Elsevier

Journal of Thoracic Oncology

Volume 4, Issue 9, September 2009, Pages 1060-1065
Journal of Thoracic Oncology

Original Article
Narrow-Band Imaging Bronchoscopy Increases the Specificity of Bronchoscopic Early Lung Cancer Detection

https://doi.org/10.1097/JTO.0b013e3181b24100Get rights and content
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Background

Detection of nonsmall cell lung cancer at the intraepithelial stage is believed to improve cure rates. New bronchoscopic technologies, including white light videobronchoscopy (WLB), autofluorescence imaging (AFI), and narrow band imaging (NBI), are aiming to diagnose airway neoplasia at a preinvasive stage.

Objectives

To evaluate the diagnostic yields of NBI individually and in combination with WLB and AFI.

Methods

A 10-month review of patients who were referred for airway screening or surveillance. Patients were randomized as to the order of AFI and NBI examinations. The airway mucosa was graded endoscopically as “normal,” “abnormal,” “suspicious,” or “tumor.” All areas that were not normal were biopsied. Biopsies with a histologic grading of moderate to severe dysplasia or carcinoma in situ were considered positive for intraepithelial neoplasia.

Results

Sixty-two patients with a mean age of 56.2 ± 9.8 years were studied. Five patients had invasive cancers and were excluded from the analysis. The remaining 57 cases had a 30% prevalence of intraepithelial neoplasia. The sensitivity of WLB was 0.18 and the specificity was 0.88. The relative sensitivities (compared with WLB) of AFI and NBI were 3.7 (p = 0.005) and 3.0 (p = 0.03), respectively. The relative specificities of AFI and NBI were 0.5 (p < 0.001) and 1.0 (p = 0.72), respectively. Combining AFI and NBI did not increase diagnostic yield significantly. The sequence of performing AFI and NBI did not impact findings.

Conclusions

NBI is an alternative to AFI in the detection of early lung cancers because it has a comparatively higher specificity without significantly compromising the sensitivity.

Keywords

Narrow band imaging
Autofluorescence imaging
White light bronchoscopy
Early lung cancer

Cited by (0)

The authors declare no conflicts of interest.