Narrow-Band Imaging in Diagnosis of Endometrial Cancer and Hyperplasia: A New Option?

Surico, Daniela; Vigone, Alessandro; Bonvini, Daniele; Tinelli, Andrea; Leo, Livio; Surico, N

doi:10.1016/j.jmig.2009.10.014

Cited by 18 publications

(25 citation statements)

References 19 publications

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“…As a result, the diagnosis may be inaccurate, or a precancerous lesion or superficial endometrial cancer may be overlooked. 10,11 When combined with magnifying endoscopy, NBI could demarcate the margin between a nonneoplastic lesion and a cancerous lesion and can increase the contrast of the morphological changes of the mucosal surface and microvessels as already demonstrated for intestinal preneoplastic lesions. 12,13 To the best of our knowledge, this is the first multicenter study in literature aimed at evaluating the clinical usefulness of NBI hysteroscopy by comparing the findings using this new technique with those of conventional WL hysteroscopy and histology in the diagnosis of endometrial cancer and hyperplasia.…”

Section: Discussionmentioning

confidence: 91%

Accuracy and efficacy of narrow-band imaging versus white light hysteroscopy for the diagnosis of endometrial cancer and hyperplasia

Tinelli

Surico²,

Leo³

et al. 2011

Menopause

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NBI showed significantly higher values in sensitivity for the detection of low-risk and high-risk hyperplasia, and this could be useful for reducing the risk of missing severe pathologies at hysteroscopy, and improving the diagnosis of preneoplastic and neoplastic pathologies. NBI hysteroscopy showed a very high diagnostic accuracy for the exploration of the uterine cavity, reducing the number of biopsies performed in wrong areas, although multicenter randomized trials are required to establish the true value of this interesting technological advancement.

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Section: Discussionmentioning

confidence: 91%

Accuracy and efficacy of narrow-band imaging versus white light hysteroscopy for the diagnosis of endometrial cancer and hyperplasia

Tinelli

Surico²,

Leo³

et al. 2011

Menopause

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“…Since our hospital is a highly advanced medical facility, more patients with AEH or endometrial carcinoma were included in the patient population compared to general hospitals. About 2/3 of the patients had AEH or endometrial carcinoma, and this proportion is higher than those in the studies of NBI hysteroscopy by Cicinelli et al (19) and Surico et al (20). Moreover, the numbers of raters and patients were limited because video records were used, with which a large-scale study cannot be designed.…”

Section: Accuracy % (95% Ci) Weighted κ Coefficient (95% Ci) -------mentioning

confidence: 88%

“…Currently, the system is mainly used in digestive endoscopy for the pharynx, esophagus, stomach, and large intestine (12)(13)(14). Use of NBI in gynecology has been reported for laparoscopic identification of peritoneal endometriosis (15,16), evaluation of vascular density in endo- metriosis (17,18), and diagnosis of endometrial lesions (19)(20)(21).…”

Section: Discussionmentioning

confidence: 99%

“…The sensitivities for identification of AEH or endometrial carcinoma were 82.6% using white light and 97.2% using white light+NBI, suggesting the usufulness of NBI for diagnosis of endometrial lesions (11). Cicinelli et al also found that the sensitivity of diagnosis of low-and high-risk hyperplasia was significantly higher using NBI compared to white light (19), and Surico et al reported that the sensitivity for diagnosis of endometrial carcinoma and hyperplasia was significantly higher using NBI than white light (20). Hysteroscopic diagnosis of endometrial lesions is often made with reference to prior clinical information from findings in cytology or histological examination of endometrial tissue, imaging such as transvaginal ultrasonography and MRI, and tumor markers.…”

Section: Accuracy % (95% Ci) Weighted κ Coefficient (95% Ci) -------mentioning

confidence: 99%

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Narrow band imaging hysteroscopy: A comparative study using randomized video images

