The Use of Narrow Band Imaging in Patients With Benign Disease

Abstract

: Narrow band imaging (NBI) is a new type of imaging technology that enhances the visibility of blood vessels used in the detection of abnormal angiogenesis in preneoplastic and neoplastic lesions. This technique is used in the diagnosis and management of dysplastic and malignant endobronchial lesions. To our knowledge, this is the first description of the use of NBI to diagnose and manage benign lesions, hereditary hemorrhagic telangiectasia (HHT). The objective of this study was to implement NBI as a tool for use in the bronchoscopic visualization leading to the diagnosis and management of nonmalignant lesions in the tracheobronchial tree. This is including but not limited to HHT. NBI was used to detect the origin of significant hemoptysis in a patient with HHT. The patient had conventional white light (CWL) bronchoscopy, followed by NBI. NBI illuminated the abnormal blood vessels significantly better than CWL bronchoscopy. This led to a more effective diagnosis and management of the abnormal vessels causing the hemoptysis. NBI may provide a higher probability of locating abnormal endobronchial lesions in both benign and malignant diseases than CWL bronchoscopy. It can be used to treat these abnormal lesions as in our patient who presented with hemoptysis. A prospective study is needed to determine whether NMI and CWL are additive as in malignant disease. Furthermore, NBI can be used in lesions of the tracheobronchial tree and the gastrointestinal tract, and pleura, so that the appropriate management can be initiated.

Use of Narrow Band Imaging in diagnosis of Unexplained Hemoptysis; A Case Report: Endobronchial Telangiectasia

“…2 The use of narrow band imaging (NBI) in conjunction with continuous white light (CWL) during bronchoscopy may be used for better identification of superficial vascular abnormalities and telangiectasia lesions. 3 NBI is a technology in bronchoscopy that enhances the visibility of vessels of the mucosa and differentiation between inflammation and pathological vascularisation of tumor by optimizing light wavelengths at 415 nm and 540 nm. NBI has found wide applications in gastroenterology and urology.…”

Dieulafoy disease of the bronchus involving bilateral arteries

“…With the use of a conventional white light bronchoscope alone, up to 29% of the vascular anomalies and dysplastic mucosal and dysplastic mucosal lesions may not be detected. [24,26] Narrow band imaging (NBI) can aid in visualizing the superficial mucosa to detect vascular lesions by using 2 different ranges of wavelengths: 390 to 445 nm and 530 to 550 nm. [26] Vascular lesions in the submucosa appear blue-green under NBI; the color blue indicates that the vessel is at a shallow location, while green indicates that the location is at a deeper location.…”

“…[24,26] Narrow band imaging (NBI) can aid in visualizing the superficial mucosa to detect vascular lesions by using 2 different ranges of wavelengths: 390 to 445 nm and 530 to 550 nm. [26] Vascular lesions in the submucosa appear blue-green under NBI; the color blue indicates that the vessel is at a shallow location, while green indicates that the location is at a deeper location. Endobronchial ultrasound scan is also a useful tool to detect vascular abnormalities which are usually hypoechoic or anechoic with hyperechoic or echogenic walls.…”

Endobronchial ultrasound and bronchial artery embolization for Dieulafoy's disease of the bronchus in a teenager: A case report

“…The combination of narrow band imaging (NBI) with autofluorescence helps to decrease the false positive rates. NBI causes enhancement of blood vessels as it uses wavelengths within the range of hemoglobin [6] .…”