Narrow-band imaging bronchoscopy in the detection of premalignant airway lesions: a meta-analysis of diagnostic test accuracy

Abstract

Our findings indicate that in the evaluation of premalignant airway lesions, narrow-band imaging has a higher sensitivity, specificity and diagnostic odds ratios compared with autofluorescence imaging bronchoscopy. However, combining autofluorescence imaging bronchoscopy and narrow-band imaging does not significantly improve test performance characteristics.

White light, autofluorescence and narrow-band imaging bronchoscopy for diagnosing airway pre-cancerous and early cancer lesions: a systematic review and meta-analysis

“…Findings of interest were that, based on the original pathological criteria from hyperplasia to INV, both over 80% sensitivity and specificity were indicated in NBI bronchoscopy in single-arm synthesis, as well as the significantly superior DOR and AUC of NBI were shown when compared with those of WLB (in direct comparison). This outcome could be a result of both the color change and characteristics of submucosa vessels seen with the use of NBI; such characteristics could help practitioners effectively recognize and distinguish malignant lesions from benign lesions (5,9).…”

“…Though the superior diagnostic performance of AFB, AFB combined with WLB (AFB + WLB) and NBI (versus WLB) has been investigated for lung cancer in several comparison meta-analyses (6)(7)(8)(9), all these available bronchoscopic techniques have not been overviewed for precancerous and cancer lesions [including high-grade lesions from moderate dysplasia (MOD) to INV] by singlearm synthesis in one article yet.…”

The role of bronchoscopy in the diagnosis of early lung cancer: a review

“…NBI is an image-enhanced endoscopy technology, able to enhance visualization of endobronchial microvasculature architecture when the tissue is irradiated by the two narrow wavebands of light: blue narrow band (390-445 nm), absorbed by surface mucosal layer capillaries and green narrow band (530-550 nm), absorbed by the hemoglobin in the deeper submucosal thick blood vessels (22). On the basis of these properties and the vascular network of the bronchial wall, NBI allows the differentiation of ASD, CIS, micro-invasive tumour and invasive SqCC ("Shibuya's descriptors") (23) and facilitates discrimination between adenocarcinoma (dotted blood vessels) and squamous histology (tortuous blood vessels and abrupt-ending vessel pattern) (24), exploiting the so-called angiogenic switch that occurs during tumorigenesis (25) (Figure 2).…”

New technologies in diagnostic bronchoscopy – an age of meta-analyses

“…Moreover, the authors stated one very important fact: NBI can differentiate between necrotic avascular region and viable tumor tissue, a fact crucially important in era of increased demand for tumor tissue necessary for extensive molecular testing due to targeted therapy initiation. The latest meta-analysis of NBI [10] showed pooled sensitivity of 80% and pooled specificity of 84%. When combined, NBI and AFB demonstrated pooled sensitivity of 86% and pooled specificity of 75%.…”