to provide a more accurate assessment of HC extension (P < 0.001). ConclusionWe propose a more appropriate NBI endoscopic classification for hypopharyngeal lesions, which can effectively improve diagnostic accuracy, especially for the early diagnosis of hypopharyngeal cancer. Moreover, the application of oxygen-injected laryngoscope is essential for the accurate assessment of HC and has a high clinical utility.

The Diagnosis of Early Gastric Cancer Based on Medical Imaging Technology and Mathematical Modeling.

The key to reducing the mortality of gastric cancer is early detection, early diagnosis, and early treatment of gastric cancer. Early diagnosis of gastric cancer is the key to early detection and diagnosis of gastric cancer. Early diagnosis and treatment of gastric cancer is of great significance for improving the curative effect and reducing mortality of gastric cancer. The purpose of this paper is to study the diagnosis of early gastric cancer based on medical imaging techniques and mathematical modeling. The effect of W-DeepLab network-assisted diagnosis of images under white light was analyzed, and the value of Narrow Band Imaging and Blue Laser Imaging in the diagnosis of early gastric cancer was compared. Because Blue Laser Imaging endoscopy can clearly observe the demarcation line and microvascular morphology; but when using Narrow Band Imaging observation, part of the demarcation line and microvascular morphology is not observed. The results show that Blue Laser Imaging is brighter than Narrow Band Imaging's endoscopic images, and it is easier to observe the microstructure of lesions under endoscopy, so as to accurately determine the nature of lesions.

The value of narrow-band imaging bronchoscopy in diagnosing central lung cancer.

AimsThis research aimed to study the value of narrow-band imaging(NBI) in the diagnosis of central lung cancer.Materials and methodsThis study included 916 patients with clinical suspected of central lung cancer or follow-up of patients after curative lung cancer surgery. All of the patients were examined by Olympus Evis Lucera electronic bronchoscope system, any sites that were abnormal when viewed by white-light bronchoscopy (WLB) or NBI were biopsied, four to six biopsies were taken at each site of the abnormal region visualized as lesions, we record the endoscopic features of NBI and compared with histopathology results, to evaluate the diagnostic value of NBI for central lung cancer and the relationship between vascular patterns of NBI and histological types of lung cancer, and try to establish a multinomial logistic regression model for predicting the histological types of lung cancer. The biopsy specimens were examined by CD34 antibody through immunohistochemistry (IHC) method, CD34 marked microvessel density(MVD), compared the number of microvessels between benign and malignant diseases and the number between different histological types of lung cancer, to verify the results of NBI.ResultsNBI provided high sensitivity (91.7%), specificity (84.9%), positive predictive value (97.6%), negative predictive value (61.5%), and agreement rate (90.7%). The predominant vascular patterns in the well-defined histological types of lung cancer were dotted blood vessels (121 patients), tortuous blood vessels (248 patients), and abrupt-ending blood vessels (227 patients). Logistic regression analysis of the results showed that smoking status of the patient, combined with vascular patterns under NBI, and age partly affect the histological types of lung cancer.ConclusionsNBI is highly accurate for the diagnosis of central lung cancer.

Application of narrow band imaging in early screening of colorectal cancer

To explore the clinical application value of narrow band imaging (NBI) in the early screening of colorectal cancer. 200 patients were selected as the research objects, and were divided into test group and control group by the randomization method, within 100 cases in each group. The patients in the test group were examined by NBI, while the patients in the control group were examined by ordinary endoscopy, and then the lesion detection rate, image definition and pathological examination results of the two groups were compared. After the patients in the test group received NBI examination, the lesion detection rate, image definition and lesion detection coincidence rate were significantly higher than those of the control group, and the comparative difference between the two groups was statistically significant (P < 0.05). NBI examination of colorectal mucosa can clearly show the pit pattern and the morphological structure of capillaries of the early colorectal cancer and its precancerous lesions, thus effectively improving the diagnosis rate of early colorectal cancer and its precancerous lesions, playing a good clinical application value in the early screening of colorectal cancer, and guiding the later treatment, so it is suitable for clinical promotion.

