PURPOSE: Narrow band imaging (NBI) is a new endoscopic imaging modality, which improves visualization of subepithelial vascular patterns of the bronchial mucosa. A trial was undertaken to investigate the value of NBI in the detection of meta-,dysplastic or cancerous lesions in comparison to conventional whitelight (WL) and autofluorescence bronchoscopy (AFB).
METHODS: Sixty-two patients (28 female, mean age 52,3 y.) with positive sputum cytology specimens or radiological suspicion for malignancy were included .Conventional white light examination was first performed and then AF was carried out .NBI through a dedicated endoscope was then used to examine the microvascular network in the bronchial mucosa, using the Shibuya descriptors. All suspicious lesions were biopsied and compared with pathological diagnoses.
RESULTS: WLB, AF and NBI detected 103 lesions, including invasive lung cancer (n= 5), carcinoma in situ (CIS)(n=1), severe squamous dysplasia (n = 5), moderate squamous dysplasia (n = 12), mild squamous dysplasias (n =23) and metaplasia (n = 57). By utilizing AF all cancer and all severe dysplasias, 9 moderate, 17 mild dyplasias and 23 metaplasias were detected as abnormal lesions. With the NBI all cancer and precancer lesions were detected as having an irregular microvascular network. 21 of the metaplasias showed a normal microvascular network using NBI. The sensitivities of differing between CIS/severe dysplasia and mild or moderate dysplasia or metaplasias by AF were 83% and 52 % and by NBI 100 % and 90%, respectively. The speciIcity of NBI (90 %) was signiIcantly higher than that of AF (52%) (p = 0.0005).
CONCLUSION: Areas of increased vessel growth and complex networks of tortuous vessels in the bronchial mucosa detected using the new NBIscope allowed better discrimination between metaplasia and dysplasia than the use of AF and WL alone.
CLINICAL IMPLICATIONS: NBI can increase the specifity of an AF bronchoscopy.
DISCLOSURE: Felix Herth, None.