The narrow-band imaging examination method in otorhinolaryngology

Abstract

Early diagnostics could improve the prognosis of patients with squamous-cell carcinomas of the head and neck. Narrow-Band Imaging (NBI) is the latest examination method in the group of biologic endoscopies. NBI improves the distinction between malignant and benign mucosal lesions. Early suspect oncologic lesions that may otherwise be missed by normal white light illumination can also be diagnosed. The biggest benefit of NBI technology is achieved by using it together with a HDTV camera that enables better contrast and higher resolution. NBI is based on better imaging of superficial mucosal vasculature. The biologic potential of mucosal lesions could be predicted from vascular changes. The colour of normal mucosa under NBI is blue and green and the vessels show no pathological features. Well-demarcated brownish areas and scattered thick dark spots and abnormal winding and branching out of vessels on the mucosa are all oncologically suspicious features. Authors report the experience from literature on the use of NBI to identify carcinomas of the oral cavity, epipharynx, oropharynx, hypopharynx and larynx and evaluation of unknown primaries. In addition, the literature reports the benefit of NBI in identifying early stage carcinomas in previously irradiated patients. Persistence and recurrence of carcinoma and the development of new primary tumour could easily be missed by using only standard white-light illumination. The method proved to be highly sensitive and specific for predicting malignant changes in the above-mentioned circumstances. Authors report their own experience with NBI technology as well. For further improvement of the method, new technologic development is expected to enable the connection of NBI and HDTV with flexible endoscopes.