Narrow band imaging in early diagnosis of laryngopharyngeal malignant and premalignant lesions

Objectives: (1) To assess the diagnostic accuracy of narrow-band imaging (NBI) in the assessment of benign, premalignant, and malignant vocal fold lesions. (2) To evaluate the diagnostic value of NBI in detection of recurrence in upper aero-digestive tract malignancy.Methods: This was a prospective, observational study done between December 2018- November 2019 in the Department of Otolaryngology. One hundred six patients of suspected benign, premalignant, malignant lesions of larynx and hypopharynx along with recurrence cases of upper aerodigestive tract malignancy who have completed chemoradiation therapy. All patients were subjected to white light endoscopy (WLE), NBI, and biopsy for histopathological diagnosis. In WLE, laryngeal lesions were classified into three types: malignant, suspected malignant, and benign. NBI images were classified into 5 types based on the intrapapillary capillary loop (IPCL) patterns: Type I-IV were considered benign and Type V lesion was considered malignant. At the end, WLE and NBI findings were correlated with histopathological reports.Results: The diagnostic accuracy of NBI in diagnosing benign, premalignant, and malignant lesions is significantly better than WLE. The sensitivity of NBI in detecting malignant lesions is significantly greater than WLE. NBI has proved to be of great value in identifying lesions that could be missed by WLE alone, as combined sensitivity of NBI and WLE is significantly higher than WLE alone.Conclusion: NBI is an excellent technique for early detection of laryngopharyngeal malignancies with significantly higher sensitivity than WLE alone.

Diagnostic Value of Narrow Band Imaging in Visualization of Pathological Lesions in Larynx and Hypopharynx.

Narrow Band Imaging (NBI) is an endoscopic optical imaging enhancement technology that improves the contrast of mucosal surface texture and enhances visualization of mucosal and submucosal vasculature. Due to its properties, it can visualize suspected malignant or precancerous lesions earlier than conventional white light endoscopy. The aim of this study was to analyze the benefit of NBI in visualization of precancerous and malignant lesions in preoperative and intraoperative diagnostics and correlation with histopathologic results. A total of 589 patients with suspicious laryngeal or hypopharyngeal lesion were investigated using conventional white light endoscopy (WLE) and NBI endoscopy with high-definition TV (HDTV NBI) from 10/2013 to 12/2019. Patients were divided into two groups based on pre-operative NBI examination (group A, 345 patients) and intraoperative NBI examination (group B, 244 patients). All suspicious lesions were graded to 5 types of Ni classification and correlated with histopathologic results. The SPSS version 8.0.4 statistical software package was used for statistical analysis. In diagnosing premalignant and malignant lesions sensitivity, specificity, positive predictive value, and negative predictive value were calculated. The agreement between NBI endoscopy and histopathological analysis in group A was statistically significant (Қ = 0.76, p < 0.001), with a sensitivity of 86.2% (95% IS: 65.4-95.2) and specificity of 90.9% (95% IS: 70.6-94.1). Moreover, in group B was proven almost perfect agreement between NBI and histopathological analysis (Қ = 0.8461, p < 0.001), with a sensitivity of 84.0% (95% IS: 60.2-92.4) and specificity of 96.0% (95% IS: 87.0-99.2). Based on our results, NBI using the Ni classification has great potential in improving diagnosis of precancerous and malignant lesions and correlates strongly with histopathologic results. It serves as a useful adjunct to white light endoscopy in the diagnosis of laryngeal and hypopharyngeal lesions, especially using HDTV NBI.

