Abstract
Introduction Narrow-band imaging is an endoscopic diagnostic tool that, focusing on superficial
vascular changes, is useful to detect suspicious laryngeal lesions, enabling their
complete excision with safe and tailored resection margins.
Objectives To analyze the applications and benefits of narrow-band imaging in detecting premalignant
and malignant laryngeal lesions through a comparison with white-light endoscopy.
Data Synthesis A literature search was performed in the PubMed, Scopus and Web of Science databases
using strict keywords. Then, two authors independently analyzed the articles, read
the titles and abstracts, and read completely only the relevant studies according
to certain eligibility criteria. In total, 14 articles have been included in the present
review; the sensitivity, specificity, positive and negative predictive values, and
accuracy of pre- and/or intraoperative narrow-band imaging were analyzed. The analysis
showed that narrow-band imaging is better than white-light endoscopy in terms of sensitivity,
specificity, positive and negative predictive values, and accuracy regarding the ability
to identify cancer and/or precancerous laryngeal lesions. Moreover, the intraoperative
performance of narrow-band imaging resulted more effective than the in-office performance.
Conclusion Narrow-band imaging is an effective diagnostic tool to detect premalignant and malignant
laryngeal lesions and to define proper resection margins. Moreover, narrow-band imaging
is useful in cases of leukoplakia that may cover a possible malignant lesion and that
cannot be easily assessed with white-light endoscopy. Finally, a shared, simple and
practical classification of laryngeal lesions, such as that of the European Laryngological
Society, is required to identify a shared lesion management strategy.
Key Points
-
Narrow-band imaging is useful in detecting suspicious laryngeal lesions and proper
resection margins showing intraepithelial papillary capillary loops (IPCLs) that are
considered a main cancer feature.
-
Narrow-band imaging is used both pre- and intraoperatively, but it provides more precise
information if used during surgery.
-
Compared with white-light endoscopy, narrow-band imaging enables a better assessment
of the lesions covered by a thick white plaque (such as in cases of leukoplakia)
-
The classification of the European Laryngological Society is the simplest and the
most practical for the identification of various laryngeal lesions compared with other
classifications.
Keywords
narrow-band imaging - early diagnosis - larynx cancer
