Narrow band imaging and high definition television in the assessment of laryngeal cancer: a prospective study on 279 patients

Narrow band imaging (NBI) is an optical technique in which a filtered light reveals superficial carcinomas in view of their neoangiogenic pattern. The accuracy of NBI is implemented by combining it with a high definition television (HDTV) camera. The aim of this study was to prospectively evaluate the diagnostic gain of NBI and HDTV in the assessment of laryngeal squamous cell carcinoma (LSCC). Between April 2007 and December 2008, we analyzed by NBI with or without HDTV 279 patients divided in two groups: Group A included 96 patients affected by LSCC and Group B included 183 subjects under follow-up after treatment for the same disease. Overall, 50 of 279 patients (18%) showed “suspicious” NBI findings histologically confirmed as neoplastic. The sensitivity, specificity, accuracy, positive and negative predictive rates of flexible NBI, HDTV with white light, and HDTV with NBI in both groups confirmed the value of these two technologies. In the pre- and intraoperative settings, NBI with or without HDTV provided better definition of tumor staging and surgical margins. NBI has also a role in the postoperative setting, due to its ability in early detection of persistences, recurrences, and metachronous tumors.

[1]  M. Muto,et al.  Prospective study of early detection of pharyngeal superficial carcinoma with the narrowband imaging laryngoscope , 2009, Head & neck.

[2]  Thomas Dreyer,et al.  Compact Endoscopy of the Larynx , 2003, The Annals of otology, rhinology, and laryngology.

[3]  S. Shapshay,et al.  Analysis of Recurrences in 322 TIS, T1, or T2 Glottic Carcinomas Treated by Carbon Dioxide Laser , 2004, The Annals of otology, rhinology, and laryngology.

[4]  S. Nonaka,et al.  Endoscopic diagnosis of pharyngeal carcinoma by NBI , 2008, Endoscopy.

[5]  Paul Fockens,et al.  Endoscopic video-autofluorescence imaging followed by narrow band imaging for detecting early neoplasia in Barrett's esophagus. , 2006, Gastrointestinal endoscopy.

[6]  H. Herr,et al.  A comparison of white‐light cystoscopy and narrow‐band imaging cystoscopy to detect bladder tumour recurrences , 2008, BJU international.

[7]  M. Gapany Impact of Re-resection for Inadequate Margins on the Prognosis of Upper Aerodigestive Tract Cancer Treated by Laser Microsurgery , 2008 .

[8]  K. Hiroshima,et al.  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 , 2003, Thorax.

[9]  Y. Sano,et al.  ENDOSCOPIC DIAGNOSIS OF INTRAEPITHELIAL SQUAMOUS NEOPLASIA IN HEAD AND NECK AND ESOPHAGEAL MUCOSAL SITES , 2006 .

[10]  F. Barrueto,et al.  The use of narrowband imaging for identification of endometriosis. , 2008, Journal of minimally invasive gynecology.

[11]  Akihito Watanabe,et al.  The value of narrow band imaging endoscope for early head and neck cancers , 2008, Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery.

[12]  C. Arens,et al.  Endoscopic high-frequency ultrasound of the larynx , 1999, European Archives of Oto-Rhino-Laryngology.

[13]  Yasushi Sano,et al.  Squamous cell carcinoma in situ at oropharyngeal and hypopharyngeal mucosal sites , 2004, Cancer.

[14]  Y. Sano,et al.  Narrow band imaging with magnifying colonoscopy as diagnostic tool for predicting histology of early colorectal neoplasia , 2008, Alimentary pharmacology & therapeutics.

[15]  Shoichi Saito,et al.  New approach to diagnosing ampullary tumors by magnifying endoscopy combined with a narrow-band imaging system , 2006, Journal of Gastroenterology.

[16]  P. Nicolai,et al.  Narrow-band imaging: a new tool for evaluation of head and neck squamous cell carcinomas. Review of the literature. , 2008, Acta otorhinolaryngologica Italica : organo ufficiale della Societa italiana di otorinolaringologia e chirurgia cervico-facciale.

[17]  P. Nicolai,et al.  Pre- and intraoperative assessment of mid-cord erythroleukoplakias: a prospective study on 52 patients , 2003, European Archives of Oto-Rhino-Laryngology.

[18]  A. Bansal,et al.  The utility of a novel narrow band imaging endoscopy system in patients with Barrett's esophagus. , 2005, Gastrointestinal endoscopy.

[19]  N. Uedo,et al.  A new method of diagnosing gastric intestinal metaplasia: narrow-band imaging with magnifying endoscopy , 2006, Endoscopy.