Poster Presentations: Wednesday, October 26, 2011 |

The Benefits of Narrow Band Imaging Bronchoscopy for the Diagnostics of Lung Tumors - An Analysis of Accuracy in Comparison With White Light Bronchoscopy FREE TO VIEW

Gustav Ondrejka, MD; Ondrej Majek, MD; Jana Skrickova, MD; Richard Tyl, MD
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Hospital Novy Jicin, Novy Jicin, Czech Republic

Chest. 2011;140(4_MeetingAbstracts):462A. doi:10.1378/chest.1112676
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PURPOSE: NBI (Narrow Band Imaging) is a new technology that enhances the visibility of vessels of the mucosa and differentiation between inflammation and pathological vascularization of tumor. On the basis of morphology and frequency of vascular structures it is possible to view the difference in the changes during malignity and inflammation. Moreover, the method is used for the determination of extension of the tumor. It is possible to detect recurrence of tumor after resection and chemotherapy. The aim of our study is to analyze relative sensitivity (the probability of positive results in subjects suffering from the disease) and the rate of false positive results (the probability of positive results in healthy subjects) during examinations in NBI mode as compared to examinations in WL (white light) mode for the diagnoses of malign tumor and severe dysplasia.

METHODS: We have analyzed a group of 500 patients examined because of hemoptysis, CT or X-ray findings. The patients were examined by white light bronchoscopy, then by NBI bronchoscopy. We used Olympus Evis Lucera system. The areas with pathological changes were targeted for biopsy. The results of histological and cytological examinations were rated with respect to relative sensitivity and relative rate of false positive results as compared with WL. Statistical significance was determined by McNemara's test.

RESULTS: The statistical evaluation has focused on the results of biopsies performed in NBI and in WL modes. We have analyzed relative sensitivity and the rate of false positive results in NBI as compared to WL in relation to histological and cytological results of malign tumor and severe dysplasia. Relative sensitivity of NBI as compared to WL is 1.06 (p=0.004). The relative rate of false positive results of NBI as compared to WL is 0.91 (p=0.012).

CONCLUSIONS: The performed statistical evaluations show a statistically significant increase in examination accuracy as compared to WL.

CLINICAL IMPLICATIONS: Better visualization of vessel anomalies in bronchial mucosa can improve the possibility of malignant lesions and severe dysplasia detection. The described bronchoscopical system enables to biopsy during examination in NBI mode. This enables to target the biopsy to the area of vascular changes and to improve the fruitfulness of biopsy. Good differentiation between necrosis and a viable tissue improves the accuracy of biopsy and enables to refrain from targeting a place not suitable for biopsy.

DISCLOSURE: The following authors have nothing to disclose: Gustav Ondrejka, Ondrej Majek, Jana Skrickova, Richard Tyl

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