Kisu

Banno

Kobayashi³

et al. 2011

Int J Oncol

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Abstract. Narrow band imaging (NBI) has been used in the gastrointestinal endoscopy field as a novel endoscopic imaging technique and has contributed to improved qualitative diagnosis and detection of lesions. However, there are only a few studies of use of NBI in the gynecology field. We applied NBI in flexible hysteroscopy at our outpatient clinic and evaluated the utility of NBI hysteroscopy for diagnosis of malignant endometrial lesions by comparison of the sensitivity and specificity between white light alone and white light+NBI using hysteroscopic video images. The subjects were 65 patients with a suspected endometrial lesion in the uterine cavity. These patients underwent flexible hysteroscopy using NBI in addition to conventional white light. Video images from 65 patients were edited into two groups, white light alone (WL group) and white light+NBI (NBI group) (130 images in total). Computerized block randomization of the order was then performed. Four raters independently diagnosed the images without use of other clinical information. Using the pathological diagnosis as the gold standard, we evaluated the sensitivity and specificity of diagnosis of atypical endometrial hyperplasia (AEH) or endometrial carcinoma compared between the WL and NBI groups. The sensitivity of diagnosis of AEH or endometrial carcinoma was numerically higher in the NBI group for all raters, and the average sensitivity was significantly higher in the NBI group compared to the WL group (78.6% vs. 63.7%, P<0.001). The specificity for each rater and the average specificity were comparable between the two groups. Compared to white light hysteroscopy, NBI hysteroscopy had a higher sensitivity for diagnosis of AEH or endometrial carcinoma without loss of specificity. This suggests that NBI hysteroscopy may be more useful than white light hysteroscopy for endoscopic diagnosis of malignant endometrial lesions. IntroductionIn hysteroscopy, the uterine cavity is directly observed using an endoscope. This method is used as a gynecological examination of the uterine cavity in patients with suspected endometrial lesions. Hysteroscopy is indicated for abnormalities detected in transvaginal ultrasonography and endometrial cytohistology, and in cases with metrorrhagia, hypermenorrhea, prolongation of menstruation, and infertility. Hysteroscopy has been suggested to be a superior examination for investigation of the uterine cavity (1,2), and high diagnostic accuracies for abnormalities in the uterine cavity (3) and endometrial carcinoma have been achieved in studies comparing hysteroscopy and histology (4,5). In contrast, Lasmar et al found sensitivities for diagnoses of endometrial hyperplasia (EH) and carcinoma using white light hysteroscopy of 56.3 and 80.0%, respectively, and suggested that this relatively poor performance of hysteroscopy may be due to a lack of standard diagnostic criteria based on morphological changes of endometrial lesions (6). Pathological examination of a biopsy specimen is recommended for diagnosis of endometrial lesio...

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“…Un procesador de imagen crea una imagen compuesta en color en un monitor, por lo que los vasos capilares aparecen marrón-negro. 13,14 La histeroscopia-biopsia sigue siendo el estándar de oro para el diagnóstico y en algunos casos el tratamiento de la hemorragia uterina anormal. 15 Bozzini fue el primero en inventar ded.…”

Section: Introductionunclassified

Utilidad de la cromohisteroscopia en la evaluación del endometrio: Hospital de San José de Bogotá DC, Colombia. febrero - Octubre 2014

Niño¹,

Wandurraga²,

Rodríguez³

et al. 2015

Repert. Med. Cir.

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ResumenObjetivo: determinar el rendimiento operativo de la cromohisteroscopia (CHC) en la evaluación del endometrio en el Hospital de San José de Bogotá DC, Colombia, entre febrero y octubre 2014. Metodología: se incluyeron 97 mujeres adultas a quienes se aplicaron 5 cc de azul de metileno al 1% en la cavidad endometrial y por histeroscopia se determinó la presencia de manchas oscuras de donde se tomaron biopsias dirigidas (estándar de oro). Mediante una hoja excel y base de datos stata13® se calcularon las características operativas por medio de tablas de contingencia, se compararon la CHC y la histeroscopia convencional (HC) por medio de la prueba de McNemar y se evaluó la concordancia entre evaluadores y técnicas por medio del coeficiente kappa. Resultados: la principal indicación fue hemorragia uterina anormal (80,41%) realizada en premenopáusicas (78,35%) con edad alrededor de 45 años que presentaban sobrepeso. La microscopía detectó un caso de cáncer endometrial, uno de hiperplasia endometrial y cuatro de endometritis crónica. La sensibilidad y valor predictivo negativo de la CHC fue 100%, la especificidad 39,8% y el VPP 1,7% para cáncer e hiperplasia. Para endometritis la sensibilidad fue 50%, especificidad 38,9%, VPP 3,5% y VPN 94,6%. No hubo diferencias estadísticas entre CHC y la HC. El acuerdo entre evaluadores fue de 79,12% y entre técnicas de 54,64%. Conclusión: la CHC en hemorragia uterina anormal puede aportar un mayor rendimiento para el diagnóstico de patologías malignas y premalignas que la HC por el alto valor predictivo negativo encontrado. Palabras clave: cromohisteroscopia, histeroscopia, cáncer endometrial, hiperplasia endometrial, endometritis. Abreviaturas: CHC, cromohisteroscopia; HC, histeroscopia convencional; HUA, hemorragia uterina anormal.Abstract Objective: to assess the efficacy of chromohysteroscopy (CHC) for evaluation of endometrium at Hospital de San José de Bogotá DC, Colombia, between February and October 2014. Methodology: ninety-seven adult women were inclu-UTILIDAD DE LA CROMOHISTEROSCOPIA EN LA EVALUACIÓN DEL ENDOMETRIO

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Narrow-Band Imaging in Diagnosis of Endometrial Cancer and Hyperplasia: A New Option?

Cited by 18 publications

References 19 publications

Accuracy and efficacy of narrow-band imaging versus white light hysteroscopy for the diagnosis of endometrial cancer and hyperplasia

Accuracy and efficacy of narrow-band imaging versus white light hysteroscopy for the diagnosis of endometrial cancer and hyperplasia

Narrow band imaging hysteroscopy: A comparative study using randomized video images

Utilidad de la cromohisteroscopia en la evaluación del endometrio: Hospital de San José de Bogotá DC, Colombia. febrero - Octubre 2014

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