Flexible transnasal endoscopy with white light or narrow band imaging for the diagnosis of laryngeal malignancy: diagnostic value, observer variability and influence of previous laryngeal surgery

Davaris, Nikolaos; Voigt-Zimmermann, Susanne; Kropf, Siegfried; Arens, Christoph

doi:10.1007/s00405-018-5256-1

Cited by 24 publications

(27 citation statements)

References 45 publications

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“…Only Ni et al 2 directly compared NBI to WLE and found NBI to be more accurate than WLE. This is also supported by studies comparing WLE to NBI in early glottic cancer, demonstrating NBI to be superior in accuracy 30,36 . The histological grading of leukoplakia varied among studies with some studies using WHO 2005 37 and others using the updated (WHO 2017), 6 with possible effects on the overall diagnosis, especially with differentiating severe dysplasia from CIS.…”

Section: Discussionmentioning

confidence: 89%

Utility of narrowband imaging in the diagnosis of laryngeal leukoplakia: Systematic review and meta‐analysis

et al. 2020

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This systematic review and meta-analysis evaluates the validity of narrowband imaging (NBI) in differentiating between low-risk leukoplakia and high-risk leukoplakia. Medline, EMBASE, Scopus, Cochrane Database of Systematic Reviews and Database of Abstracts of Reviews of Effects were searched. Studies evaluating the diagnostic accuracy of NBI in the assessment of laryngeal leukoplakia were included. Pooled sensitivity, specificity and diagnostic odds ratio were calculated. Seven studies met the inclusion criteria assessing a total of 586 lesions with laryngeal leukoplakia. In differentiating between low-risk and high-risk leukoplakia, NBI had a pooled sensitivity and specificity of 85.4% (95% CI [76-99.9]) and 94.9% (95% CI [91.1-97.2]) respectively. Pooled diagnostic odds ratio was 99.2 (95% CI [38.28-257.18]). NBI is a useful imaging modality in differentiating between low-risk leukoplakia and high-risk laryngeal leukoplakia. The high sensitivity, specificity and diagnostic odds ratio make NBI a useful tool in the workup of laryngeal leukoplakia.

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Section: Discussionmentioning

confidence: 89%

Utility of narrowband imaging in the diagnosis of laryngeal leukoplakia: Systematic review and meta‐analysis

et al. 2020

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“…It could be assumed that the evaluation after TOLS should be easy because there are no postirradiation‐like changes in the tissues. In contrast, Davaris et al pointed out that the evaluation of endoscopic findings after previous surgical treatment may also be rather complicated. In our study, in most cases, the recurrent tumor appearance was different from the standard tumor appearance usually observed in previously untreated terrain.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Transnasal Flexible Videoendoscopy With Narrow Band Imaging for Follow‐Up of Patients After Transoral Laser Cordectomy