The value of three narrow-band imaging model in the diagnosis of small colorectal polyps

This prospective study was aimed to evaluate the clinical value of narrow-band imaging (NBI), magnification endoscopy with narrow-band imaging (NBIME) and magnification endoscopy with acetic acid enhancement and narrow-band imaging (AA-NBIME) in the diagnosis of small colorectal polyps. We studied 261 small colorectal polyps from 122 patients with the use of above three techniques. Lesions were resected for histopathological analysis. The endoscopic images were independently reviewed by three experts and three non-experts and the diagnostic accuracy and image definition were compared among the modalities. The “experts-agreed” diagnostic accuracy was 87.7% for NBI versus 91.6% for NBIME versus 94.6% for AA-NBIME. The “non-experts-agreed” diagnostic accuracy was 80.1% for NBI versus 84.3% for NBIME versus 89.3% for AA-NBIME. All experts and non-experts diagnosed the small colorectal polyps statistically more accurately with AA-NBIME than NBI (P < 0.05). In all three modalities, the expert group’s diagnostic accuracies were statistically significantly higher compared with the non-expert group. For experts, the Kappa values for AA-NBIME, NBIME and NBI diagnosis were 0.962 (0.892–1.032), 0.577 (0.507–0.647) and 0.567 (0.497–0.637), respectively; while for nonexperts, 0.818 (0.748–0.888), 0.532 (0.462–0.602) and 0.530 (0.460–0.600). This demonstrated a good reproducibility of AA-NBIME diagnosis. The average scores (experts and non-experts) of images acquired using AA-NBIME were significantly higher than those acquired using NBIME and ME (P < 0.05). AA-NBIME is a promising tool to clearly visualize the mucosal pit pattern (PP) of colorectal polyps for better differentiating neoplastic polyps from non-neoplastic ones.

The value of narrowband imaging using the Ni classification in the diagnosis of laryngeal cancer.

IntroductionNarrowband imaging (NBI) is a special endoscopic optical enhancement setting allowing better visualization of mucosal microvasculature compared to white light endoscopy. This study evaluates the validity of NBI using the Ni classification in the detection and differentiation of severe dysplasia (SD) and glottic squamous cell carcinoma (SCC).MethodsPatients with suspicious vocal cord lesions underwent conventional white light endoscopy followed by clinically indicated biopsy. At the same time, NBI images were obtained and graded independently. Lesions were graded from I to V according to the Ni classification and compared to histopathological findings.ResultsFifty‐two patients were included in this study (40 SCC and 12 SD). The sensitivity and specificity of NBI in diagnosing laryngeal cancer was 95.0% (CI, 83.9%‐99.4%) and 83.3% (CI, 51.6%‐97.9%), respectively. The negative likelihood ratio was 0.06. Higher Ni grades correlated very strongly with more advanced disease.ConclusionsNBI using the Ni classification is a sensitive diagnostic tool for the detection and differentiation of early neoplastic and preneoplastic glottic lesions. As higher Ni classification correlates strongly with advanced disease, it serves as a useful adjunct to white light endoscopy in the diagnosis of laryngeal cancer.Level of Evidence: Level IV.

Narrow-band imaging: a useful tool for early recognition of oral lichen planus malignant transformation?

Oral lichen planus (OLP) lesions have an overall malignant transformation rate of 1.37%. In patients with chronic disease, the diagnosis of malignancy relies on histopathological examination guided by clinical suspicion. Narrow-band imaging (NBI) is a promising endoscopic technique which, using a filtered light with specific wavelengths, can highlight microvascular abnormalities associated with subclinical neoplastic changes of the upper aerodigestive tract epithelium. This study aimed to analyse the value of NBI in selecting patients for biopsy before the emergence of clinical changes, allowing early detection of oral malignancies arising from OLP. A prospective study was conducted, enrolling 32 consecutive patients with a histological diagnosis of OLP with no previous diagnosis of oral cancer or other oral inflammatory diseases. Patients with suspicious NBI lesions underwent biopsies, while other patients were included in the follow-up. Two patients were judged positive at NBI evaluation and squamous cell carcinoma was diagnosed after histological examination. None of the other patients developed clinical features of malignancies during follow-up. NBI evaluation may increase the accuracy of detection of subclinical neoplastic transformation in OLP lesions and further encourage clinicians to perform biopsies in selected cases.

