Usefulness of narrow band imaging with magnifying endoscopy for the differential diagnosis of cancerous and noncancerous laryngeal lesions

Abstract

Background We evaluated the accuracy of endoscopic findings observed by narrow band imaging (NBI) combined with magnifying gastrointestinal endoscopy (GIE) for the differential diagnosis of cancerous and noncancerous laryngeal lesions. Methods A total of 166 vocal cord lesions for which good images were obtained on NBI with magnifying GIE were evaluated with respect to the following 6 variables: macroscopic type, tumor location, color, white coat, keratinization, and abnormal microvessels. Results Multivariate analysis showed that white coat (odds ratio [OR], 2.95, P = 0.05), keratosis (OR, 3.14, P = 0.02) and abnormal microvessels (OR, 31.1, P < 0.0001) were significantly related to laryngeal cancer. In the diagnosis of laryngeal cancer, the sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of abnormal microvessels were 84.4%, 88.6%, 91%, 80.5%, and 86.1%, respectively. Conclusion The abnormal microvessels on NBI combined with magnifying GIE are useful for the differential diagnosis of laryngeal lesions.

Role of Narrow Band Imaging Technology in the Diagnosis and Follow up of Laryngeal Lesions: Assessment of Diagnostic Accuracy and Reliability in a Large Patient Cohort

“…The results obtained in group A are in accordance with those reported in literature with a similar cohort of patients [1,9,10]. In particular, Vilaseca et al [1] showed that accuracy improved from 74.1% with WLE to 88.9% with NBI and demonstrated additionally, a better PPV (NBI: 89% vs. WLE: 74%).…”

“…Furthermore, NBI is widely used for inflammatory pathologies of the head and neck in all age groups [7,8]. However, a precise diagnosis of mucosal lesions remains challenging and recent studies aimed at assessing its diagnostic accuracy in laryngeal lesions [9,10]. Considering the wide application of NBI in the head and neck area and the difficulties encountered by the physician with the number of different pathologies affecting these structures, the aim of our study was to assess the accuracy of NBI based on the differential diagnosis of laryngeal premalignant lesion, early cancers and tumor recurrences after radiotherapy in a large case series and single institution.…”

The value of narrowband imaging using the Ni classification in the diagnosis of laryngeal cancer

“…However, it is important to note that the sensitivities reported in this study were based on three expert assessments of still NBI and WLE images, not histopathological diagnosis. Recently, Hosono and colleagues 23 further reported a sensitivity of 84.4% using NBI even with high definition magnifying endoscopy. Although this is a higher sensitivity relative to Piazza et al 21 and Shoffel‐Havakuk et al, 22 it is much lower than the pooled sensitivity reported by Sun et al 18 …”

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

“…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.…”