Learning curve for endoscopic evaluation of vocal folds lesions with narrow band imaging

Žůrek, Michal; Rzepakowska, Anna; Osuch‐Wójcikiewicz, Ewa; Niemczyk, Kazimierz

doi:10.1016/j.bjorl.2018.07.003

Cited by 12 publications

(9 citation statements)

References 21 publications

(28 reference statements)

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“…The accuracy of narrow-band imaging endoscopy in differentiating between benign and malignant vocal fold leukoplakia significantly improved to reach 0.770 after the narrow-band imaging training. Though moderate, the training also improved the consistency of laryngologists’ judgements on the nature of vocal fold leukoplakia, indicating that their understanding of mucosal microvascular morphology in the narrow-band imaging mode had an impact on their judgement 22 . In addition, the narrow-band imaging training significantly improved the specificity of the diagnosis of malignant vocal fold leukoplakia, indicating that narrow-band imaging training could reduce the misdiagnosis rate of vocal fold leukoplakia.…”

Section: Discussionmentioning

confidence: 92%

“…Though moderate, the training also improved the consistency of laryngologists' judgements on the nature of vocal fold leukoplakia, indicating that their understanding of mucosal microvascular morphology in the narrow-band imaging mode had an impact on their judgement. 22 In addition, the narrow-band imaging training significantly improved the specificity of the diagnosis of malignant vocal fold leukoplakia, indicating that narrow-band imaging training could reduce the misdiagnosis rate of vocal fold leukoplakia. In this study, we observed that consistency of the new diagnostic classification of vocal fold leukoplakia by narrow-band imaging as summarised was not good, especially for types III, IV and VI.…”

Section: Discussionmentioning

confidence: 95%

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Effect of a training course on the diagnosis of vocal fold leukoplakia by narrow-band imaging

Zhu

Zhang

et al. 2020

J. Laryngol. Otol.

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Objective To investigate the value of narrow-band imaging training for differentiating between benign and malignant vocal fold leukoplakia. Method Thirty cases of vocal fold leukoplakia were selected. Results Narrow-band imaging endoscopy training had a significant positive effect on the specificity of the differential diagnosis of vocal fold leukoplakia. In addition, the consistency of diagnostic typing of vocal fold leukoplakia by narrow-band imaging improved to ‘moderate agreement’ following the combination of types I and II and the combination of types IV, V and VI in the typing of vocal fold leukoplakia. Conclusion The narrow-band imaging training course may improve the ability of laryngologists to diagnose vocal fold leukoplakia. The new endoscopic diagnostic classification by narrow-band imaging needs to be further simplified to facilitate clinical application.

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Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 95%

Effect of a training course on the diagnosis of vocal fold leukoplakia by narrow-band imaging

Zhu

Zhang

et al. 2020

J. Laryngol. Otol.

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“…This is mostly observed in the first six months of use. 14 21 Indeed, regarding this issue, Zurek et al 22 showed that after 65 to 70 NBI examinations, the plateau of the learning process is reached. However, the included studies reported the ability of NBI to detect premalignant and malignant lesions as far as SE, SP, PPV, NPV, and ACC.…”

Section: Discussionmentioning

confidence: 99%

The Impact of Narrow-band Imaging on the Pre- and Intra- operative Assessments of Neoplastic and Preneoplastic Laryngeal Lesions. A Systematic Review