Diagnostic value of narrow-band imaging combined with endoscopic ultrasonography for ampullary tumors

Objective To study the diagnostic value of narrow-band imaging (NBI) combined with endoscopic ultrasonography (EUS) for ampullary tumors. Methods A total of 21 patients suspected with ampullary lesions by imaging or endoscopic examination from December 2015 to March 2017 were enrolled in this prospective study. All patients underwent NBI and EUS, and 20 patients underwent biopsy. The type of ampullary tumor was predicted by preoperative examination, and appropriate treatment methods were chosen. The final diagnosis was confirmed by biopsy, surgical pathology, and clinical follow-up for more than 6 months. The accuracy of NBI combined with EUS and biopsy in diagnosis of ampullary malignant tumors was calculated according to the gold standard. The Chi-square test was used to compare diagnostic accuracies. Results The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of NBI combined with EUS in diagnosis of ampullary malignancies were 94.1% (16/17), 100.0% (4/4), 95.2% (20/21), 100.0% (16/16), and 80.0% (4/5), respectively. The corresponding indicators of preoperative biopsy were 41.2% (7/17), 100.0% (3/3), 50.0% (10/20), 100.0% (7/7), and 23.1% (3/13), respectively. The accuracy of NBI combined with EUS in diagnosing ampullary malignant tumor was significantly higher compared with preoperative biopsy (P=0.004). Conclusion NBI combined with EUS can more accurately predict benign or malignant ampullary tumor, and better guide the choice of surgical methods compared with preoperative biopsy. Key words: Diagnostic techniques, digestive system; Ultrasonography; Narrow-band imaging; Preoperative biopsy; Ampullary tumor

THE VALUE OF NARROW BAND IMAGING ENDOSCOPY IN DIAGNOSIS OF HYPOPHARYNGEAL AND LARYNGEAL CANCER AND FOLLOWING - UP POST TREATMENT

Background: To evaluate the value of narrow band imaging (NBI) endosocopy in diagnosis of hypopharyngeal and laryngeal cancer and following – up post treatment. Material and methods: A total of 75 patients included 36 patients with hypopharyngeal cancer and 39 patients with laryngeal cancer who had diagnosed at Department of Otoloryngology – Hue Central Hospital from 5/2017 to 5/2018. A prospective cohort study was conducted. Results: The age group 51 - 60 years occurred most often, 33.3%, the mean age was 62.1 ± 13.4. The UICC stage III was 65.3%. Tumor was in ulcerlarative and infiltrate form (89.4%), edema and inflammation of magrin tumor (41.3%), invasive (58.7%). Intrapapillary capillary loops – IPCL - type V was predominant, type V-n was 46.7%. The tumor with IPCL type V-n had strong enhancement (51.3%) and moderate enhancement (44.4%) after contrast medium injection on CT scan. One month after treatment, there were 33.3% of tumor – free, 53.7% of mucosal edema and 13% tumor size-decreasing on NBI image. Conclusion: NBI endoscopy is an useful tool for diagnosing of hypopharyngeal and laryngeal cancer and following – up post treatment. Key words: narrow band imaging endoscopy, hypopharyngeal cancer, laryngeal cancer

Enhanced endoscopic imaging for urothelial cancer

The precise identification and detection of bladder tumours is a prerequisite for complete transurethral resection and, thus, the reduction of recurrence. White-light cystoscopy remains the gold standard and has been further improved by the introduction of digital HD techniques. New digital techniques such as narrow-band imaging (NBI) or the IMAGE 1 S-System have been introduced to better visualise suspicious areas. They are particularly valuable in the outpatient setting. However, fluorescence or photodynamic diagnostics (PDD) after instillation of hexaminolevulinic acid into the bladder is the only approach supported by good evidence. It is recommended by most guidelines in high-grade tumours or carcinoma in situ, while the value of NBI and the Image 1 S-System is under evaluation. Newer approaches include microscopic techniques such as optical coherence tomography, confocal laser endomicroscopy or molecular imaging. The combination of these methods with macroscopic imaging could be very promising.

