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

Abstract

Abstract. Narrow band imaging (NBI) is a new endoscopic technique in which images of mucosal microstructures and capillary structures are enhanced by shifting the light spectrum to a narrow band. Image-enhanced gastrointestinal endoscopy using NBI has improved the qualitative diagnosis of the grade and depth of invasion of an atypical lesion. NBI is currently not commonly used in gynecological endoscopy, but has recently been applied in laparoscopy and hysteroscopy. The utility of NBI for diagnosis of endometrial lesions and endometriosis has also been shown. In gynecological endoscopy, NBI provides enhanced images of mucosal microstructures and capillary structures and improves visual identification of lesions. Therefore, image-enhanced observation using NBI is likely to be useful for improved detection of lesions in endoscopic diagnosis. However, this technique remains experimental so far, and no study has demonstrated improved clinical outcome using this technique. In this review, we discuss the utility and potential applications of NBI in clinical practice in gynecology.

Improving tissue characterization, differentiation and diagnosis in gynecology with the narrow‑band imaging technique: A systematic review

“…While Kisu et al ( 44 ) performed a review in 2012, the present systematic review is substantially updated and includes quality assessment of the studies according to the QUADAS-2 and the CARE guidelines ( 6 , 7 ).…”

“…In fact, of the eight additional suspicious-appearing nodules visualized with NBI, only three were confirmed as malignant on final pathology, and none of the patients had surface malignancies identified with NBI that were not also seen with WL, even if in a different area ( 39 ). Aloisi et al ( 39 ) pointed out that further exploration of the use of NBI/3D WL imaging is required; this will now be further evaluated in a large randomized clinical trial with clinically relevant endpoints, with adequate power, quality control and measures ( 44 ). This will be according to the Idea, Development, Exploration, Assessment and Long-term Study (IDEAL) framework, describing 5 stages of evolution for new surgical therapeutic interventions.…”

Prospective Comparative Study of Laparoscopic Narrow Band Imaging (NBI) Versus Standard Imaging in Gynecologic Oncology

“…In gynecology, NBI has demonstrated usefulness in laparoscopic/hysteroscopic diagnosis 22 and treatment of benign conditions such as endometriosis 23–26 or abnormal uterine bleeding. 27–31 When compared with white light imaging alone, NBI technology increases the number of endometriotic lesions identified during laparoscopy.…”