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

Jacopo Galli, Stefano Settimi, Dario Antonio Mele, Antonio Salvati, Enrico Schiavi, Claudio Parrilla, Gaetano Paludetti

Research output: Contribution to journalArticlepeer-review

Abstract

Background: The aim of this study was to assess diagnostic accuracy and reliability of narrow band imaging (NBI) in the differential diagnosis of laryngeal premalignant lesion, early cancers and recurrences. Material and methods: We enrolled 231 patients who underwent endoscopic examination with white light endoscopy (WLE) + NBI and divided them into two groups, group A, without previous radiochemotherapy and group B, with previous radiochemotherapy. When indicated, we performed surgical biopsies to evaluate sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), accuracy and likelihood of endoscopic examination comparing WLE alone and WLE + NBI. Results: A positive NBI lesion, compared with a negative NBI lesion, had a 29.68 (group A) and 13.96 (group B) times higher probability to be histologically positive (i.e., confirmed) compared with WLE alone improving the diagnostic accuracy. In group A, the NBI mode showed excellent sensitivity (95.0%), which was higher than WLE 2 mode (77.5%). However, the greatest differences were recorded regarding specificity (96.8% vs. 40.6%). In group B, both NBI alone and WLE + NBI mode showed a 94.1% specificity compared with WLE alone, which had a maximum specificity of 85.3%. The mode comparison between NBI and WLE in both groups showed a statistically significant difference, with p-values <0.0001. Conclusions: NBI represents a reliable technology in challenging situations, especially in the context of post-radiotherapy or post-surgical mucosal changes showing a high NPV. NBI could reduce the number of unnecessary biopsies related to increased microvascular anomaly revelation, which could help to identify early-stage lesions suitable for minimally invasive surgery and, consequently, decrease hospital admissions.

Original languageEnglish
Article number1224
Pages (from-to)1-10
Number of pages10
JournalJournal of Clinical Medicine
Volume10
Issue number6
DOIs
Publication statusPublished - Mar 2 2021

Keywords

  • Head and neck cancer
  • Larynx
  • Narrow band imaging

ASJC Scopus subject areas

  • Medicine(all)

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