A study on the value of narrow-band imaging (NBI) for the general investigation of a high-risk population of nasopharyngeal carcinoma (NPC)

BackgroundThis study aims to explore the feasibility of narrow-band imaging (NBI) applied for the diagnostic screening of a high-risk population of nasopharyngeal carcinoma (NPC) and increase the accuracy rate of nasopharyngeal biopsy and the diagnosis rate of early-stage patients.MethodsThe positive high-risk population of NPC to EB virus antibody was followed up. At the same time, serological screening and pharyngorhinoscopy were carried out. The specific methods were as follows: (1) all subjects received nasopharyngeal examinations through both the HD endoscopic white light mode (WL) and NBI mode, (2) nasopharyngeal biopsy was conducted on positive subjects with microscopic examination, and, finally, (3) a comparative analysis was conducted between the biopsy pathology results and microscopy results. In addition, the following comparative indicators were recorded under different modes: sensitivity, specificity, accuracy, positive likelihood ratio, and negative likelihood ratio. Then, the area under the ROC curve and the kappa coefficient were calculated.ResultsA total of 115 subjects were detected to be positive by microscopic examination under the WL mode. Among these subjects, 19 subjects were diagnosed with NPC. In addition, 24 subjects were detected to be positive by microscopic examination under the NBI mode. Among these subjects, 23 subjects were diagnosed with NPC. Under the WL mode, the specific values of the comparative indicators were as follows: sensitivity, 82.61%; specificity, 0%; and area under the ROC curve, 0.413. Furthermore, the WL mode in the diagnosis on the high-risk population of NPC exhibited poor consistency with the biopsy pathology results (kappa coefficient = − 0.069). Under the NBI mode, the specific values of the comparative indicators were as follows: sensitivity, 100%; specificity, 98.96%; and area under the ROC curve, 0.995. Furthermore, the NBI mode in the diagnosis on the high-risk population of NPC exhibited relatively satisfactory consistency with the biopsy pathology results (kappa coefficient = 0.973). Therefore, the NBI mode is significantly superior to the WL mode.ConclusionNBI endoscopic examinations should be conducted on a routine basis for high-risk populations of NPC. This can decrease the frequency of biopsies and enhance diagnostic effects.

Can Narrowband Imaging Improve the Laparoscopic Identification of Superficial Endometriosis? A Prospective Cohort Trial

To assess the usefulness of narrowband imaging (NBI) to detect additional areas of endometriosis not identified by standard white light in patients undergoing laparoscopy for the investigation of pelvic pain. A prospective cohort trial (Canadian Task Force classification II). Evidence obtained from a well-designed cohort study. A tertiary laparoscopic subspecialty unit in Melbourne, Australia. Fifty-seven patients undergoing laparoscopy for the investigation of pelvic pain were recruited. Fifty-three patients were eligible for analysis. Patients underwent standard white-light laparoscopy of the pelvis followed by NBI survey to assess for any additional areas suspicious for endometriosis. All identified areas of possible endometriosis were resected and sent for blinded histopathological analysis. The additional predictive value of NBI was 0% if the preceding white-light survey was negative and 86% if the preceding white-light survey was positive. The use of NBI at laparoscopy for the investigation of pelvic pain is beneficial in finding additional areas of endometriosis if endometriosis is already suspected after white-light survey in a tertiary laparoscopic unit. Further research in nonspecialized units may show additional benefit and requires further research. NBI may also be useful as a diagnostic aid for trainees.

