Does use of narrow band imaging (NBI) influence observer agreement while making diagnostic decisions using rigid endoscopy of the upper aerodigestive tract?
Bottom Line
The addition of NBI to conventional white light imaging (WLI) improves inter- and intraobserver agreement for diagnosing (pre)malignant lesions in the larynx, hypopharynx, and oropharynx and therefore improves the reliability of endoscopic examinations.
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October 2016
Examples of different Ni classification types applied in studied group of patients. Type I: thin, interconnected vessels. Type II: enlarged vessel diameter. Type III: vascular patterns obscured by white mist. Type IV: small regularly distributed dots. Type Va: solid or hollow thick brown spots with various shapes. Type Vb: destroyed loop, its remnants are visible as line-like shapes. Type Vc: combination of type Va and Vb, irregular distribution.
Background: NBI is a relatively new endoscopic technique for detecting (pre)malignant lesions in the head and neck area, and is based on the principle that the wavelength of light influences the penetration depth in tissues: The larger the wavelength, the deeper the penetration. Currently, Ni’s intraepithelial papillary capillary loop (also called intrapapillary capillary loop) classification is most frequently used to classify mucosal laryngeal lesions. NBI increases the contrast between a lesion and healthy epithelium, and seems to be a promising technique for differentiation between benign and (pre)malignant lesions.
Study design: Retrospective study.