Role of narrow-band imaging and high-definition television in the surveillance of head and neck squamous cell cancer after chemo- and/or radiotherapy

Abstract

Narrow-band imaging (NBI) is an endoscopic technique enhancing mucosal vasculature and better identifying superficial carcinomas due to their neo-angiogenic pattern. NBI accuracy is increased by combination with a high-definition television (HDTV) camera. The aim of this report was to evaluate the diagnostic improvement of NBI +/- HDTV in the evaluation of head and neck squamous cell cancer (HNSCC) previously treated by chemo-radiotherapy (CHT-RT) or RT. A total of 390 patients affected by HNSCC were prospectively evaluated by NBI and white light (WL) endoscopy +/- HDTV between April 2007 and April 2009 at a single academic institution. Among them, we focused on 59 (15%) patients who received CHT-RT or RT as part of their treatment. Of 59 patients, 13 (22%) showed adjunctive preoperative NBI findings when compared to the standard WL examination. These findings were always confirmed by intraoperative HDTV NBI, while only eight (62%) were visible with HDTV WL. Of 13 lesions, 12 received histopathologic confirmation (from carcinoma in situ to invasive carcinoma). The sensitivity of flexible NBI, HDTV WL, and HDTV NBI was 100, 66 and 100%, respectively. The specificity was 98, 100, and 98%. The positive predictive value was 92, 100, and 92%. The negative predictive value was 100, 94, and 100%. The accuracy was 98, 91, and 98%. NBI +/- HDTV after CHT-RT or RT was of value in detecting tumor persistence (n = 2), early recurrences (n = 6), and metachronous tumors (n = 4). By contrast, only 1 of 59 (2%) patients was found to be false positive.

Laryngeal preneoplastic lesions and cancer: challenging diagnosis. Qualitative literature review and meta-analysis.

“…Nevertheless, NBI is able to better specify their exact extension and show infiltration of neighboring structures. Additionally, NBI might detect second primaries or field cancerization in these patients (138) and it presents a potential advantage in post-treatment surveillance (247)(248)(249). Compared to AFE, NBI endoscopy has the advantage of being able to obtain the same information using both a videoendoscope coupled with a HDTV camera and rigid telescopes (137).…”

Value of Narrow Band Imaging Endoscopy in Detection of Early Laryngeal Squamous Cell Carcinoma

“…V roce 2008 Piazza et al v analýze dostupné literatury hodnotili význam NBI systému ve screeningu a dia gnostice slizničních lézí v aerodigestivním traktu [14]. V další studii z roku 2010 hodnotili také benefit NBI zobrazení při sledování pa cientů po prodělané onkologické léčbě maligního nádoru ORL oblasti [15]. V roce 2011 Piazza et al demonstrovali na skupině 347 pa cientů zisk nových inVčasný záchyt těchto malignit je proto jedním z nejdůležitějších faktorů úspěš-nosti jejich léčby [3].…”

Narrow Band Imaging (NBI) — Endoscopic Method for Detection of Head and Neck Cancer

“…Recently, NBI was used for diagnosis of oral [12], oropharyngeal [13], hypopharyngeal [14], nasopharyngeal [15] and laryngeal [16] pathologies. NBI is used for screening and for followup after chemo-and/or radiotherapy treatment of head and neck SCC [17]. Some authors also used NBI intraoperatively to perform targeted biopsies of most suspect areas and also to determine the safe limits of resection margins [17] (Figure 5).…”

“…NBI is used for screening and for followup after chemo-and/or radiotherapy treatment of head and neck SCC [17]. Some authors also used NBI intraoperatively to perform targeted biopsies of most suspect areas and also to determine the safe limits of resection margins [17] (Figure 5). …”

“…Improved contrast between mucosal epithelium and blood vessels helps to visualize mucosal lesions few millimetres in Endoscopydiameter ( Figure 6). The sensitivity and specificity of flexible NBI endoscopy in follow-up of head and neck SCC patients were reported 91,3 -100% and 91,6 -98% respectively [17,11].…”