Diagnostic Performance of Narrow Band Imaging for Nasopharyngeal Cancer: A Systematic Review and Meta‐analysis

Objective The purposes of this study were to verify the effectiveness of the narrow band imaging (NBI) system in diagnosing nasopharyngeal cancer (NPC) as compared with white light endoscopy. Data Sources PubMed, Cochrane Library, EMBASE, CNKI, and Wan Fang databases. Review Methods Data analyses were performed with Meta-Disc. The updated Quality Assessment of Diagnostic Accuracy Studies-2 tool was used to assess study quality and potential bias. Publication bias was assessed with a Deeks asymmetry test. The registry number of the protocol published on PROSPERO is CRD42015026244. Results This meta-analysis included 10 studies of 1337 lesions. For NBI diagnosis of NPC, the pooled values were as follows: sensitivity, 0.83 (95% CI, 0.80-0.86); specificity, 0.91 (95% CI, 0.89-0.93); positive likelihood ratio, 8.82 (95% CI, 5.12-15.21); negative likelihood ratio, 0.18 (95% CI, 0.12-0.27); and diagnostic odds ratio, 65.73 (95% CI, 36.74-117.60). The area under the curve was 0.9549. For white light endoscopy in diagnosing NPC, the pooled values were as follows: sensitivity, 0.79 (95% CI, 0.75-0.83); specificity, 0.87 (95% CI, 0.84-0.90); positive likelihood ratio, 5.02 (95% CI, 1.99-12.65); negative likelihood ratio, 0.34 (95% CI, 0.24-0.49); and diagnostic odds ratio, 16.89 (95% CI, 5.98-47.66). The area under the curve was 0.8627. The evaluation of heterogeneity, calculated per the diagnostic odds ratio, gave an I2 of 0.326. No marked publication bias ( P = .68) existed in this meta-analysis. Conclusion The sensitivity and specificity of NBI for the diagnosis of NPC are similar to those of white light endoscopy, and the potential value of NBI for the diagnosis of NPC needs to be validated further.

The diagnostic value of narrow-band imaging for flat bladder lesions

Objective To investigate the diagnostic value of narrow-band imaging for flat bladder lesions. Methods Forty-nine patients with flat bladder lesions diagnosed by white light cystoscopy + narrow-band imaging followed by transurethral resection were included. The diagnostic value of narrow-band imaging was evaluated based on postoperative pathological results. Results A total of 59 flat lesions were identified, in which 8 were normal urothelium, 3 were chronic inflammation, 1 was papillary urothelial neoplasm of low malignant potential, 1 were mild dysplasia, 1 was moderate dysplasia, 1 were severe dysplasia, 3 were carcinoma in situ, 16 were low-grade papillary urothelial carcinoma, 16 were high-grade papillary urothelial carcinoma, and 8 were invasive papillary urothelial carcinoma. For narrow-band imaging, the sensitivity was 86.7% (39/45), specificity was 57.1% (8/14), diagnostic accuracy was 79.7% (47/59), false-positive rate was 42.9% (6/14), positive predictive value was 86.7% (39/45), negative predictive value was 57.1% (8/14), area under ROC curve was 0.719. Among these lesions, the sensitivity and specificity for postoperative recurrent lesions were 100% (3/3) and 40% (2/5), respectively, and those for erythematous patch-like lesions were 90% (9/10) and 100% (4/4), respectively. Conclusion Narrow-band imaging can improve the detection rate for flat bladder tumor lesions, and reduce the risk for missed diagnosis under white light cystoscopy, especially for otherwise indistinguishable erythematous patch-like lesions. Key words: Bladder tumors; Flat bladder lesions; Flexible cystoscopy; Narrow-band imaging

The value of narrow band imaging in diagnosis of head and neck cancer: a meta-analysis

Head and neck cancer is difficult to diagnose early. We aimed to estimate the diagnosis value of narrow band imaging(NBI) in head and neck cancers. We identified relevant studies through a search of PubMed, Embase and the Cochrane Library. We used a random effect model. Subgroup analysis and meta-regression analysis were performed to estimate the factors which may influence the sensitivity and specificity of the NBI. We included 25 studies with total 6187 lesions. The pooled sensitivity, specificity, positive likelihood rate, negative likelihood rate and diagnostic odds ratios of NBI were 88.5%, 95.6%, 12.33, 0.11 and 121.26, respectively. The overall area under the curve of SROC was 96.94%. The location, type of assessment, type of endoscope system and high definition were not significant sources of heterogeneity (P > 0.05). However, magnification may be related to the source of heterogeneity (P = 0.0065). Therefore, NBI may be a promising endoscopic tool in the diagnosis of head and neck cancer.

