Role of narrow band imaging in the diagnosis of laryngeal lesions: Pilot study from India

INTRODUCTION: Narrow band imaging (NBI) is a new imaging technique developed to improve the diagnostic accuracy of head and neck cancers by depiction of tumor-specific neo-angiogenesis. The purpose of this study was to assess the value of NBI in the diagnosis of laryngeal lesions. AIM: To assess the...

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Bibliographic Details
Published in:Indian journal of cancer 2018-07, Vol.55 (3), p.242-247
Main Authors: Sakthivel, Pirabu, Sikka, Kapil, Thakar, Alok, Singh, Chirom, Sharma, Suresh, Rajeshwari, Madhu, Kakkar, Aanchal
Format: Article
Language:English
Subjects:
Cancer
Cancer research
Diagnosis
Endoscopy
Head & neck cancer
Health aspects
Laryngeal cancer
Laryngoscopy
Otolaryngology
Patients
Radiation therapy
Squamous cell carcinoma
Tumors
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Summary:INTRODUCTION: Narrow band imaging (NBI) is a new imaging technique developed to improve the diagnostic accuracy of head and neck cancers by depiction of tumor-specific neo-angiogenesis. The purpose of this study was to assess the value of NBI in the diagnosis of laryngeal lesions. AIM: To assess the sensitivity and specificity of combined white light endoscopy (WLE) and NBI compared with WLE alone in the diagnosis of laryngeal lesions. SETTINGS AND DESIGN: Prospective study. MATERIALS AND METHODS: Thirty consecutive patients with various laryngeal lesions scheduled for microlaryngoscopic evaluation underwent WLE followed by NBI. Endoscopic NBI findings were classified into five types (I-V) according to the intraepithelial papillary capillary loop features. Types I-IV are considered benign, whereas type V is considered malignant. The observations were compared with histopathology. STATISTICAL ANALYSIS: Sensitivity, specificity, and positive and negative predictive values for the diagnosis of malignancy (i.e., invasive carcinoma and carcinoma in situ) by means of NBI with WLE were calculated. RESULTS: The sensitivity of WLE combined with NBI (100%) was higher than WLE alone (82.6%) in detecting laryngeal cancers. NBI helped in identifying four malignant lesions missed by WLE alone. Two children with respiratory papillomatosis also demonstrated type V pattern, a potential pitfall, leading to an overall positive predictive value of 92% and a negative predictive value of 100%. CONCLUSION: Combining NBI with WLE increases the sensitivity of detection of laryngeal cancer and its precursor lesions. NBI is also useful in some benign lesions as well as in post-radiotherapy patients.
ISSN:0019-509X
1998-4774
DOI:10.4103/ijc.IJC_590_17