Saraniti

Chianetta

Greco

et al. 2020

Int Arch Otorhinolaryngol

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Introduction Narrow-band imaging is an endoscopic diagnostic tool that, focusing on superficial vascular changes, is useful to detect suspicious laryngeal lesions, enabling their complete excision with safe and tailored resection margins. Objectives To analyze the applications and benefits of narrow-band imaging in detecting premalignant and malignant laryngeal lesions through a comparison with white-light endoscopy. Data Synthesis A literature search was performed in the PubMed, Scopus and Web of Science databases using strict keywords. Then, two authors independently analyzed the articles, read the titles and abstracts, and read completely only the relevant studies according to certain eligibility criteria. In total, 14 articles have been included in the present review; the sensitivity, specificity, positive and negative predictive values, and accuracy of pre- and/or intraoperative narrow-band imaging were analyzed. The analysis showed that narrow-band imaging is better than white-light endoscopy in terms of sensitivity, specificity, positive and negative predictive values, and accuracy regarding the ability to identify cancer and/or precancerous laryngeal lesions. Moreover, the intraoperative performance of narrow-band imaging resulted more effective than the in-office performance. Conclusion Narrow-band imaging is an effective diagnostic tool to detect premalignant and malignant laryngeal lesions and to define proper resection margins. Moreover, narrow-band imaging is useful in cases of leukoplakia that may cover a possible malignant lesion and that cannot be easily assessed with white-light endoscopy. Finally, a shared, simple and practical classification of laryngeal lesions, such as that of the European Laryngological Society, is required to identify a shared lesion management strategy. Key Points

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“…reported that magnifying NBI could be easily and rapidly learned by beginners for the diagnosis of esophageal neoplastic lesions, and that the 2‐h training program improved the diagnostic skills of less‐experienced endoscopists to the level of highly experienced endoscopists. Żurek et al . analyzed learning curves for endoscopic evaluations of laryngeal lesions using NBI and found that a minimum of 65–70 NBI examinations were required to reach a plateau in the learning process associated with the assessment of these lesions.…”

Section: Discussionmentioning

confidence: 99%

Skill‐up study of systemic endoscopic examination technique using narrow band imaging of the head and neck region of patients with esophageal squamous cell carcinoma: Prospective multicenter study

Okamoto

Morimoto

Yamamoto

et al. 2019

Digestive Endoscopy

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Objective To evaluate the usefulness of a training program on endoscopic head and neck surveillance for beginner endoscopists. Methods This prospective multicenter study included 13 beginner endoscopists from 10 institutions who received training in systematic observation techniques and diagnostic criteria, and the training involved hands‐on learning. Between May 2016 and February 2017, enrolled patients with current or previously diagnosed esophageal squamous cell carcinomas underwent head and neck surveillance using narrow band imaging (NBI) endoscopy, and histologically confirmed head and neck squamous cell carcinoma (HNSCC) detection rates, endoscopic image quality, and examination times were compared before (group A) and after (group B) the training program. Maximum possible score for the endoscopic images was 30 points. Results A total of 330 patients, comprising 181 in group A and 149 in group B, were enrolled. Three patients with HNSCC were detected in group A (1.7%) and in group B (2.0%; P = 1.000). Mean ± standard deviation (SD) examination times were 157 ± 71 s and 174 ± 109 s in groups A and B, respectively, (P = 0.073). Mean ± SD scores of the endoscopic images were 25.04 ± 5.47 points and 27.01 ± 4.35 points in groups A and B, respectively, (P < 0.001). Conclusion The HNSCC detection rate based on the use of NBI on patients with ESCC did not improve after the training program for beginner endoscopists; however, endoscopic image quality improved significantly after the training program.

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Learning curve for endoscopic evaluation of vocal folds lesions with narrow band imaging

Abstract: A minimum of 65th-70th narrow band imaging examinations are required to reach a plateau phase of the learning process in assessment of glottis lesions. Analysis of learning curves is useful for the development of training programs and determination of a mastery level.

Cited by 12 publications

References 21 publications

Effect of a training course on the diagnosis of vocal fold leukoplakia by narrow-band imaging

Effect of a training course on the diagnosis of vocal fold leukoplakia by narrow-band imaging

The Impact of Narrow-band Imaging on the Pre- and Intra- operative Assessments of Neoplastic and Preneoplastic Laryngeal Lesions. A Systematic Review

Skill‐up study of systemic endoscopic examination technique using narrow band imaging of the head and neck region of patients with esophageal squamous cell carcinoma: Prospective multicenter study

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