High magnification bronchovideoscopy combined with narrow band imaging could detect capillary loops of angiogenic squamous dysplasia in heavy smokers at high risk for lung cancer

Abstract

Background: We investigated the use of high magnification bronchovideoscopy combined with narrow band imaging (NBI) for the detailed examination of angiogenic squamous dysplasia (ASD). This was carried out in relation to bronchial vascular patterns with abnormal mucosal fluorescence in heavy smokers at high risk for lung cancer. Methods: Forty eight patients with sputum cytology specimens suspicious or positive for malignancy were entered into the study. Conventional white light and fluorescence bronchoscopic examination was first performed. Observations by high magnification bronchovideoscopy with conventional white light were made primarily at sites of abnormal fluorescence, and then repeated with NBI light to examine microvascular networks in the bronchial mucosa. Spectral features on the RGB (Red/Green/Blue) sequential videoscope system were changed from the conventional RGB broadband filter to the new NBI filter. The wavelength ranges of the new NBI filter were B1: 400-430 nm, B2: 420-470 nm, and G: 560-590 nm. ASD tissues were also examined using a confocal laser scanning microscope equipped with argon-krypton (488 nm) and argon (514 nm) laser sources. Results: The microvessels, vascular networks of various grades, and dotted vessels in ASD tissues were clearly observed in NBI-B1 images. Diameters of the dotted vessels visible on NBI-B1 images agreed with the diameters of ASD capillary blood vessels diagnosed by pathological examination. Capillary blood vessels were also clearly visualised by green fluorescence by confocal laser scanning microscopy. There was a significant association between the frequency of dotted vessels by NBI-B1 imaging and tissues confirmed as ASD pathologically (p = 0.002). Conclusions: High magnification bronchovideoscopy combined with NBI was useful in the detection of capillary blood vessels in ASD lesions at sites of abnormal fluorescence. This may enable the discrimination between ASD and another pre-invasive bronchial lesion.

Narrow band imaging (NBI) cystoscopy and assisted bipolar TURBT: A preliminary experience in a single centre

“…However, some questions have been raised as regards the cost-effectiveness of this approach. Numerous studies have demonstrated the ability to display improved images of the surface layers of the various apparatuses using NBI (10,(12)(13)(14)(15)(16)(17)(18). NBI is a diagnostic imaging technique that improves the contrast between mucosal surfaces and microvascular structures, based on the wavelength-dependent increase in the depth of light penetration into the mucosa, without additional costs to conventional cystoscopy and without lengthening the operating time.…”

Diagnoses of endobronchial pretumor pathology and early forms of lung cancer

“…NBI -это сравнительно новая эндоскопическая диагности-ческая методика, которая представлена как альтернативная тех-нология для оценки бронхиального эпителия и выявления ран-него рака легкого [48].…”

Narrow band imaging in gynecology: A new diagnostic approach with improved visual identification (Review)

“…Neoplastic vessels develop in the surface of tumor lesions, and thus NBI is very useful for observation of microvessels for qualitative diagnosis of tumors and non-tumor lesions (1,5,6,(8)(9)(10). In contrast, evaluation of the microvascular structure with conventional white light endoscopy is difficult.…”