et al. 2019

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Background and Objectives Transoral laser surgery is the optimal surgical treatment modality for the early stages of glottic cancer. To allow for further treatment to be as effective and as minimal as possible, persistent or recurrent tumors should be detected very soon. The main aim is to minimize the risk of necessity of performing a total laryngectomy. Flexible videoendoscopy with narrow band imaging (NBI) was recommended by the European Laryngological Society as a diagnostic method for the follow‐up of patients treated for laryngeal cancer. Nevertheless, the efficacy of this technique has not been extensively studied in patients after transoral laser cordectomies for vocal fold cancer. The aim of this study was to evaluate the efficacy of in‐office transnasal NBI flexible videoendoscopy in the follow‐up of patients after transoral laser cordectomy for glottic cancer. We also focused on describing the specific characteristics of recurrent tumor appearance. Materials and Methods The presented study was conceived as a prospective study. Ninety‐four consecutive patients who underwent transoral laser cordectomy for severe dysplasia, Tis, T1, and T2 glottic cancer in the period from June 2010 to August 2015 were enrolled in the study. All patients were postoperatively regularly followed using transnasal videoendoscopic examinations with NBI. Whenever a suspect lesion was identified during in‐office examination, its nature was proven histologically. Results We discovered 23 suspect findings in 21 patients by means of flexible videoendoscopy with NBI. Fifteen (65.2%) of them were histologically confirmed as recurrent tumors, whereas in 8 (34.8%) of them, the recurrent tumor was not proven. In two patients, the recurrent tumor was evident on computed tomography or magnetic resonance imaging, but NBI endoscopy did not reveal relapsing disease. The rest (71 patients) were considered true negative. Of the 15 recurrent tumors detected by NBI‐coupled videoendoscopy, 8 (53.3%) were identified as submucosal masses with nonsignificant or no vascular changes, 4 (26.7%) were noted as the progression of leukoplakia without visible vascular changes, only 2 (13.3%) showed typical vascular changes, and, in 1 (6.7%) case, evident, significantly exophytic tumor with pathological vascularization was discovered. The sensitivity, specificity, and positive and negative predictive values of the in‐office transnasal videolaryngoscopy with NBI were calculated to be 88%, 92%, 71%, and 97%, respectively. Conclusions The results of the study demonstrate that transnasal endoscopy with NBI in an outpatient setting is an excellent method for the follow‐up of patients after transoral laser cordectomy for glottic cancer. The method achieves high sensitivity, specificity, and negative predictive value and a slightly low positive predictive value. Nevertheless, we must bear in mind that recurrent tumors after previous endoscopic resection may have a completely different appearance than new tumors originating from previously untreated tissues. Lasers ...

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“…Two reviewers summarized all data using standard forms. The diagnostic odds ratios (DORs), 4‐31,35‐37 summary receiver operating characteristic (SROC) curves, areas under the curves (AUCs), 4‐31,35‐37 and the extent of inter‐rater agreement 17,22,23,26 associated with NBI studies were evaluated, as was the (comparative) diagnostic accuracy of WLE. Each DOR was calculated as: (true positive (TP)/false positive [FP])/(false negative [FN]/true negative [TN]) with 95% confidence intervals (CIs); we used random‐effects models that considered both within‐ and between‐study variations.…”

Section: Methodsmentioning

confidence: 99%

Use of narrowband imaging for the diagnosis and screening of laryngeal cancer: A systematic review and meta‐analysis

Kim

et al. 2020

Head & Neck

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We evaluated the diagnostic accuracy of narrowband imaging (NBI) in terms of detecting laryngeal cancer compared to that of white light endoscopy (WLE). Two reviewers individually searched the six databases for studies published between the first record date and December 31, 2019. We recorded the numbers of true positives, true negatives, false positives, and false negatives. Quality Assessment of Diagnostic Accuracy Studies ver. 2 software was used to assess the studies. The extent of the inter‐rater agreement was also measured. The diagnostic odds ratio (OR) associated with NBI was 87.463 (95% confidence interval [CI]: 46.968, 160.873). The area under the summary receiver operating characteristic curve was 0.954. NBI was more diagnostically accurate than WLE, which was associated with a diagnostic OR of 13.750. NBI affords high diagnostic accuracy, thus supporting a role for NBI in the diagnostic work‐up of laryngeal cancer.

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Flexible transnasal endoscopy with white light or narrow band imaging for the diagnosis of laryngeal malignancy: diagnostic value, observer variability and influence of previous laryngeal surgery

Cited by 24 publications

References 45 publications

Utility of narrowband imaging in the diagnosis of laryngeal leukoplakia: Systematic review and meta‐analysis

Utility of narrowband imaging in the diagnosis of laryngeal leukoplakia: Systematic review and meta‐analysis

Efficacy of Transnasal Flexible Videoendoscopy With Narrow Band Imaging for Follow‐Up of Patients After Transoral Laser Cordectomy

Use of narrowband imaging for the diagnosis and screening of laryngeal cancer: A systematic review and meta‐analysis

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