Role of narrow band imaging in the diagnosis of laryngeal lesions: Pilot study from India.

Narrow band imaging (NBI) is a new imaging technique developed to improve the diagnostic accuracy of head and neck cancers by depiction of tumor-specific neo-angiogenesis. The purpose of this study was to assess the value of NBI in the diagnosis of laryngeal lesions. To assess the sensitivity and specificity of combined white light endoscopy (WLE) and NBI compared with WLE alone in the diagnosis of laryngeal lesions. Prospective study. Thirty consecutive patients with various laryngeal lesions scheduled for microlaryngoscopic evaluation underwent WLE followed by NBI. Endoscopic NBI findings were classified into five types (I-V) according to the intraepithelial papillary capillary loop features. Types I-IV are considered benign, whereas type V is considered malignant. The observations were compared with histopathology. Sensitivity, specificity, and positive and negative predictive values for the diagnosis of malignancy (i.e., invasive carcinoma and carcinoma in situ) by means of NBI with WLE were calculated. The sensitivity of WLE combined with NBI (100%) was higher than WLE alone (82.6%) in detecting laryngeal cancers. NBI helped in identifying four malignant lesions missed by WLE alone. Two children with respiratory papillomatosis also demonstrated type V pattern, a potential pitfall, leading to an overall positive predictive value of 92% and a negative predictive value of 100%. Combining NBI with WLE increases the sensitivity of detection of laryngeal cancer and its precursor lesions. NBI is also useful in some benign lesions as well as in post-radiotherapy patients.

The value of narrow band imaging combined with stroboscopy for the detection of applanate indiscernible early-stage vocal cord cancer

Background: Narrow band imaging (NBI) and stroboscopy are non-invasive techniques to detect the malignant lesions of the vocal cord. This study was to assess the diagnostic value of combined endoscopic analysis in the applanate indiscernible early-stage vocal cord cancer.Methods: A total of 110 patients with 160 suspicious vocal cord malignant lesions were included in this retrospective study. Stroboscopy was immediately performed after NBI and white light endoscopy (WLE) were performed in all patients. Excisional biopsy was performed to examine histopathology examination.Results: We found that the diagnostic specificity and PPV were higher in the NBI and WLE combined with stroboscopy group than in the NBI and WLE group without stroboscopy (88.9% vs 72.5%, 88.4% vs 60.9%). However, the diagnostic sensitivity was not significantly different in those two groups (69.3% vs 67.7%).Conclusion: NBI and WLE combined with stroboscopy is a promising method to detect early-stage vocal cord cancer with the advantage of clinical feasibility and diagnostic specificity.

Usefulness of office examination with narrow band imaging for the diagnosis of head and neck squamous cell carcinoma and follow-up of premalignant lesions.

The purpose of this study was to evaluate the value of narrow band imaging (NBI) examination in the office for the diagnosis and follow-up of upper airway premalignant and malignant lesions. Four hundred eighty lesions were evaluated with white light endoscopy (WLE) and NBI before a biopsy/excision. Additionally, 151 premalignant lesions were followed up without proven biopsy. Carcinoma-free survival was calculated. The learning curve was analyzed. Overall, the accuracy improved from 74.1% with WLE to 88.9% with NBI, being relevant in all anatomic subsites. The accuracy of NBI increased significantly with increasing experience (area under the curve [AUC] >0.9). After a follow-up of 25 months, 14 of 151 lesions (9.3%) converted into carcinoma. The 4-year carcinoma-free survival rate was 86.4%. The 4-year carcinoma-free survival rate differed significantly between lesions classified as benign/mild dysplasia versus those presenting as moderate/severe dysplasia (88.9% vs 73.5%; P = .018). The NBI provided a greater accuracy than WLE and showed promising usefulness for the follow-up of premalignant lesions.