Clinical experience of narrow band imaging (NBI) usage in diagnosis of laryngeal lesions

Abstract

Introduction: One of the most recent methods used in imaging of the larynx is narrow band imaging (NBI). NBI enables us to detect specific patterns of pathological angiogenesis suggestive of premalignant or neoplastic lesions. The aim of the study was to compare imaging of laryngeal lesions in white light endoscopy (WLE) and NBI in relation to histopathological examination. Material and methods: 333 patients with laryngeal lesions underwent endoscopic evaluation in WLE and NBI. Sensitivity, specificity, positive and negative predictive value (PPV, NPV) for WLE and NBI were calculated. The diagnostic value for WLE and NBI was evaluated for two assumptions (positive result is:1. severe dysplasia and cancer 2. only cancer) Results: Sensitivity, specificity, PPV, NPV of first assumption were respectively for white light compared to NBI: 95.4% vs 98.5%; 84.2% vs 98.5%; 79.6% vs 97.7% and 96.6% vs 99.0%. The values of second assumption were: 97.4% vs 100%; 79.3% vs 93.5%; 72.6% vs. 89.4% and 98.2% vs. 100.0%. Higher sensitivity was observed for the second assumption, while higher specifity was recorded for the first assumption. Specificity was significantly higher for NBI than for WLE (p<0.001). Conclusions: NBI enables us to detect and differentiate laryngeal lesions, which are invisible in WLE. Endoscopic examination, especially in NBI-mode, is non-invasive, repeatable and remains a useful tool in the daily practice and diagnosis of patients with pathological lesions in the larynx.

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

“…The results obtained in group A are in accordance with those reported in literature with a similar cohort of patients [1,9,10]. In particular, Vilaseca et al [1] showed that accuracy improved from 74.1% with WLE to 88.9% with NBI and demonstrated additionally, a better PPV (NBI: 89% vs. WLE: 74%).…”

“…In particular, Vilaseca et al [1] showed that accuracy improved from 74.1% with WLE to 88.9% with NBI and demonstrated additionally, a better PPV (NBI: 89% vs. WLE: 74%). In addition, Popek et al [9] showed a PPV of 97.7% for NBI vs. 79.6% for WLE.…”

“…Furthermore, NBI is widely used for inflammatory pathologies of the head and neck in all age groups [7,8]. However, a precise diagnosis of mucosal lesions remains challenging and recent studies aimed at assessing its diagnostic accuracy in laryngeal lesions [9,10]. Considering the wide application of NBI in the head and neck area and the difficulties encountered by the physician with the number of different pathologies affecting these structures, the aim of our study was to assess the accuracy of NBI based on the differential diagnosis of laryngeal premalignant lesion, early cancers and tumor recurrences after radiotherapy in a large case series and single institution.…”

Vocal Fold Leukoplakia: Which of the Classifications of White Light and Narrow Band Imaging Most Accurately Predicts Laryngeal Cancer Transformation? Proposition for a Diagnostic Algorithm

“…Vascular structure alterations due to microvessel proliferation, one of the first signs of malignant transformation, can be visualized with NBI on the mucosal surface [34]. Epithelial changes such as plaque morphology (smooth, elevated, rough) and microvascular NBI characteristics play a significant role in the differential diagnosis of benign and malignant lesions [35][36][37][38][39][40]. First, a 5-degree scale of the vascularization of pathological changes (Ni 2011) was established by Ni.…”

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

“…Klimza et al 5 Piazza et al 14 Ni et al 16 Ni et al 15 Popek et al 4 Number to this gap in the number of articles which used one classification rather than the other one, we cannot include this topic as an evaluation criterion in the present review.…”